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Hip Pain & Problems

Most hip pain comes from wear-and-tear arthritis, irritated tissues on the outside of the hip, or problems in the lower back, and much of it eases with exercise, weight and activity changes. A fall followed by not being able to stand, a child who limps or won’t bear weight, or a hot, swollen hip with fever needs care right away.

Call 911 or get emergency care right away if:

  • After a fall, someone can’t stand up or put weight on the leg, or the leg looks shorter or turned outward. These are signs of a broken hip: with most hip fractures you can’t stand, bear weight or move the upper leg, and the injured leg often looks shorter and twisted or rotated (AAOS OrthoInfo). The NHS says to get emergency help for severe hip pain after a fall, for not being able to walk or put weight on the leg, or for tingling or loss of feeling in the hip or leg after an injury — and not to drive yourself; call for an ambulance (NHS). In the U.S., that means calling 911.
  • A child is limping with a fever, or refuses or can’t put weight on a leg. Get medical care the same day. A fever raises concern that a limp is caused by a bone or joint infection (AAOS OrthoInfo), and the NHS advises an urgent appointment if a child has sudden pain in the hip, thigh or knee, is limping, or can’t put weight on one leg (NHS). A teenager who suddenly can’t bear weight on one leg may have an unstable slipped hip (SCFE), which needs urgent treatment (AAOS OrthoInfo).
  • The hip is hot and swollen, the skin has changed color, or you have hip pain with a fever or feel hot, cold or shivery (NHS). This can be septic arthritis, a serious joint infection that needs checking straight away and is usually treated in hospital (NHS).
  • After a hip replacement: pain and swelling in the hip or leg with chest pain or trouble breathing could be a blood clot in the lungs — call 911. Throbbing or cramping pain in the leg, a fever, pus or oozing from the wound, or redness and swelling that is getting worse can mean infection or a blood clot and need urgent care (NHS, AAOS OrthoInfo). Sudden severe pain, or new clicking or popping, can mean the new hip has dislocated (NHS) — call your surgeon straight away.

Don’t wait for a chiropractic, acupuncture or massage appointment for any of these.

What causes hip pain?

The hip is a ball-and-socket joint: the top of the thighbone fits into a socket in the pelvis (AAOS OrthoInfo). Sports, overuse or falls can cause strains, bursitis, dislocations and fractures, and osteoarthritis and osteoporosis are common in older people (MedlinePlus). The NHS links common patterns to likely causes (NHS):

  • Severe pain and unable to walk after a fall: possible fracture (see Hip fractures).
  • Over 45, pain worse when walking, stiff after moving: osteoarthritis.
  • Pain and stiffness after rest, such as on waking: rheumatoid arthritis (see our arthritis guide).
  • Pain spreading to the outer thigh, worse lying on that side: bursitis (see Pain on the outside of the hip).

Labral tears, children’s hip conditions, back problems and avascular necrosis have their own sections below. Don’t try to diagnose the cause yourself (NHS).

Hip osteoarthritis

Osteoarthritis, sometimes called “wear-and-tear” arthritis, most often develops in weight-bearing joints like the hip, usually in people 50 and older. The cartilage gradually wears away and becomes frayed and rough, the space between the bones narrows, and bone spurs may form (AAOS OrthoInfo). About 7 in 100 people worldwide have it, more women than men (AAOS guideline summary). Risk factors include age, family history, an earlier hip injury, obesity and a hip that formed abnormally at birth (AAOS OrthoInfo).

Symptoms: pain that develops slowly and worsens over time, most often in the groin or thigh and sometimes spreading to the buttock or knee; stiffness that is worse in the morning or after sitting; pain that flares with vigorous activity; locking, sticking or grinding; and less movement in the hip, which can cause a limp (AAOS OrthoInfo). There is no cure, but many treatments ease pain and keep people active, and the sooner you start, the more likely you are to lessen its impact (AAOS OrthoInfo). A fuller MBHA guide to osteoarthritis is on the way.

How is hip pain diagnosed?

