Hip Pain: Causes, Exercises & Treatment

Hip pain can make everything harder. Walking, sitting, sleeping, climbing stairs, even getting out of a chair. The hip is your body’s largest weight-bearing joint, and when it’s not happy, you feel it in everything you do.

The hip also plays a much bigger role than most people realize. It connects your upper body to your lower body, powers your walking stride, and provides the stability that protects your knees and lower back. Weakness or dysfunction in the hip is one of the most common hidden causes of pain in other areas.

Here’s the encouraging part: hip pain responds remarkably well to the right exercises. Whether you’re dealing with tight hip flexors from sitting all day, bursitis that flares up at night, or pelvic floor issues, targeted movement is your most powerful treatment.

Dealing with hip pain? Take our free pain assessment quiz to find out what’s going on and get personalized exercise recommendations.

Common Causes of Hip Pain

Tight Hip Flexors

If you sit for hours a day (and most of us do), your hip flexors are probably tight and overactive. Tight hip flexors pull your pelvis forward, compress the front of the hip joint, and contribute to lower back pain. Hip flexor exercises can make a dramatic difference, often providing noticeable relief within the first week.

Hip Bursitis

Hip bursitis causes pain on the outside of the hip that often radiates down the outer thigh. It tends to be worse at night when lying on the affected side, and with activities like climbing stairs or walking for long distances. Despite the name suggesting inflammation, current research shows it’s more often a tendon problem (gluteal tendinopathy) than pure bursa inflammation.

Pelvic Floor Dysfunction

Pelvic floor physical therapy addresses a range of conditions including urinary incontinence, pelvic pain, postpartum recovery, and pain during intercourse. The pelvic floor muscles are part of the hip complex, and dysfunction here can contribute to hip pain, lower back pain, and other issues that people often don’t connect to the pelvic floor.

Hip Arthritis

Osteoarthritis of the hip causes stiffness, aching, and reduced range of motion that typically worsens with activity and improves with rest. It’s most common after age 50 but can occur earlier, especially after hip injuries. Exercise is the first-line treatment, and research shows it reduces pain as effectively as anti-inflammatory medication.

Labral Tears

The hip labrum is a ring of cartilage that deepens the hip socket. Tears can cause clicking, catching, or a feeling of the hip “giving way.” Some labral tears cause significant pain; others are found incidentally on imaging and aren’t actually the source of symptoms. Conservative treatment with PT is often successful.

Muscle Strains

Hip flexor, groin, and hamstring strains are common in athletes and active people. They typically result from sudden movements, overstretching, or fatigue. Most heal well with progressive exercise, though they can be frustratingly slow.

Referred Pain from the Back

Lower back problems, especially disc herniations, can send pain into the hip and buttock area. If your hip pain is accompanied by lower back symptoms or radiating leg pain, the source may be your spine. Sciatica exercises address this common overlap.

Hip Pain Patterns and What They Mean

Where and when your hip hurts tells a lot about the cause:

• Front of the hip (groin area) → hip flexor strain, labral tear, arthritis, or hip impingement
• Outside of the hip → bursitis/gluteal tendinopathy, IT band tightness
• Back of the hip (buttock) → piriformis syndrome, sciatica, SI joint dysfunction
• Hip pain at night → bursitis, arthritis, or referred pain from the spine
• Hip pain when sitting → hip flexor tightness, labral tear, or hip impingement
• Pain with walking or stairs → arthritis, bursitis, or muscle weakness

Hip Pain at Night

Hip pain at night is one of the most disruptive symptoms because it affects your sleep quality. Lying on your side compresses the bursa and tendons on the outside of the hip. Lying on your back can aggravate hip flexor tightness. The nighttime guide covers sleeping positions, pillow strategies, and pre-bed routines that help.

Hip Pain When Sitting

Hip pain when sitting is increasingly common in our desk-bound world. Prolonged sitting shortens the hip flexors, weakens the glutes, and compresses the front of the hip joint. The fix involves both exercise (strengthening and stretching) and workplace modifications.

