Why Does My Hip Hurt When I Stand Up After Sitting?

What is start-up pain in the hip?

Start-up pain is stiffness and aching with the first steps after rest, which eases as you get moving. It is a classic early sign of hip osteoarthritis. AAOS OrthoInfo explains that arthritis pain and stiffness may be worse in the morning or after sitting or resting for a while, and that it can make everyday tasks such as rising from a chair harder.

In osteoarthritis, the smooth cartilage that covers the ball and socket gradually wears away. AAOS OrthoInfo notes that this condition occurs most often in people 50 and older, although it can appear earlier, especially after a prior hip injury or in hips that formed abnormally. Pain is usually felt in the groin or thigh and can spread to the buttock or knee.

Why does rest make it worse? A joint with worn cartilage tends to stiffen when it sits still, and the first movements stretch the tight capsule and muscles around it. As you keep walking, the joint warms up and moves more freely. Over time, AAOS OrthoInfo explains, the pain may become more frequent and can show up during rest or at night.

How do you know if it is arthritis?

Start-up pain on its own is only a clue. It often travels with other signs. AAOS OrthoInfo lists these common symptoms of hip osteoarthritis:

• Groin or thigh pain that may spread to the buttock or knee
• Stiffness that makes it hard to walk, bend or put on shoes and socks
• Pain that flares with vigorous activity
• A grinding sensation, or locking and sticking of the joint
• Reduced range of motion and a limp

Why does my groin hurt while I am sitting?

If the groin hurts during sitting itself, especially in low chairs, car seats or with your knees higher than your hips, the joint may be pinching. In femoroacetabular impingement (FAI), AAOS OrthoInfo explains, extra bone on the ball or socket makes the joint fit imperfectly, so the bones rub during deep bending. That can cause pain in the groin and, over time, damage the labrum and cartilage.

AAOS OrthoInfo notes that FAI often causes sharp pain with turning, twisting and squatting, and sometimes a dull ache. People with impingement or a labral tear often say that long drives, deep couches and getting out of a car are the worst parts of their day. Their pain usually starts in the groin and may be felt toward the outer hip.

FAI is usually found in younger, active adults, while arthritis is more common after 50, but the two overlap. AAOS OrthoInfo notes that FAI can lead to osteoarthritis over time. X-rays show the shape of the bones and any arthritis, and an MRI can show damage to the labrum and cartilage.

Why does my outer hip hurt after crossing my legs?

Pain on the outside of the hip when you stand after sitting cross-legged often comes from the gluteal tendons, which attach to the bony point of the outer hip. Crossing your legs stretches and compresses those tendons. Cleveland Clinic lists sitting for a long time or sitting cross-legged among the positions that make gluteal tendinopathy pain worse, along with lying on your side and climbing stairs.

This pain is usually tender to press and may spread down the outside of the thigh toward the knee. Cleveland Clinic suggests avoiding low chairs and not crossing your legs to reduce the strain on these tendons while they recover.

Could my back be causing the pain when I stand up?

Yes, sometimes. MedlinePlus notes that pain felt in the hip may reflect a problem in the back. Lower back problems can cause stiffness and buttock pain when you first stand, and pain that travels down the leg with tingling points toward a nerve. Dr. Stride examines the spine at every visit because treating the hip alone will not help pain that starts in the back.

The patterns can overlap. A stiff, arthritic hip changes how you stand and walk, which can strain the lower back, and the reverse is also true. Sorting out how much of the pain comes from each area helps our team choose the right treatment first.

What can you do to ease the pain?

Small changes during the day can make standing up easier. These steps are simple to try while you wait to be seen.

MedlinePlus also suggests over-the-counter pain relievers such as ibuprofen or acetaminophen if they are safe for you, losing weight if you are overweight, and wearing flat, cushioned shoes. Every pound you carry is felt by the hip each time you rise from a chair.

• Get up and move regularly instead of sitting for hours at a time
• Choose a firm, higher chair so your hips sit level with or above your knees
• Avoid crossing your legs and very low, deep couches
• Take a few slow steps or gentle hip circles before walking off
• Stay active with low-impact exercise such as cycling or swimming

When is it time to have your hip checked?

See a specialist if stiffness lasts well into the morning or keeps getting longer, if you are developing a limp, or if pain now shows up at rest or at night. MedlinePlus also suggests contacting a provider if pain persists after a week of home care or if you have trouble with stairs and walking. Early care gives you more options, since AAOS OrthoInfo notes that arthritis tends to worsen over time and starting treatment sooner can lessen its impact.

Most people with start-up pain begin with non-surgical care, including physical therapy, activity changes, weight management when it applies and guidance on medication. If standing up has become the hardest part of your day, the Saturday Hip Pain Clinic in Memorial City is a good place to get a clear diagnosis and a plan.

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