A doctor asks about your symptoms, examines the hip’s movement and your walk, and usually orders X-rays, which can show arthritis; MRI or CT is occasionally needed (AAOS OrthoInfo). Most hip fractures show on an X-ray (AAOS OrthoInfo). Because pain from the lower back and from the hip joint can overlap, doctors may need to examine both and sometimes use a numbing injection to find the true source (Le et al., 2026).

When to see a provider (not an emergency): the NHS suggests seeing a doctor if hip pain is stopping you doing normal activities or affecting sleep, is getting worse or keeps coming back, hasn’t improved after 2 weeks of home treatment, or if your hip is stiff for more than 30 minutes after waking. Ask for an urgent appointment for severe hip pain that started suddenly without a fall or injury (NHS).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Exercise and physical therapy, weight loss, walking aids, NSAIDs, image-guided steroid injections, and hip replacement when other care fails; prompt surgery for fractures; fall-risk screening (CDC STEADI). Medicare Part B covers medically necessary PT. Hip replacement about $20,000–$50,000+ without insurance. Other costs being researched. Exercise and NSAIDs help many people a little; steroid shots help for a short time. Hip replacement greatly reduces pain for most people with severe arthritis.
Chiropractic Hip mobilization and manipulation with exercise and advice — never after a fall with possible fracture, and with extra care if you have osteoporosis. About $90–$200 for a first visit and $55–$100 for follow-ups without insurance; Medicare covers only spinal adjustments. Fair evidence for short-term relief in hip arthritis and limited evidence for longer term; reviews disagree on whether it adds to exercise.
Acupuncture Needle treatments for hip arthritis pain, alongside exercise and other care. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Mixed: a Cochrane review found little or no benefit over sham needling, while a U.S. guideline gives it a conditional recommendation. Side effects are usually minor.
Herbal medicine Turmeric (curcumin) and glucosamine/chondroitin are popular; anti-inflammatory gels are sold over the counter. Cost estimate being researched. Glucosamine didn’t beat placebo for hip arthritis, and turmeric is unproven for the hip. Some supplements raise bleeding risk with warfarin.
Massage therapy Soft-tissue work around the hip, buttock and thigh for comfort and relaxation — never on a possible fracture or a hot, swollen hip. One national chain: about $70–$90 a month for a 60-minute membership session. Other costs being researched. Little research for hip problems; a U.S. guideline recommends against massage as a treatment for hip arthritis, though it may still feel good.
MBHA Wellness Coach Strength and balance work (including tai chi), walking aids, home fall-proofing, weight goals, and pacing activity. Cost estimate being researched. Supports — never replaces — medical care. Exercise programs cut falls in older adults, and tai chi is strongly recommended for hip arthritis.

Approach 1 of 6

Conventional medicine (AMA)

The steps below focus on hip osteoarthritis; other conditions have their own sections below. Early treatment of hip arthritis is nonsurgical (AAOS OrthoInfo), and every treatment, especially surgery, has risks you and your doctor should weigh together (AAOS guideline summary).

1. Exercise and physical therapy

Exercise is strongly recommended for hip osteoarthritis in the 2019 American College of Rheumatology (ACR) guideline (ACR/AF guideline, 2019), and the AAOS says physical therapy can help people with mild to moderate hip arthritis move better with less pain, based on high-quality evidence (AAOS guideline summary).

How much it helps is debated. A 2014 Cochrane review of 10 trials concluded that land-based exercise can reduce pain and improve function (Fransen et al., Cochrane, 2014). Its 2026 update, with 18 studies, was more cautious: compared with no treatment, exercise probably improves pain and function only slightly, by amounts unlikely to be clinically meaningful (Hall et al., Cochrane, 2026). In one trial, a 12-week physical therapy program was no better than a sham treatment (Bennell et al., 2014). Side effects in exercise trials have mostly been temporary extra pain (Fransen et al., Cochrane, 2014), and exercise that includes balance work helps prevent falls (Sherrington et al., Cochrane, 2019), so it remains a sensible foundation.

