Hip Pain When Walking: 12 Common Causes

While healthy hips are easily taken for granted, hip pain can become all-consuming, significantly impacting daily activities like walking. This can be debilitating, so knowing the causes of hip pain is crucial for proper diagnosis and treatment.

The hip, a major joint supporting your entire body, is susceptible to various pain sources. This guide explores 12 common reasons for hip pain, especially when walking, and helps you identify potential culprits behind your discomfort. By understanding these causes, you can take steps to alleviate pain and improve your quality of life.

What Is Hip Pain?

Hip pain encompasses any discomfort in the hip area, groin, outer thigh, buttocks, or even lower back. Ranging from mild to severe, it may come with stiffness, swelling, or limited movement. Underlying conditions affecting bones, joints, muscles, tendons, or nerves can cause it.

Since the hip joint connects bones, muscles, ligaments, and other tissues, pinpointing the source can be tricky. Generally, pain in the groin or inner hip indicates a problem within the joint itself. Conversely, outer thigh, buttock, or outer hip pain often suggests an issue with surrounding soft tissues like tendons, ligaments, or muscles. In some cases, the perceived hip pain may actually originate from other areas like the lower back.

Who Is Most at Risk for Developing Hip Pain When Walking?

Individuals of all ages can experience hip pain, but certain factors may increase the risk, including age, obesity, previous hip injuries or surgeries, poor posture, and certain medical conditions like osteoarthritis or rheumatoid arthritis.

Athletes, particularly runners and dancers, may also be prone to hip pain due to repetitive stress on the hip joints. Additionally, sedentary lifestyles or occupations that involve prolonged sitting can contribute to hip discomfort when walking.

How Do You Know If Your Hip Pain Is Serious?

Hip pain can be uncomfortable, but how do you know whether it’s a “weekend warrior” injury that will subside in a few days or something more serious? One of the first signs that your hip problem might require medical attention is how long it lasts. If it’s longer than a few days without signs of improvement, it may be wise to see a doctor.

When to See a Doctor for Hip Pain

Signs that you should seek immediate medical help for a hip injury include:

• Fever
• Bleeding
• Exposed bone or muscle
• An area that’s warm to the touch
• A popping sound
• Inability to bear weight

It’s also important to seek help right away if you experience swelling, redness, warmth, tenderness, or soreness in the area of your hip joint because these could be signs of more serious conditions. Septic arthritis, for example, is a joint infection that can lead to deformities or osteoarthritis if left untreated.

12 Common Causes of Hip Pain When Walking

Hip pain when walking can stem from a variety of underlying causes, each with its own set of symptoms and treatment approaches. In this section, we will explore 12 common reasons why individuals may experience hip discomfort while walking and shed light on their symptoms, diagnostic methods, and treatment options.

1. Arthritis

Several different types of arthritis can affect the hip joint, but the most common is osteoarthritis. Osteoarthritis, also known as "wear-and-tear" arthritis, indicates that the protective cartilage in the joint has degenerated to the point where bone rubs on bone, leading to pain, stiffness, and reduced mobility. This type mainly affects those over 50, although younger people can experience it as well.

Arthritis hip pain can keep someone from being as active as they would like, and can seriously impact well-being. Treatment may include medications, physical therapy, and in severe cases, hip replacement surgery.

2. Labral Tears

A labral tear is damage to the ring of cartilage (labrum) that surrounds the hip socket. Repetitive motions, falls, or other accidents can lead to labral tears, and they can also appear in early osteoarthritis. Often, activities like ballet or sports like ice hockey, football, golf, and soccer can lead to hip labral tears. However, they can also be caused by abnormalities in the structure of the hip joint itself.

Symptoms of labral tears can include a locking or clicking sensation in your hip joint, stiffness, sharp pain in the groin or hip area, and a decreased range of motion that’s made worse by long periods of inactivity. Treating labral tears can be as simple as just resting, but in some cases, surgery to repair the torn labrum is required.

