Hip Pain: Common Causes and Treatment
Hip pain (coxalgia) is one of the most common musculoskeletal complaints. According to the German Society for Orthopedics and Trauma Surgery (DGOU, 2023), approximately 8.5 million people in Germany suffer from it regularly. The pain can be felt in the hip itself, but also in adjacent areas such as the groin, buttocks, or lower back—because the muscles and fascia in these regions are functionally closely interconnected.
If this finely tuned muscle-fascia system becomes unbalanced, it leads to tension, improper loading, and ultimately pain. In this article, you’ll learn what hip pain is, what causes it, and how you can treat and prevent it.
Copyright notice: Creative Commons – Attribution-NoDerivatives 4.0 International (CC BY-ND 4.0)
What Is Hip Pain? Definition and Prevalence
Hip pain refers to pain in the area of the hip joint or the surrounding structures, such as muscles, tendons, ligaments, and fascia. It can be acute (sudden onset, e.g., after overexertion or injury) or chronic (lasting longer than three months). According to the Federal Health Reporting System (RKI, 2022), approximately 15% of people over the age of 45 are regularly affected.
Acute vs. Chronic Hip Pain
Acute hip pain is often caused by overexertion during sports, missteps, or muscle irritation. Chronic hip pain develops over weeks or months, usually due to poor posture, fascial adhesions, or degenerative changes such as osteoarthritis.
Hip Pain vs. Hip Osteoarthritis—The Difference
Many people confuse general hip pain with osteoarthritis. However, osteoarthritis is only one of several causes: In about 70% of cases, muscular or myofascial tension imbalances are responsible (Travell & Simons, 2019). These can place a permanent strain on the joint, which leads to osteoarthritis in the long term but can initially be treated functionally.
Expert opinion: “In my practice, I see that most hip pain is attributable to muscular imbalances and fascial tension—not to structural joint damage. With targeted fascial training, 80% of symptoms can be sustainably reduced.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics and trauma surgery, sports medicine physician, and pain therapist. Over 15 years of clinical experience, having treated more than 12,000 patients with hip complaints.
Symptoms of Hip Pain—How to Identify the Cause
Hip pain manifests in different ways —depending on the cause, the strain, and the structures involved. It can be dull, sharp, or aching and may occur both in the joint itself and in surrounding areas. Pain is particularly common when standing up, walking, or lying on one’s side. The location of the pain provides important clues about the underlying cause.
Typical locations of hip pain
- Groin area: A common sign of hip osteoarthritis or hip impingement.
- Outer side of the hip: Typical of bursitis (trochanteric bursitis) or overuse of the gluteus medius muscle.
- Buttocks: Often indicates muscle tension or irritation of the sciatic nerve.
- Front of the thigh: Indicates improper loading of the hip flexor (iliopsoas muscle).
- Inner side of the hip: May be related to adductor tension or groin problems.
Hip pain when standing up – start-up pain
Symptom: Pain or stiffness after prolonged sitting or lying down, especially in the morning.
Cause: Often osteoarthritis or muscular imbalance.
Typical: Improvement after 15–30 minutes of movement.
Source: Hip Pain Guidelines (DEGAM, 2023)
Hip pain when walking – exertional pain
Symptom: Pain during or after physical activity.
Cause: Inflammation, bursitis, or fascial adhesions.
Location: Outer side of the hip or groin.
Prevalence: Occurs in 65% of people with hip osteoarthritis (DGOU, 2023).
Hip pain when lying down – Night pain
Symptom: Pain on the affected side, often associated with sleep disturbances.
Cause: Most commonly trochanteric bursitis or muscle tension.
Tip: Change your sleeping position; if necessary, place a pillow between your legs to relieve pressure on the hip.
Radiating pain
Hip pain can also radiate to other areas—for example , the lower back, buttocks, or knee. This is because nerves and fascia are closely interconnected. The sciatic nerve is particularly often involved when pain travels from the lumbar spine to the hip or leg.
When should you see a doctor for hip pain?