When to See a Doctor

Get evaluated promptly if you experience:

• Sudden, severe hip pain after a fall (especially if you’re over 60)
• Inability to bear weight on the leg
• Visible deformity of the hip or leg
• Hip pain accompanied by fever
• Rapidly worsening pain that doesn’t respond to any home treatment
• Numbness or weakness in the leg that’s progressing
• Groin pain during pregnancy that limits walking (this can be treated)

For hip pain lasting more than 2 to 3 weeks, a physical therapist can identify the cause and start you on the right treatment. In most states, you can see a PT without a doctor’s referral.

Best Exercises for Hip Pain

Hip Flexor Exercises

Hip flexor exercises include stretches to release tight muscles and strengthening exercises for the muscles that oppose them (primarily the glutes). The combination of stretching what’s tight and strengthening what’s weak is what creates lasting change. If you sit more than 4 hours a day, these exercises should be part of your routine.

General Hip Pain Exercises

Hip pain exercises cover the fundamentals that apply to most hip conditions: glute strengthening (bridges, clamshells, side-lying leg raises), hip mobility work (90/90 stretches, figure-4 stretches), and core stability exercises that support the hip complex.

Hip Bursitis Exercises

Hip bursitis treatment exercises focus specifically on strengthening the gluteal tendons (the actual problem) while avoiding movements that compress the outside of the hip. Isometric holds are particularly effective in the early stages.

Pelvic Floor PT

Pelvic floor physical therapy involves assessment and treatment by a specially trained PT. Exercises may include pelvic floor strengthening (not just Kegels), relaxation techniques, core coordination, and breathing strategies. If you’re experiencing pelvic floor symptoms, working with a specialist makes a big difference.

Exercises for Night Pain

The exercises in our hip pain at night guide focus on reducing inflammation, improving hip mobility before bed, and strengthening the gluteal muscles to reduce tendon irritation.

Exercises for Sitting Pain

Our hip pain when sitting guide combines hip flexor stretches, seated mobility exercises you can do at your desk, and strengthening work that counteracts the effects of prolonged sitting.

Get your personalized hip exercise plan → Take the free quiz

Treatment Options

Physical Therapy

PT is the most effective treatment for the vast majority of hip conditions. A physical therapist will assess your hip mobility, muscle strength, movement patterns, and functional limitations to create a targeted program. For hip arthritis specifically, clinical guidelines list exercise and PT as the top recommended treatment, ahead of medication or injections. Here’s what a typical PT timeline looks like.

Heat and Ice

Heat vs. ice for hip pain: heat generally works better for hip stiffness and muscle tightness (use before exercise), while ice is better for acute flare-ups and post-exercise soreness. A warm shower or heating pad on the hip before your exercises can improve your mobility significantly.

Foam Rolling

Foam rolling the muscles around the hip (quads, IT band, glutes, piriformis) can reduce tension and improve mobility. Be cautious with foam rolling directly on the outside of the hip if you have bursitis, as this can irritate the tendons further.

Medication

Over-the-counter anti-inflammatories can help manage hip pain in the short term. For arthritis, acetaminophen and NSAIDs are commonly recommended. Always combine medication with exercise for the best results.

Injections

Corticosteroid injections into the hip joint or bursa can provide temporary relief. They’re most useful as a bridge to allow you to participate in PT when pain is too high for exercise. PRP (platelet-rich plasma) injections are being studied for hip conditions but evidence is still mixed.

Surgery

Hip arthroscopy (for labral tears and impingement) and hip replacement (for severe arthritis) are options when conservative treatment fails. Hip replacements have excellent outcomes, but the surgery and rehab are significant undertakings. PT before and after surgery improves results.

The Hip-Everything Connection

The hip is the body’s central joint. It connects the upper body to the lower body, and when it’s not working right, problems cascade in both directions.

