Why Does My Hip Hurt When I Walk?

Where exactly does your hip hurt when you walk?

The word "hip" covers a lot of territory. Patients point to the groin, the bony point on the outside of the upper thigh, the buttock or even the knee. MedlinePlus notes that pain from a hip problem is not always felt over the hip itself and may show up in the groin, thigh or knee.

Our team starts every evaluation by asking you to point with one finger to where it hurts most. That single gesture narrows the list of likely causes more than almost any other question.

• Front of the hip or groin: usually the joint itself, such as arthritis, a labral tear or impingement
• Outside of the hip: usually the gluteal tendons or the trochanteric bursa
• Buttock or back of the hip: often the lower back, the hamstring tendon or the sacroiliac joint

What does groin pain while walking usually mean?

Pain deep in the groin with walking is the classic sign of a problem inside the ball-and-socket joint. MedlinePlus explains that pain from the hip joint itself is often felt most in the groin. According to AAOS OrthoInfo, hip osteoarthritis typically causes groin or thigh pain that can spread to the buttock or knee, stiffness that makes walking and bending hard, and sometimes a limp.

In younger, active adults, groin pain with walking, pivoting or long strides can also come from femoroacetabular impingement (FAI) or a labral tear. These problems tend to bother people most with twisting, deep bending and getting in and out of a car.

Why does the outside of my hip hurt on longer walks?

Pain over the bony point on the outside of the hip, often spreading down the side of the thigh, usually comes from the gluteal tendons or the bursa that sits over them. AAOS OrthoInfo notes that this kind of hip bursitis pain may get worse with prolonged walking, stair climbing or squatting, and is often worse at night when lying on that side.

Many people describe a pattern where the first part of the walk feels fine and the ache builds after a mile or so. The area usually feels tender to press, which is a helpful clue that the problem sits in the soft tissue on the outside of the hip rather than deep in the joint.

Could pain in my buttock be coming from my back?

Yes, and it often is. Pain in the buttock that spreads down the back of the thigh, especially with tingling or numbness, frequently starts in the lower spine. AAOS OrthoInfo describes lumbar spinal stenosis as causing buttock and leg pain that worsens with standing and walking and eases when you sit or lean forward, such as on a shopping cart.

Because back problems so often mimic hip problems, Dr. Stride checks the lower back at every hip exam. Treating the wrong source is one of the most common reasons hip pain lingers.

What does the timing of the pain tell you?

When the pain starts during a walk is almost as useful as where it is. Pay attention to these patterns before your visit, because they help our team match your symptoms to a cause.

• Pain and stiffness with the first steps after sitting that loosen up: common with early arthritis
• An ache that builds after a mile or on long walks: often tendon or bursa related
• Pain going uphill or up stairs: can point to the joint or the gluteal tendons
• Leg pain that forces you to stop and sit, then eases: suggests the spine
• Sharp catching or clicking with certain steps: can suggest a labral problem

When is walking pain urgent, and what helps in the meantime?

Some walking pain should not wait for a routine appointment. MedlinePlus advises getting emergency help if you cannot bear weight on the leg or cannot move the hip, or if the leg looks deformed after a fall. A hip that is hot and swollen along with a fever also needs same-day care, since joint infection can cause lasting damage if treatment is delayed.

A limp that is getting worse week by week, or pain that keeps you from finishing ordinary errands, is a reason to be seen within days. MedlinePlus also suggests contacting a provider if hip pain continues after a week of home care or if you start limping and having trouble with stairs.

For mild pain without red flags, simple steps often take the edge off. MedlinePlus suggests avoiding the activities that make the pain worse, using over-the-counter pain relievers such as ibuprofen or acetaminophen if they are safe for you, and wearing flat, cushioned shoes. Standing with your weight even on both legs and avoiding long periods on your feet can also help.

Try shorter, more frequent walks on flat, even ground instead of one long outing, and skip steep hills for now. Keep a short note of where the pain is, how far you can walk before it starts and what eases it. That record makes your first visit faster and more useful.

How does our team find the cause of walking pain?

A visit with Dr. Stride starts with your story and a hands-on exam, including watching you walk. Gait analysis shows whether you are shortening your stride, leaning over the sore side or protecting the leg, and each pattern points toward a different source. Standing X-rays are usually the first imaging test, and an MRI is added only when it will change the plan.

Most walking-related hip pain improves with non-surgical care such as activity changes, targeted physical therapy and medication guidance. If your walks have been getting shorter, the Saturday Hip Pain Clinic in Memorial City is set up for exactly this kind of new hip pain. Bring any X-rays or MRI you already have, and our team will help you understand what is going on.

Questions patients ask