2. Weight and walking aids

Weight loss is strongly recommended for people with hip arthritis who are overweight (ACR/AF guideline, 2019); it reduces stress on the hip, easing pain and improving function (AAOS OrthoInfo). The ACR strongly recommends a cane when arthritis is affecting walking, stability or pain (ACR/AF guideline, 2019).

3. Pain relievers (by class)

We don’t list doses; ask your doctor or pharmacist what is safe for you.

4. Injections

A corticosteroid injection into the hip can reduce pain and improve function, but only for a short time (AAOS guideline summary). The ACR strongly recommends these injections for hip arthritis and strongly recommends imaging guidance, such as ultrasound, for hip injections (ACR/AF guideline, 2019). Hyaluronic acid (“gel”) shots are not recommended for the hip: they work no better than placebo and are not FDA approved for hips (AAOS guideline summary).

5. Surgery

When arthritis pain causes disability despite other treatment, the main option is total hip replacement; hip resurfacing and, rarely, osteotomy are others (AAOS OrthoInfo). See Hip replacement and Hip fractures.

6. Fall-risk screening (CDC STEADI)

Most hip fractures follow falls. CDC’s STEADI initiative (Stopping Elderly Accidents, Deaths & Injuries) helps health care providers screen older patients for fall risk, assess risk factors that can be changed, and intervene with effective strategies (CDC). If you’re 65 or older, ask your provider to evaluate your fall risk and review your medicines (CDC). See also our balance guide.

What it costs

  • Physical therapy: Medicare Part B covers medically necessary outpatient PT when your provider certifies you need it; you pay 20% of the approved amount after the deductible (Medicare.gov). Cash prices: MBHA cost estimate being researched.
  • Hip replacement: commonly about $20,000–$50,000 or more without insurance; people with commercial insurance may still owe about $2,000–$9,000 or more (cost guide: The Pricer). Ask your hospital and insurer for a personal estimate.
  • Office visits, imaging, injections and fracture care: MBHA cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Some people with hip arthritis see a chiropractor for hands-on treatment of the hip, often alongside exercise. The research is limited and mixed, and much of it was done by physical therapists rather than chiropractors.

What the research says

  • Chiropractic review: a 2012 review of manipulative therapy for lower-limb problems, led by an author from a chiropractic college, rated the evidence for hip osteoarthritis as “fair” for short-term treatment and “limited” for long-term treatment, and called for larger, better trials (Brantingham et al., 2012).
  • One positive trial: in a Dutch trial of 109 people, nine sessions of hip manipulation and mobilization in a hospital physical therapy clinic beat an exercise program after five weeks, with benefits lasting to 29 weeks (Hoeksma et al., 2004).
  • Less encouraging reviews: a 2015 analysis of six trials found no clear benefit of manual therapy over placebo or no treatment, though the authors weren’t confident in that conclusion (Wang et al., 2015). The ACR guideline conditionally recommends against adding manual therapy to exercise over exercise alone (ACR/AF guideline, 2019).
  • If your “hip” pain actually comes from your lower back, see our back problems guide for the evidence there.

Safety

  • Never have a hip manipulated after a fall until a doctor has ruled out a fracture, and don’t have hands-on treatment of a hot, swollen hip or a child’s painful hip or limp — see the warning signs at the top of this page.
  • Osteoporosis: tell your chiropractor if you have it. In a study of nearly a million spinal manipulation sessions at Hong Kong chiropractic clinics, the only two severe side effects were rib fractures in women over 60 with osteoporosis (Chu et al., 2023). Among older Medicare patients, overall injury risk after a chiropractic visit was lower than after a primary care visit, but injury was more likely in chiropractic patients who had osteoporosis (Whedon et al., 2015).
  • Mild, short-lived soreness or stiffness is common after spinal manipulation; serious problems are very rare, and may be more likely in people with health problems that raise their risk of injury (NCCIH).

What it costs

  • Without insurance: about $90–$200 for a first visit and $55–$100 for follow-ups; an exam plus several weeks of care can total $500–$1,000 (The Pricer).
  • Medicare covers only spinal adjustments to correct a subluxation — not treatment of the hip itself, or X-rays, massage or acupuncture a chiropractor orders; you pay 20% after the deductible (Medicare.gov).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is often tried for arthritis pain. For the hip, the evidence is mixed: well-controlled trials are few and small, and experts read them differently.