3. Femoroacetabular Impingement (FAI)

Femoroacetabular impingement (FAI) occurs when one or both of the bones that form the hip joint grow an irregular bone spur that results in hip pain, stiffness, damage around the joint, and discomfort, especially during walking uphill or physical activity.

There are three types of impingements:

• Pincer: When a bone growth extends over the edge of the acetabulum hip socket
• Cam: When a bone growth is on the edge of the femur and restricts movement of the hip’s ball joint
• Combined: When both pincer and cam bone growths are present

FAI is the result of hip bones that are abnormal at birth or do not form normally during childhood growth, and little can be done to prevent it. It is also possible for children to develop FAI from sports that require repeatedly squatting or twisting at the hip.

4. Bursitis

Bursitis, or inflammation of the fluid-filled sacs (bursae) cushioning your hip joint, is a common cause of hip pain. Repetitive activities, overuse, or direct trauma can irritate these bursae, leading to pain, swelling, and tenderness.
The most common type is trochanteric bursitis, which affects the bursae between the outer hip bone and connecting tendon.

Bursitis can be especially painful when lying on the affected side, moving around a lot, or walking. Treatment for bursitis typically involves rest, anti-inflammatory medications, steroid injections, and physical therapy to reduce symptoms and prevent future episodes.

5. Osteonecrosis

Osteonecrosis, or avascular necrosis, is a lesser-known hip condition. It occurs when cells of the hip bone start to die due to insufficient blood supply. Most often, osteonecrosis happens as a result of excessive use of alcohol or steroids. However, it can also be the result of hip dislocation or fracture.

Symptoms of osteonecrosis include pain in the thighs, buttocks, or knees, as well as hip and groin pain that gets worse with walking. It’s most common in the hip, although it can occur in other joints as well.

6. Hip Fractures

Hip fractures are serious breaks or cracks in the upper thigh bone near the hip joint. They are most commonly caused by falls or car accidents, especially in individuals with weakened bones due to osteoporosis or other conditions. These fractures cause significant pain, swelling, and an inability to bear weight on the affected leg, making walking impossible.

Due to their severity, all hip fractures require immediate medical attention from an orthopedic specialist. While direct trauma is the usual culprit, factors like osteoporosis, cancer, or even stress injuries can weaken the hip joint and increase fracture risk.

7. Tendonitis

Throughout your body, tendons act as strong, flexible bands that connect muscles to bones. Their constant activity makes them susceptible to irritation and inflammation, known as tendonitis.

The tendons around your hips are particularly strong due to the weight-bearing role of the hip joint. However, this strength comes at a cost, making them prone to stress and strain. Repetitive activities, especially in sports like soccer, tennis, or running, can wear down these tendons.

Left untreated, what starts as a minor overuse strain can develop into a full-blown tendonitis injury. Common signs include pain in the hip flexor muscles, which help raise your knee towards your body. This pain can be triggered by movement or even gentle touch.

Tendons attach muscles to bones and are found throughout the body. They are thick and strong because of the work they do every day, but can become irritated or inflamed. When tendons are injured or overused, the resulting pain is called tendonitis.

8. Hip Flexor Strain

A hip flexor strain occurs when the muscles or tendons in the front of your hip are stretched or torn. The key players here are the iliopsoas and rectus femoris muscles, responsible for lifting your leg upward. These strains are common in athletes participating in activities with repetitive hip flexion, such as cycling, running, or sports that involve kicking motions like soccer or martial arts. Trauma, like a direct blow to the hip, can also be a culprit.

The hallmark symptom of a hip flexor strain is pain in the front of your hip, often worsening with activities that involve hip flexion like walking, climbing stairs, or getting up from a seated position. Depending on the severity of the strain, symptoms can range from swelling, weakness in the affected muscles, and restricted movement, to an inability to fully lift the affected leg.

