Symptom
Making sense of hip pain together
You get out of the car after a long drive and need a few steps before your hip feels freer again. Or a familiar walk becomes a struggle even though nothing particular has happened. Perhaps the pain is mainly in your groin, or perhaps on the outside of your thigh. In everyday language, ‘hip’ often refers to several different areas.
Possible causes include hip osteoarthritis. Pain on starting to walk and decreasing mobility may fit this pattern. However, groin pain does not automatically mean osteoarthritis. We consider the joint, tendons and other possible causes together.
Open individual sections or all the details on this page.
Which changes need prompt help
Severe pain after a fall, a visibly altered leg or an inability to bear weight need immediate medical assessment. Do not keep walking to see whether it ‘still works after all’. If the injury is serious or you cannot be transported safely, call 112.
Sudden severe hip pain without an accident, particularly with fever or feeling very unwell, should also be assessed immediately. A joint infection cannot be ruled out using a description on a website; fever is not always present. New signs of paralysis or bladder or bowel problems together with back or leg pain are also warning signs requiring immediate help. Do not wait for an online reception reply in these situations.
Understanding
A closer look
We want to work with you to identify which structure is most likely to explain your symptoms. To do this, we consider their onset, the demands placed on the area and the physical examination together. You do not need to know the correct diagnosis or arrange an MRI yourself before your first consultation.
Where the pain is and what it may mean
Pain from the hip joint is often felt at the front, in the groin. It can also spread into the thigh or down to the knee. Symptoms on the outside, for example when lying on the affected side, may instead be associated with tendons or nearby bursae. These patterns offer clues; they do not provide a reliable self-diagnosis.
Symptoms can also radiate into this area from the back. We therefore ask about back pain, tingling and numbness and examine neighbouring areas where necessary. Groin pain can also have causes outside the musculoskeletal system. If the findings point in another direction, we discuss the appropriate further assessment with you.
Further information
What the course of your symptoms tells us
It matters whether the pain began after an injury, followed an unfamiliar activity or developed over months. Also tell us whether the first steps are difficult, whether the pain increases on a longer walk and how the hip feels at rest.
Activities that you now avoid are important too. Perhaps you have started cancelling walks or only choosing shoes you can put on without bending down. When these adjustments become part of everyday life, it is easy to underestimate the extent of the limitation. We want to know what you are missing and what you would like to be able to do again.
How we examine the hip
Among other things, we assess how you walk, which movements are possible and what brings on your familiar pain. Depending on the question, this may include muscle strength, tenderness and examination of the back or knee. One painful movement alone does not determine the diagnosis.
During the examination, tell us whether you recognise your usual pain or whether something feels different. The range of a movement is meaningful only in the context of your situation. A movement goal for a longer walk may differ from one for a particular sport.
When imaging is helpful
X-rays can show bone changes and signs of osteoarthritis. Ultrasound helps answer selected questions about fluid collections or soft tissues. MRI or CT can provide additional information when there is a further question to answer; we arrange these scans externally. Not every investigation is needed for every case of hip pain.
Bring existing images and reports. We consider them alongside the examination and discuss which findings may explain your symptoms. An abnormal imaging finding does not automatically tell us how much your everyday life is affected. Equally, substantial symptoms deserve assessment even when a previous report describes few abnormalities.
Activity before the next steps are agreed
If there is no acute injury or other urgent cause, avoiding all movement is often not the aim. Initially, it may help to modify activities that strongly trigger symptoms and divide activity into shorter, manageable periods. Which movements are suitable for you depends on the findings, however.
A general exercise plan cannot replace this assessment. Do not force a clearly painful joint into a movement. Instead, note which activity causes symptoms and how long they last afterwards. This helps us tailor a recommendation more closely to your daily life.
What to expect and next steps
What may change after assessment
Treatment depends on the cause. A joint condition may call for different steps from tendon irritation or symptoms originating in the back. We explain the aim of any proposed measure and which observations will help us review progress.
Depending on the findings, non-surgical care may include movement and exercise advice, suitable aids and, where appropriate, pain relief medication. Any necessary physiotherapy is considered following medical assessment. An injection is not indicated simply because the hip hurts. Before any additional treatment, its aim, suitability, risks and alternatives must be clarified.
How we decide on the next step
Earlier reports, a medication list and your experience of previous measures are helpful for the consultation. Also describe what did not help or was not practical for you. A recommendation should fit your circumstances, for example if you spend much of your working day standing or care for relatives.
Under ‘Appointments & enquiries’, you can choose the appropriate contact route. Mention when the symptoms began and the main limitations. For other urgent concerns that are not immediately life-threatening, access to the acute clinic can be discussed in advance. If you have difficulty using the online route, arrangements can be made by phone. Routine booking does not replace emergency care.
Our doctors in this specialty
Priv. Doz. Dr. med. habil.Richard Kasch
Specialist in orthopaedics and trauma surgery
View profile
Dr. med.Christoph Jährling
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profile
Björn Weidemann
Specialist in orthopaedics and trauma surgery
DVO-certified osteologist
View profileHere you can see which of our doctors assess your symptoms. Your questions and the difficulties you experience in everyday life help guide the assessment.
Frequently asked questions
Can hip pain spread as far as the knee?
Yes. Pain originating in the hip joint can be felt as far down as the knee. An additional hip examination may therefore be useful for knee pain. This does not mean that knee pain always comes from the hip.
Is pain when lying on my side always osteoarthritis?
No. Tendons and structures on the outer side can also cause symptoms. The likely cause cannot be identified from your sleeping position alone.
Will I definitely need an MRI?
No. The medical question comes first. Your description, examination and, where appropriate, X-rays often help. MRI is used if it can answer an additional relevant question.
Can I continue going for walks with hip pain?
Severe unexplained symptoms or new symptoms first need an assessment of their cause. After that, we can establish an appropriate level of activity. A diagnosis of osteoarthritis does not automatically mean you have to give up walking.
What should I mention if I already have a hip replacement?
Mention the operation when contacting us and bring any available reports. New severe pain, fever or a sudden reduction in your ability to bear weight need prompt medical assessment.
Your next step