What the research says

  • Cochrane review (2018): six trials with 413 people. In the two trials that compared real with sham acupuncture, acupuncture probably had little or no effect on pain or function, though the trials were too small to rule out a moderate benefit. One unblinded trial found benefits when acupuncture was added to routine care, likely due at least partly to people’s expectations (Manheimer et al., Cochrane, 2018).
  • ACR guideline (2019): acupuncture is conditionally recommended for hip arthritis; the panel noted that its effectiveness remains controversial (ACR/AF guideline, 2019).
  • In osteoarthritis studies generally, acupuncture is consistently better than no treatment but not necessarily better than simulated acupuncture, and expectation and belief appear to play important roles (NCCIH).

If you try it, use it as an add-on to exercise and medical care, not a replacement.

Safety

In the Cochrane trials, side effects were minor, such as bruising, bleeding or pain where needles went in, with no serious problems reported (Manheimer et al., Cochrane, 2018). Complications have come from non-sterile needles and improper technique; the FDA requires needles to be sterile and single-use (NCCIH).

What it costs

Published cash prices run about $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Glucosamine and chondroitin

These cartilage building blocks are among the most popular supplements for arthritis, but evidence for the hip is thin. The one high-quality hip study, a two-year trial of 222 people, found glucosamine no better than placebo for pain, function or joint structure (NCCIH). The ACR strongly recommends against glucosamine and chondroitin for hip arthritis (ACR/AF guideline, 2019). No major safety problems have turned up in large studies, but glucosamine may raise blood sugar in some people, and both have been linked to more bleeding in people taking warfarin (NCCIH).

Turmeric (curcumin)

Turmeric is promoted for osteoarthritis. Early evidence for oral turmeric or curcumin is positive for knee arthritis but needs higher-quality research, and we don’t know enough to say it helps any condition (NCCIH). MBHA found no hip-specific evidence. Turmeric can cause nausea and other stomach upset, liver damage has been reported with highly absorbable curcumin products, and supplements may be unsafe in pregnancy (NCCIH).

Topical NSAID gels (conventional, but sold over the counter)

The NHS suggests ibuprofen gel among the ways to ease hip pain (NHS). But the hip joint lies deep under the skin, so the ACR panel judged rub-on NSAIDs unlikely to help hip arthritis and didn’t review them for it (ACR/AF guideline, 2019).

Supplements, NSAIDs and blood thinners: some herbs interact with medicines — for example, ginkgo taken with warfarin raises the risk of major bleeding (NCCIH). If you take any medicine, talk with your provider before using an herbal product (NCCIH), and remember that blood thinners are often prescribed after hip surgery (AAOS OrthoInfo). We don’t list doses, and no herb treats a broken hip, an infected joint or a slipped hip in a child.

What it costs

Cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage can feel good and help some people relax, and physical therapists sometimes use rolling massage as part of treatment for hip bursitis (AAOS OrthoInfo). As a treatment for hip problems, though, the evidence is limited.

What the research says

  • Very few studies have looked at massage for osteoarthritis, and the little evidence there is concerns the knee (NCCIH). We found little research on massage for hip problems specifically.
  • The ACR guideline conditionally recommends against massage as a treatment for hip arthritis, because studies have been small, at high risk of bias and haven’t shown benefit for arthritis outcomes — while acknowledging that massage may have other benefits (ACR/AF guideline, 2019).

Safety

Never massage a hip that may be broken, or one that is red, hot and swollen. Arthritic joints are sensitive, so a therapist working with arthritis should understand its needs (NCCIH). Serious problems are rare, but a blood clot, nerve injury or broken bone has been reported, some with vigorous deep-tissue massage or in older adults (NCCIH). After hip surgery, check with your surgeon before any massage of the leg, since blood clots are a common complication of hip replacement (AAOS OrthoInfo).

What it costs

At one national chain, Massage Envy, a membership runs about $70–$90 a month for one 60-minute session, with a 12-month initial term; prices vary by location (The Pricer). Other costs being researched.

