Hip Pain When Walking: Common Causes and
When to See a Physical Therapist

This article is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Hip pain when walking has several common causes, including joint wear (osteoarthritis), irritated tendons or bursae, muscle strain, and pain referred from the lower back. Walking loads the hip with every step, so these problems often show up then. A physical therapist can evaluate your movement and help work out which one applies.

Why Does My Hip Hurt When I Walk?

The hip is a ball-and-socket joint cushioned by cartilage and surrounded by tendons, muscles, and fluid-filled sacs called bursae. Every step sends force through all of it, so walking is often when a worn, irritated, or strained part shows itself.

MedlinePlus, from the National Library of Medicine at the National Institutes of Health (NIH), notes that hip pain is not always felt over the hip. It can appear in the groin, thigh, or knee.

Where You Feel It Tells You Something

Where the pain sits offers clues, not a diagnosis. Front-of-hip or groin pain more often points to the joint itself, while outer-hip pain more often involves tendons or bursae. Buttock pain, or pain that travels toward the knee, can come from the hip or the back.

Sources: the American Academy of Orthopaedic Surgeons (AAOS), Hospital for Special Surgery (HSS), and MedlinePlus.

Common Causes of Hip Pain When Walking

Several conditions can cause hip pain when walking, and more than one may be involved. The most common are osteoarthritis, hip bursitis, tendon irritation, muscle strain, labral problems, and pain referred from the back. Only an exam can tell them apart.

• Osteoarthritis. This wear-and-tear arthritis most often causes groin pain and stiffness, which AAOS says can be worse in the morning or after resting.
• Hip bursitis. Inflammation of the bursa at the point of the hip causes outer-hip pain, which AAOS says often worsens with prolonged walking.
• Tendon irritation. Irritated tendons can cause burning pain at the side of the hip or near the groin, according to HSS.
• Muscle strain. Repetitive motion can strain hip muscles such as the hip flexors, hamstrings, and groin, as MedlinePlus notes.
• Labral tear or irritation. The labrum is a ring of cartilage lining the hip socket, and repetitive motion or a fall can damage it.
• Referred back pain. Problems in the lower back can be felt in the hip.

For a broader overview, read our earlier guide, Hip Pain: Causes, Diagnosis, and Treatment.

Hip Pain at Night and When Sleeping on Your Side

Hip pain at night often shares causes with hip pain when walking. AAOS says hip bursitis pain is often worse at night and when lying on the affected hip, and hip arthritis can hurt at rest or at night over time.

On your side, MedlinePlus suggests lying on the pain-free side with a pillow between your legs.

When the Problem Is Really in the Lower Back

Sometimes the hip is not the source. MedlinePlus notes that hip pain can reflect a back problem, and AAOS describes sciatica as pain in the lower back or hip that spreads down the back of the thigh and into the leg. Leg tingling, numbness, or weakness can be a clue.

A physical therapist can look at your back and hip together. See our guide to the top causes of lower back pain and our physical therapy for back pain page.

Warning Signs That Need Prompt Medical Attention

Most hip pain is not an emergency, but some signs need care right away. Severe pain after a fall, being unable to put weight on your leg, or a deformed leg calls for emergency help. Other signs, such as fever or a red, swollen joint, call for prompt medical care.

Get emergency help if:

• Severe hip pain follows a serious fall or injury
• Your leg is deformed, badly bruised, or bleeding
• You cannot move your hip or bear weight
• Pain worsens and you have trouble urinating or having a bowel movement

Contact a healthcare provider promptly if:

• You have a fever or rash with your hip pain
• The joint is red and swollen with fever and severe pain, which can signal infection
• Sudden hip pain comes with sickle cell anemia or long-term steroid use
• Both hips and other joints hurt
• Pain lasts beyond about a week of home care
• You start limping or have trouble with stairs

Sources: MedlinePlus pages on hip pain and septic arthritis. If unsure, call 911 or go to the nearest emergency room.

How Physical Therapy Helps Hip Pain

Physical therapy is a nonsurgical option for many causes of hip pain. A physical therapist evaluates how you move, builds a plan around what they find, and teaches exercises to continue at home. For mild to moderate hip osteoarthritis, AAOS recommends physical therapy based on high-quality evidence.

At Physical Therapy of SA, care for hip pain can include:

• Evaluation. We review your history and goals and look for the root cause.
• Manual therapy. Hands-on techniques for stiff joints and tight muscles.
• Strengthening and flexibility exercises. Targeted work for the muscles around your hip.
• Movement and body-mechanics education. Guidance on posture and everyday movement.
• A home exercise program. Exercises matched to your in-clinic care.

Progress varies from person to person, and your therapist adjusts your plan as you go.

What to Expect at Your First Visit at Physical Therapy of SA in Live Oak

Do I need a referral? Under Texas law (House Bill 4099 and state board rules), a qualified physical therapist may treat you for up to 30 consecutive calendar days without a physician referral. A referral is needed to continue after that. Your health plan may have its own rules, so call us to confirm.

Your therapist reviews your history and goals, asks where the pain is, when it started, and what makes it worse, then examines how your hip, back, and legs move. Share any past injuries or surgeries.

Dr. Douglas Glosup, PT, DPT, sees patients at our Live Oak office. He holds Dry Needling and Graston certifications. We are at 12881 I35, Live Oak, TX 78233, open Monday through Friday, 8 AM to 5 PM.

Simple Ways to Ease Hip Pain While You Wait for an Appointment

While you wait for an appointment, a few steps can help ease hip pain. Cut back on what aggravates it, choose gentler movement, and support your hip when you sleep. These steps are not a treatment plan and do not replace an evaluation.

• Pace your activity. Cut back on movements that hurt, such as stair climbing.
• Choose gentler movement. AAOS notes swimming or cycling can be easier on the hips than running or tennis.
• Sleep on your pain-free side. Place a pillow between your legs.
• Ask about pain relievers. Over-the-counter options are not safe for everyone, so check with a provider or pharmacist.