9. Snapping Hip Syndrome

Snapping hip syndrome is a condition characterized by a popping or snapping sensation in the hip, often felt during walking. This painless or mildly uncomfortable snapping occurs when tendons or tight muscles rub against bony structures in the hip.

One of the most commonly affected tissues in snapping hip syndrome is the iliotibial band, more commonly referred to as the IT band, which runs from the hip along the outside of the thigh. When the IT band passes over the upper thigh bone, it creates the snapping sound.

Tightness, structural abnormalities, or overuse can contribute to this condition, which is particularly common in athletes and dancers (hence the nickname "dancer's hip"). Treatment typically focuses on stretching and strengthening exercises to address underlying muscle tightness or imbalance, effectively managing the discomfort associated with snapping hip syndrome.

10. Sciatica

Sciatica refers to pain that radiates along the path of the sciatic nerve, which runs from the lower back through the hips and down each leg. It can result from compression or irritation of the nerve roots in the lumbar spine, causing sharp or burning pain in the hip, buttock, and leg. Compressions can be the result of a bone spur on your spine, a herniated disk, or narrowing of the spine.

Sciatica pain may worsen with walking or prolonged sitting. Treatment often involves rest, gentle stretching, physical therapy, and medications to alleviate pain and reduce inflammation.

How Do You Know If It’s Hip Pain or Sciatica?

Differentiating between hip pain and sciatica can be challenging as they can share similar symptoms, such as discomfort in the hip and buttock region. However, hip pain typically originates from the hip joint itself, while sciatica originates from the lower back and radiates down the leg. Consulting with a healthcare professional and undergoing diagnostic tests can help pinpoint the exact cause of your discomfort.

11. Inguinal Hernia

An inguinal hernia can cause pain in the front of the hip joint and happens when tissue (part of the intestine, for example) protrudes through a weak spot in the abdominal wall. It can happen as the result of a sports injury, or because of the extra pressure that women experience on their abdomens as the result of pregnancy.

Hernias can be quite painful, especially if aggravated by a cough or lifting something heavy. One symptom is a bulge on either side of your pubic bone that’s easier to see when standing up. It can burn or ache at the site, or cause a heavy or dragging sensation in the groin.

Sometimes, hernias resolve on their own and are not dangerous. More severe hernias, however, can cause persistent pain, get larger, or cause other complications. In these cases, surgery is often recommended.

12. Gynecological and Back Issues

What feels like hip pain can sometimes originate from other areas. For women, gynecological conditions like fibroids or endometriosis can trigger groin pain during ovulation or menstruation. Similarly, problems in the urinary or digestive systems, such as prostate cancer or gastroenteritis, may mimic hip pain.

Lower back issues like herniated discs or spinal stenosis can also cause hip discomfort due to pinched nerves. This pain may radiate from the back or spine down the buttocks and into the hip area.

How Is Hip Pain Diagnosed?

Doctors determine the source of hip pain using a number of different diagnostic techniques, from medical history to medical imaging.

During a physical exam, your doctor will assess your hip joint by observing movement while you walk, comparing range of motion to the other hip, and potentially manipulating the joint to identify pain points. Specific tests, like the straight-leg raise for sciatica, can be used to pinpoint potential causes. Doctors will also ask detailed questions about your pain, including its location, severity, and any aggravating factors.

Imaging and lab tests, such as X-rays, ultrasounds, MRIs, CT scans, blood tests, or joint fluid analysis, might be used to create a more complete picture of the underlying issue. The choice of tests depends on your doctor's initial assessment.