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

An MBHA Wellness Coach can help you build habits that ease sore hips and prevent falls, alongside — never instead of — your medical care.

Strength and balance, including tai chi

Walking aids

A cane, crutches or walker can improve mobility and independence (AAOS OrthoInfo), and an occupational therapist can advise on walking aids and other ways to make life easier (NHS).

Home safety

  • Remove things you could trip over, add grab bars in and near the tub, shower and toilet, and put railings on both sides of stairs; have your eyes checked at least once a year (CDC). Avoid low chairs, which put extra pressure on the hips (NHS).
  • Ask your provider about osteoporosis screening and vitamin D (CDC).

Weight

For people with hip arthritis who are overweight, losing weight is strongly recommended, and its benefits are greater when combined with exercise (ACR/AF guideline, 2019). A coach can help with realistic food and activity goals. An MBHA guide to weight control is on the way.

Pacing

Another approach

Hip fractures in older adults

A hip fracture is a break in the upper thighbone. More than 300,000 people in the U.S. have one each year, mostly adults 65 and older injured in falls at home or in the community; most hip fractures happen in older people whose bones have been weakened by osteoporosis (AAOS OrthoInfo). In weak bones even a simple twist or trip can cause a break, and sometimes the bone breaks while someone is just standing or walking — “the break occurs before the fall” (AAOS OrthoInfo). CDC counts nearly 319,000 older adults hospitalized for hip fractures each year, and falls cause 88% of hip-fracture hospital and emergency visits (CDC). MBHA guides to osteoporosis and to joints are on the way.

  • Signs: severe pain in the groin and upper thigh, being unable to stand or bear weight, and a leg that looks shorter and turned. A few fractures hurt less at first and still allow walking (AAOS OrthoInfo) — so hip pain after a fall still needs a prompt medical check, even if you can walk.
  • Treatment: almost always surgery — screws, nails, rods or plates, or a partial or total hip replacement (NHS). Surgery within 24 to 48 hours may reduce complications, and getting out of bed quickly helps prevent bed sores, blood clots and pneumonia (AAOS OrthoInfo).
  • Recovery: most people start physical therapy the day after surgery; some need a short stay in a rehabilitation facility (AAOS OrthoInfo). Healing takes weeks or months, and some people never regain the same strength and need a walking aid (NHS).
  • Preventing the next one: anyone over 50 who breaks a hip should ask about bone health care to prevent further fractures (NHS).

Another approach

Pain on the outside of the hip (trochanteric bursitis)

Pain at the bony point on the outside of the hip, spreading down the outer thigh, is often called trochanteric bursitis. It is typically worse at night, when lying on that side, getting up from a chair, or with long walks, stairs or squatting, and is more common in women and in middle-aged and older people (AAOS OrthoInfo). Risks include overuse, a fall onto the hip, a tight iliotibial (IT) band, unequal leg lengths, and spine problems that change how you walk (AAOS OrthoInfo). Outer-hip pain was long diagnosed simply as bursitis; doctors now often use the broader term greater trochanteric pain syndrome, which includes trochanteric bursitis, a snapping hip and problems with the hip’s abductor (gluteal) tendons (Redmond et al., 2016).

Treatment starts with activity changes, NSAIDs, a cane if needed, and stretching and strengthening; steroid injections can give relief, and surgery is rarely needed (AAOS OrthoInfo). In a trial of 204 people with painful gluteal tendons, an education-plus-exercise program beat a single steroid injection at eight weeks and gave better overall improvement at one year (Mellor et al., 2018). See the hip section of our bursitis guide for more.

Another approach

Labral tears and hip impingement (FAI)

The labrum is a rim of tough cartilage that seals the hip socket like a gasket. In femoroacetabular impingement (FAI), extra bone on the ball, the socket rim or both makes the bones rub during movement, which over time can tear the labrum and wear down cartilage (AAOS OrthoInfo). It starts with how the hip formed during childhood; exercise doesn’t cause it, though active people may notice pain earlier. Symptoms are groin pain, stiffness and limping, with sharp pain on turning, twisting or squatting (AAOS OrthoInfo).