Hip weakness causes knee pain. Weak hip abductors (the muscles on the side of your hip) allow the knee to collapse inward during walking, running, and stairs. This is one of the most common hidden causes of knee pain, especially in women. Strengthening the hips often fixes the knees.

Tight hips cause back pain. When hip flexors are tight and hip rotation is limited, your lower back compensates by moving more than it should. This is why back pain exercises and hip exercises often go hand in hand.

Hip dysfunction affects the foot and ankle. Changes in hip strength and mobility alter how forces travel through the leg, potentially contributing to ankle problems and foot pain.

Wondering about the cost of getting professional help? Learn about physical therapy costs and what insurance typically covers.

Prevention and Long-Term Management

1. Break up sitting time. Stand and move for 2 to 3 minutes every 30 to 45 minutes.
2. Strengthen your glutes regularly. Strong glutes protect the hip joint and reduce stress on the surrounding tendons.
3. Stretch your hip flexors daily. Especially if you have a desk job.
4. Stay at a healthy weight. Extra weight increases the forces on the hip joint significantly.
5. Cross-train. Mix high-impact activities with swimming, cycling, or yoga to give the hip variety.
6. Address problems early. Hip pain that’s ignored tends to get worse and can lead to compensations that cause knee or back pain.

Related Conditions

Hip pain often connects to issues above and below:

• Back Pain: Causes, Exercises & Treatment: the hip and lower back are deeply interconnected
• Knee Pain: Causes, Exercises & Treatment: hip weakness is one of the top causes of knee pain
• Foot & Ankle Pain: Causes, Exercises & Treatment: the kinetic chain connects everything from foot to hip

Frequently Asked Questions About Hip Pain

Why does my hip hurt at night?

Nighttime hip pain usually results from bursitis/gluteal tendinopathy (lying on the affected side compresses the irritated tendon), arthritis (inflammation increases at rest), or referred pain from the lower back. Our nighttime hip pain guide covers causes and solutions in detail.

Can sitting too much cause hip pain?

Yes. Prolonged sitting shortens the hip flexors, weakens the glutes, and compresses the front of the hip joint. It’s one of the most common causes of hip pain in younger adults. Regular movement breaks and targeted exercises can reverse these effects.

What exercises should I do for hip pain?

The best exercises depend on your specific condition, but most people with hip pain benefit from glute strengthening (bridges, clamshells), hip flexor stretches, and core stability work. Hip pain exercises cover the fundamentals. Take our quiz for a more personalized recommendation.

Is walking good for hip pain?

Generally yes. Walking keeps the hip joint mobile, strengthens surrounding muscles, and helps manage weight. If walking itself is painful, start with shorter distances on flat ground and gradually increase. Swimming and cycling are good alternatives if walking is too uncomfortable.

How do I know if my hip pain is serious?

Most hip pain is not serious and responds well to exercise. Warning signs that need prompt medical attention include: inability to bear weight, severe pain after a fall (especially if over 60), visible deformity, fever with hip pain, and rapidly progressive numbness or weakness in the leg.

What’s the difference between hip bursitis and arthritis?

Bursitis causes pain primarily on the outside of the hip and outer thigh, often worse at night and with stairs. Arthritis causes stiffness and aching in the groin or front of the hip, worse with activity and improved with rest. Hip bursitis treatment explains the condition and best exercises in detail.

Can hip pain cause knee pain?

Absolutely. Weak hip muscles (especially the gluteus medius) allow the knee to collapse inward during walking and stairs, stressing the kneecap and surrounding structures. Fixing hip weakness often resolves or improves knee pain. This is why knee strengthening programs always include hip exercises.

When should I consider hip replacement?

Hip replacement is considered when arthritis significantly limits your daily activities and quality of life, and conservative treatments (PT, exercise, medication, injections) have been tried for at least 3 to 6 months without adequate relief. Most hip replacement patients are very satisfied with the outcome.

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