Hip Pain: Causes and When to See a Hip Specialist
A guide to the most common causes of hip pain, organized by where it hurts, from Frisco sports medicine and hip surgeon Dr. Andrew Dold, MD.
Hip pain is one of the most common reasons people see an orthopedic surgeon. Where you feel the pain is one of the best clues to its cause. Use this guide to understand the most likely possibilities. Dr. Dold can then confirm the diagnosis with an exam and imaging.
- Fell and cannot put weight on the leg (go to the emergency room, especially if you’re older)
- Have hip pain with fever, redness or feeling unwell
- Have pain that wakes you at night or keeps getting worse
- Feel the hip lock, catch or give way
- Still have pain after 2 to 3 weeks of rest and simple care
Pain in the front of the hip or groin
Pain deep in the groin or the front of the hip usually comes from the hip joint itself. Many patients cup their hand around the side of the hip in a “C” shape when describing it.
- Hip arthritis: groin pain and stiffness, trouble putting on socks or shoes, most common after age 50
- Hip impingement (FAI): pinching pain with deep bending, sitting or pivoting, often in active teens and adults
- Labral tear: sharp groin pain with clicking, catching or locking
- Hip flexor strain: pain after a sprint or kick, usually improving over weeks
- Athletic pubalgia (sports hernia): lower abdominal and groin pain in athletes, worse with cutting and sit-ups
- Stress fracture of the femoral neck: groin pain that builds with running. This needs prompt evaluation.
- Avascular necrosis: deep groin pain from loss of blood supply to the ball of the hip
Pain on the outside of the hip
Pain on the outer hip, especially when lying on that side, usually comes from the tendons and soft tissues over the bony point of the hip (the greater trochanter), not the joint itself.
- Gluteus medius tear or tendinopathy: aching on the side of the hip, a limp, pain climbing stairs
- Hip bursitis (greater trochanteric pain syndrome): tenderness over the outer hip, pain lying on the side
- IT band syndrome and snapping hip: snapping or tightness along the outer thigh
Pain in the back of the hip or buttock
- Proximal hamstring tear: sudden pain at the “sit bone,” often with bruising, after a slip or sprint
- Deep gluteal (piriformis) syndrome: buttock pain, sometimes with sciatic-type symptoms down the leg
- Low back and sacroiliac joint problems: buttock pain is often referred from the spine, which Dr. Dold will check for
Hip pain at night or when lying on your side
Pain lying on the side most often points to the outer-hip tendons (gluteal tendinopathy or tears, or bursitis). Deep groin pain that wakes you can be a sign of more advanced arthritis. Try a pillow between the knees, and avoid lying directly on the sore side. See a specialist if the pain regularly disturbs your sleep.
Hip pain when walking
Groin pain and stiffness when walking suggest arthritis or impingement. A limp with outer-hip pain suggests a gluteus medius problem. Pain that starts after a certain distance and eases with rest can also come from the spine or circulation, so a full evaluation matters.
How Dr. Dold diagnoses hip pain
- A detailed history and hands-on exam of the hip, spine and gait
- X-rays, usually taken at your first visit in our Frisco office
- An MRI or MR arthrogram when a labral tear, tendon tear or early bone problem is suspected
- Sometimes a diagnostic injection to confirm the pain is coming from the joint
Treatment options
Most hip pain improves without surgery, through activity changes, physical therapy, anti-inflammatory medicine and targeted injections. When surgery is needed, Dr. Dold offers both hip preservation (hip arthroscopy) and anterior hip replacement, so your options are weighed together.
Already been told you need hip surgery? Learn about getting a second opinion.
Why see Dr. Dold
- Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
- Fellow of the American Orthopaedic Association (FAOA), the American Academy of Orthopaedic Surgeons (FAAOS), the American College of Surgeons (FACS) and the Royal College of Surgeons of Canada (FRCSC)
- Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
- Member of the International Society for Hip Arthroscopy (ISHA)
- D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google
Frequently asked questions
Why does my hip hurt when I lie on my side?
Pain lying on the side most often comes from the tendons on the outside of the hip (gluteal tendinopathy or a gluteus medius tear) or from hip bursitis. A pillow between the knees can help. If it keeps disturbing your sleep, see a specialist.
Is hip pain in the groin a sign of arthritis?
Groin pain is the classic location for pain from the hip joint itself, including arthritis, impingement and labral tears. X-rays and an exam can tell these apart.
When should I see a doctor for hip pain?
See a doctor right away if you can’t bear weight after a fall, or have fever or redness. Book a visit if the pain lasts more than 2 to 3 weeks, wakes you at night, or comes with locking or giving way.
Can hip pain come from my back?
Yes. Problems in the lower spine or sacroiliac joint often cause buttock and outer-hip pain. Dr. Dold examines the spine as part of every hip evaluation.
Do I need an MRI for hip pain?
Not always. X-rays are usually the first step. An MRI is helpful when a labral tear, tendon tear, stress fracture or avascular necrosis is suspected.
Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed September 30, 2026. This page is general information, not medical advice.