Treatment usually starts with activity changes, NSAIDs and physical therapy. If pain persists and imaging shows damage, arthroscopy (keyhole surgery) can repair the labrum and trim the extra bone (AAOS OrthoInfo). After arthroscopy, some people need crutches for a month or two and physical therapy; many return to full activity, but severe damage can’t always be reversed (AAOS OrthoInfo).

Another approach

Hip pain and limping in children

Most limps in children come from minor injuries and get better on their own, but a limp that lasts more than a week or keeps getting worse needs a doctor (AAOS OrthoInfo). Hip problems in children can be felt in the thigh or knee (NHS), so a child with knee pain may still need their hip checked.

  • Irritable hip (transient synovitis) is the most common cause of hip pain in children. It usually gets better in 1 or 2 weeks with rest and children’s pain relievers. Go back to the doctor if pain worsens, lasts beyond 2 weeks or returns, or the child gets a fever (NHS).
  • Septic arthritis (an infected joint) is less common but more serious (NHS). A fever with a limp raises concern for a bone or joint infection (AAOS OrthoInfo).
  • Slipped capital femoral epiphysis (SCFE), the most common hip disorder in adolescents: the ball of the thighbone slips at the growth plate, usually ages 12 to 16 in boys and 10 to 14 in girls, and excess weight is a risk factor. It may cause weeks of groin, thigh or knee pain and a limp with the foot turned out, or a sudden slip where the child can’t bear weight. Treatment is always surgery, and early diagnosis gives the best chance of avoiding complications (AAOS OrthoInfo).
  • Perthes disease: the blood supply to the ball of the hip is temporarily disrupted, usually in children aged 4 to 10, more often boys. Early signs are a limp or odd running style and pain in the hip, groin, thigh or knee. Treatment ranges from observation and physical therapy to casts or surgery, and most children do well long-term (AAOS OrthoInfo).

Don’t take a child with hip pain or a limp to a chiropractor, acupuncturist or massage therapist instead of a medical evaluation; a doctor may need to examine the hip and arrange an X-ray, and sometimes blood tests or scans (NHS).

Another approach

When hip pain comes from the back

Not all “hip” pain starts in the hip. Hip arthritis usually hurts in the groin or thigh (AAOS OrthoInfo), while pain from a pinched nerve in the lower back (sciatica) usually affects the buttock and the back of one leg, often down to the foot, sometimes with tingling, numbness or weakness (NHS). Lumbar spinal stenosis can cause burning pain that starts in the buttocks and moves down the leg (AAOS OrthoInfo). Hip and spine problems often occur together, so doctors first try to find the main pain source with a careful exam and sometimes diagnostic injections (Le et al., 2026).

Go to the emergency room for numbness around the genitals or bottom, new trouble controlling your bladder, or severe or worsening weakness or numbness in both legs (NHS). See our back problems guide; an MBHA guide to sciatica is on the way.

Another approach

Hip replacement: what to expect

In a total hip replacement, the damaged ball and socket are replaced with metal, plastic or ceramic parts (AAOS OrthoInfo). It is considered when pain limits everyday activities or continues at rest and medicines, physical therapy and walking aids aren’t enough; decisions are based on pain and disability, not age (AAOS OrthoInfo). Non-surgical treatments are usually tried first (NHS).

Another approach

Avascular necrosis (osteonecrosis)

Avascular necrosis happens when the blood supply to the ball of the hip is cut off, so the bone dies and gradually collapses, leading to severe arthritis. It is most common between ages 40 and 65. Risk factors include hip injuries, heavy alcohol use, long-term corticosteroid medicines, and conditions such as sickle cell disease and lupus. It starts as a dull ache or throbbing in the groin or buttock and over months becomes harder to stand on; early diagnosis matters, because early treatment is linked with better results (AAOS OrthoInfo). Before collapse, procedures such as core decompression may save the hip; after collapse, hip replacement is the most successful treatment (AAOS OrthoInfo). Tell your doctor about new hip pain if you take steroids long term or drink heavily.

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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