How To Prevent Hip Pain When Walking

Preventing hip pain when walking requires a multifaceted approach that focuses on maintaining overall joint health and minimizing strain on the hips. Here are some of our best tips to limit hip pain while you’re walking:

• Stay Active: Regularly exercise to strengthen hip muscles, improve joint stability, and increase flexibility. Include exercises like hip abduction, extension, and flexion to build strength and resilience.
• Maintain a Healthy Weight: Excess weight puts stress on your hips. Aim for a balanced diet and healthy weight to reduce joint strain and improve overall joint function.
• Choose the Right Shoes: Opt for shoes with proper cushioning, arch support, and shock absorption to minimize impact on your hips. Ensure a good fit and replace worn-out shoes regularly.
• Walk Smart: Practice good posture, engage your core, and take smooth, controlled steps. Avoid overstriding and focus on a natural gait pattern to distribute force evenly.
• Address Underlying Conditions: Manage existing conditions like osteoarthritis, bursitis, or muscle imbalances through physical therapy, medication, or lifestyle changes to prevent pain during walking.

By incorporating these strategies, you can promote hip health, enhance mobility, and enjoy pain-free walks!

What Are the Treatments for Hip Pain?

Treatment for hip pain depends on the underlying cause and can range from conservative measures like lifestyle modifications or physical therapy for mild injuries to surgical intervention for severe cases.

Conservative Treatment

Conservative treatments, the first line of defense against hip pain, address the underlying cause or manage symptoms through non-surgical methods:

• Lifestyle changes: Weight management and exercise to reduce stress on the joint.
• At-home remedies: Applying ice or heat, using a cane to decrease pressure, and taking over-the-counter pain relievers.
• Physical therapy: Strengthening muscles, improving flexibility, and correcting movement imbalances for long-term hip health.
• Activity modification: Reducing strain on the joint during specific movements to manage pain.

Non-Surgical Treatments

In addition to conservative treatments, several non-surgical options target the specific cause of your hip pain:

• Cortisone injections: Powerful anti-inflammatory medication is injected directly to the inflamed area for pain relief and improved mobility.
• Antibiotics: Antibiotics combat the underlying infection to alleviate pain.
• Targeted physical therapy: A physical therapist can recommend specific exercises to address your unique hip issues.
• Acupuncture or massage therapy: While evidence is mixed, some people find these complementary therapies helpful in managing pain.

Your doctor can determine the most suitable non-surgical course of treatment based on the specific diagnosis.

Surgical Treatments

If conservative and non-surgical treatments don't provide enough relief, surgery may be an option. The type of surgery depends on the cause of your hip pain. These are some of the more common surgical treatments for hip pain:

• Hip arthroscopy: Hip arthroscopy is a minimally invasive procedure for hip impingement or torn cartilage, allowing surgeons to see and repair the joint through small incisions.
• Fracture repair: This surgery uses pins, plates, and screws to promote healing in cases of severe fractures.
• Total hip replacement: This surgery is the most common for severe arthritis, where the damaged joint is replaced with prosthetic implants to restore pain-free movement.

Remember, discuss the risks and benefits of any surgery with a qualified orthopedic surgeon to determine if it's the right course of action for you.

What Are Signs That You Need a Hip Replacement?

While pain is a common indicator, there isn't a single, definitive sign that you need hip replacement surgery. However, a combination of several symptoms can suggest that total hip replacement surgery may be necessary:

• Pain that persists or gets worse despite medication and other treatments
• An increase in stiffness, a decrease in range of motion, or an inability to walk (even with assistance)
• Persistent pain that prevents you from resting comfortably or sleeping
• Difficulty standing up from a seated position, walking up or down stairs, or completing daily activities

It's important to remember that these are just some potential signs. The best course of action is to consult with an orthopedic doctor if you're experiencing persistent hip pain that disrupts your daily life.

Schedule an Appointment for Your Hip Pain at Alexander Orthopaedic

To address your hip pain effectively, schedule an appointment with Alexander Orthopaedics Associates. Our experienced orthopedic surgeons specialize in diagnosing a wide range of hip conditions and providing personalized hip pain treatments tailored to your needs. Don't let hip pain limit your mobility and quality of life – take the first step towards relief by contacting us today.