Understanding hip pain: osteoarthritis and pain on the side of the hip

A friendly guide to the two most common causes of long-lasting hip pain in adults: hip osteoarthritis and greater trochanteric pain syndrome. Where it hurts, what it means, and why there's hope.

6 min read · last reviewed October 1, 2026

Your hips carry you through every step, every climb up the stairs and every time you get up from a chair. So when a hip starts to hurt, you notice.

This guide explains the two most common causes of hip pain that lasts or keeps coming back in adults: hip osteoarthritis and pain on the outside of the hip (greater trochanteric pain syndrome). The good news: both usually improve with the right kind of exercise, and when hip osteoarthritis is severe, hip replacement works very well.

How your hip works

Your hip is a ball-and-socket joint. The ball at the top of your thigh bone fits snugly into a deep, cup-shaped socket in your pelvis. Smooth cartilage covers both surfaces, so they glide easily. Strong ligaments and big muscles, especially the buttock (gluteal) and thigh muscles, hold the joint steady and move it.

On the outside of your hip is a bony bump you can feel, called the greater trochanter. Tendons from your buttock muscles attach there.

Where does it hurt? A useful clue

• Groin, front of the thigh or deep in the buttock: often the hip joint itself, such as osteoarthritis. The pain can also spread down to the knee.
• Outside of the hip: often the tendons on the greater trochanter.
• Low back and buttock, sometimes down the leg: can come from the lower back.

Your doctor or physiotherapist will put this together with your story and an examination.

Hip osteoarthritis

Osteoarthritis is the most common type of arthritis, and the hip is one of the joints it most often affects. It is more common as we get older, and after past hip problems or injuries.

What happens in the joint? The cartilage becomes thinner and rougher. The bone underneath changes, and small bony bumps can form. The joint lining can get irritated. Over time, the hip can get stiffer, and the muscles around it weaker.

It is not simply "wear and tear." The joint is living tissue that is always repairing itself. Movement and strong muscles help it work better.

Common symptoms:

• Pain in the groin or thigh when walking, standing or climbing stairs
• Stiffness after sitting or first thing in the morning, usually easing within 30 minutes
• Trouble with tasks that need hip bending or turning, like putting on socks and shoes, cutting toenails or getting in and out of a car
• A limp, especially when tired

Symptoms often go up and down. Many people stay about the same for years.

How is it diagnosed? UK guidelines say osteoarthritis can be diagnosed without an X-ray in people aged 45 and over who have activity-related joint pain and little or short morning stiffness. An X-ray is still often used for hips, especially if the cause isn't clear, the symptoms are unusual, or hip replacement is being considered. Remember, how you feel and what you can do matter more than how the X-ray looks.

Something you can do today: Notice which everyday tasks are hardest for your hip. These are good goals to share with your physiotherapist.

Pain on the outside of the hip (greater trochanteric pain syndrome)

This is a common cause of hip pain, especially in women over 40. It used to be called hip bursitis, but we now know it is usually caused by irritated tendons of the buttock muscles (gluteal tendinopathy), sometimes with an irritated bursa too.

How does it feel?

• Pain on the outside of the hip, sometimes spreading down the side of the thigh
• Pain lying on that side at night, and sometimes lying on the other side too
• Pain climbing stairs, getting up from a low chair, or standing on one leg
• Pain after sitting with your legs crossed

What causes it? The tendons are squeezed and loaded in certain positions, such as when your hip drops to the side or your leg crosses your body. A sudden change in activity, weakness of the buttock muscles, and changes around menopause may all play a part.

What helps? A large Australian trial (LEAP) found that education plus a specific exercise programme worked better than a "wait and see" approach, and better than a single steroid injection. The injection gave some short-term relief, but its benefit faded over time. Our treatment guide explains more.

Simple changes can ease it now:

• Avoid crossing your legs and standing with your weight on one hip.
• When lying on your side, put a pillow between your knees.
• Avoid low chairs, or put a cushion on the seat.

Other causes of hip pain

Hip pain can also come from the lower back, hip impingement in younger active adults, stress fractures, or rarely, infection or loss of blood supply to the bone. A broken hip after a fall is an emergency. See the warning signs on our hip pain page.

A hopeful outlook

Whether your pain is from osteoarthritis or tendons, you are not stuck. Exercise, a few smart changes and the right support help most people move more comfortably. And if hip osteoarthritis becomes severe, hip replacement is one of the most successful operations in medicine.

Something you can do this week: Try a simple exercise, such as standing and holding a counter while you slowly lift one leg out to the side, 10 times on each leg.

Questions to ask your care team

• Is my pain coming from my hip joint, the tendons, or my back?
• Do I need an X-ray? Why or why not?
• What exercises should I start with?
• Can you refer me to a physiotherapist or a hip exercise programme?
• What can I do to sleep more comfortably?
• Which signs mean I should come back sooner?

This article is general information, not medical advice. Talk with your health care team about your own situation. In an emergency, call 9-1-1 or your local emergency number.

In an emergency, call 9-1-1 or your local emergency number.

General information, not medical advice. It does not replace your own care team. If you think you or someone else is having a medical emergency, call 9-1-1 or your local emergency number. If you are in crisis or thinking about suicide, call or text 9-8-8 (Canada and the US).

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