Hip Pain and Osteoarthritis: Common Causes and What Actually Helps

The hip is the body's largest weight-bearing joint, and when it starts to complain it touches almost everything — walking, stairs, getting out of a chair, even sleeping on your side. Hip pain is common and has a short list of usual causes, and crucially, where it hurts is one of the best clues to what is wrong. This guide walks through the common causes, how they are told apart, what genuinely helps, and an honest look at where newer regenerative approaches do and do not fit.

What's actually causing your hip pain?

A few conditions account for most hip pain, and they tend to hurt in different places:

• Hip osteoarthritis. Gradual wear of the cartilage in the ball-and-socket joint, and the most common joint cause of hip pain. It is common: symptomatic hip OA affects around 9.2% of adults aged 45 and over, with about 27% showing signs on X-ray ¹. The classic symptom is groin pain, often with stiffness and a reduced range of movement. It is the same disease process we cover for another joint in our knee osteoarthritis guide.
• Trochanteric bursitis (greater trochanteric pain syndrome). Pain on the outer side of the hip, often worse lying on it at night or climbing stairs. We cover it in depth in our trochanteric bursitis guide.
• Muscle and tendon problems — hip-flexor strains or gluteal tendinopathy around the side and back of the hip.
• Referred pain from the lower back. Sometimes the hip is not the problem at all — irritation in the spine can be felt around the buttock and hip, which is why our lower back pain guide is worth a look if the pain sits behind the hip.
• Labral tears and impingement, more common in younger, active people, causing groin pain and a catching sensation.

A quick clue: where does it hurt?

Because the causes cluster by location, the site of your pain is a useful first filter — though only an assessment can confirm it, since these can overlap.

One twist worth knowing: hip osteoarthritis can sometimes be felt in the knee or thigh rather than the hip itself, so stubborn knee pain occasionally turns out to be a hip problem. It is another reason a proper examination beats guessing.

How is hip pain diagnosed?

A good assessment combines the location clues above with a hands-on examination — checking how far the hip moves (osteoarthritis classically limits rotation and feels stiff), exactly where it is tender, and how you walk. An X-ray is usually the first imaging test when osteoarthritis is suspected, showing how much of the joint space and cartilage cushion remains; MRI or ultrasound are reserved for soft-tissue problems such as tendon, bursa, or labral issues, or when the picture is unclear. Because hip pain can be referred from the lower back — and hip arthritis can be felt in the knee — a thorough assessment usually checks those neighbouring areas too, so the right problem gets treated.

When should hip pain be checked?

Most hip pain can be managed sensibly at home at first, but some signs warrant being seen sooner:

• Inability to bear weight, or severe pain, after a fall or injury.
• A hip that is hot and swollen, or pain with fever.
• Night pain that consistently disturbs sleep, or pain that is steadily worsening.
• New numbness, weakness, or pain shooting down the leg.

How hip pain is treated

For most causes, and certainly for early hip osteoarthritis, treatment starts conservatively and steps up only as needed:

• Activity adjustment and weight management — reducing the load through the joint is one of the most effective things you can do.
• Physiotherapy and strengthening, particularly of the gluteal and core muscles that stabilise the hip.
• Walking aids such as a stick used on the opposite side, which meaningfully offloads an arthritic hip.
• Pain relief and anti-inflammatories, and for some people an injection to settle a painful phase.
• Total hip replacement. For end-stage hip osteoarthritis that no longer responds to conservative care, hip replacement is one of the most successful operations in all of medicine, reliably reducing pain and restoring function and quality of life.

The encouraging message is that a lot can be done long before surgery is on the table — and when a hip does eventually need replacing, the results are generally excellent.

Where do regenerative approaches fit?

Regenerative options such as mesenchymal stem cell injections are studied mainly in the knee, and the hip is less well-researched still. Even in the knee, an ESSKA systematic review found that such therapy offers only short-term improvement and that the evidence is limited ², and a 2025 meta-analysis estimated that roughly 63% of the symptomatic benefit people report is down to contextual and placebo effects rather than the cells ³. For the hip specifically, that means regenerative treatment is best viewed as unproven — a considered option for selected cases, never a substitute for rehabilitation or, in advanced disease, for the genuinely effective option of joint replacement. At Cureon it is offered only after assessment, and we set out the field's real limits in our overview of regenerative medicine.

Can you protect your hips?

You cannot prevent every hip problem, but you can stack the odds:

• Keep a healthy weight, since every kilogram is amplified through the hip with each step.
• Build and maintain hip and gluteal strength to support and stabilise the joint.
• Stay active within comfort — movement keeps the joint nourished and mobile, while total inactivity stiffens it.
• Increase activity gradually and respect early aches rather than pushing through them for months.

What we see at the clinic

People are often surprised by how much groin and hip pain improves with strengthening, weight management, and a sensible activity plan — and equally surprised to learn that their "knee" pain is sometimes coming from the hip. We are honest that for advanced hip osteoarthritis, replacement is a highly effective answer, and that no injection reliably regrows a worn hip joint. Where a regenerative approach might suit an earlier, milder case, we assess first and keep expectations realistic.

Common questions

Is groin pain always a hip problem? Groin pain is the classic symptom of hip osteoarthritis, but not the only cause — an assessment sorts the joint from muscle, tendon, and other sources.

Does hip pain ever cause knee pain? Yes. Hip problems can refer pain to the thigh and knee, so persistent knee pain with a normal-feeling knee sometimes turns out to be the hip.

Will I definitely need a hip replacement? No. Many people manage hip osteoarthritis for years with conservative care; replacement is reserved for advanced disease that no longer responds — and when it is needed, it works very well.

Do injections help hip pain? A corticosteroid or other injection can settle a painful flare for some people, usually as part of a broader plan rather than a lasting cure.

Could a stem cell injection fix my hip arthritis? There is no reliable evidence it regrows a worn hip joint, and most of the studied benefit even in the knee appears to be a placebo effect — so treat any guarantee with real caution.

Key takeaway

Most hip pain has a recognisable cause — and where it hurts is the biggest clue. Start with weight management, strengthening, and sensible activity; treat injections as adjuncts, hip replacement as a highly effective option for advanced arthritis, and regenerative treatments as unproven extras decided with a clinician. For the related joints, see our guides to knee osteoarthritis and foot and heel pain.