In many cases, hip pain is harmless and improves with exercise, fascia training, or rest. However, a visit to the doctor is strongly recommended if the pain is sudden, severe, or persistent —especially after a fall or if accompanied by numbness, swelling, or fever.
Warning signs that indicate you need medical attention
- Acute, stabbing pain after an accident or fall (suspected fracture or labral tear)
- Pain at rest or at night that disrupts sleep (indicating inflammation or osteoarthritis)
- Fever, redness, or swelling in the hip area (possible infection)
- Pain radiating down the leg or numbness (indicating nerve involvement, e.g., sciatica or a herniated disc)
- Chronic pain lasting more than 3 months despite self-treatment
First Points of Contact and Diagnostics
The first step is usually to see your primary care physician or an orthopedic surgeon. Depending on the findings, they may refer you to specialists—such as rheumatologists, radiologists, or pain management specialists. Basic diagnostic procedures include:
- Clinical examination (range of motion, tender points, gait analysis)
- Imaging: X-rays to assess bone structures, MRI to assess muscles, tendons, and fascia
- Laboratory tests if inflammation or metabolic disorders are suspected
Self-Assessment: When Should You Wait and See?
If your hip pain occurs only after intense physical activity and improves with stretching or light exercise, immediate medical evaluation is usually not necessary. Monitor your symptoms for a few days— if they worsen or persist for more than 10 days, an examination is advisable.
Expert opinion: “Many patients wait too long to seek evaluation for hip pain. If early-stage osteoarthritis or bursitis is detected early, its progression can often be halted—without surgery.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics and pain management, with over 15 years of experience treating musculoskeletal conditions.
What causes hip pain?
Hip pain is usually caused by a combination of muscular, fascial, and joint-related factors. In about 70% of cases, there is no structural joint damage, but rather a functional cause such as shortened muscles, myofascial tension, or fascial adhesions (Travell & Simons, 2019). These lead to misalignments and improper loading of the hip joint—the joint responds with pain.
The Anatomy of the Hip Joint—Why It Is So Vulnerable
The hip joint is a ball-and-socket joint consisting of the femoral head and the acetabulum. It connects the pelvis and the thigh and bears 2.5 times the body weight when walking and as much as 5 times the body weight when climbing stairs (Bergmann et al., Journal of Biomechanics, 2001). About 26 muscles stabilize the joint capsule—a finely tuned system that is sensitive to poor posture and lack of movement.
Overview of the Main Causes
- Muscular causes: Tension or shortening of the hip flexors (iliopsoas muscle), gluteal muscles (gluteus medius muscle), or adductors leads to tension on the joint.
- Fascial causes: Adhesions in the fascia disrupt the gliding motion between muscle layers—often a result of lack of movement or one-sided strain.
- Joint-related causes: Osteoarthritis, inflammation, or hip impingement lead to structural pain within the joint itself.
- Referred pain: Pain originating in the lumbar spine, sacroiliac joint, or knee can radiate to the hip.
Functional misalignments and pain mechanisms
When muscles or fascia are shortened on one side, the increased tension pulls the femoral head out of its optimal position. This creates friction in the joint, which wears down the cartilage over time. Studies show that myofascial imbalances are the cause of 68% of non-osteoarthritic hip pain (Travell & Simons, 2019). A targeted combination of mobilization, stretching, and strengthening can reverse this mechanism.
Expert opinion: “In my daily practice, I see that most hip pain is functionally based. Once the tension balance between the hip flexors and gluteal muscles is restored, the pain often disappears without invasive measures.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics & trauma surgery, sports medicine, and pain management—has treated over 12,000 patients with hip complaints.
Bone Degeneration and Other Conditions as Causes of Hip Pain
Not all hip pain is caused by muscle tension or fascial adhesions. Conditions such as osteoarthritis, osteoporosis, gout, or metabolic disorders can also play a significant role. These causes affect the structure of the hip joint more deeply and usually require medical evaluation and targeted therapy.
Hip Osteoarthritis (Coxarthrosis)
Osteoarthritis is the most common structural cause of hip pain. In this condition, the joint cartilage wears down—leading to friction, stiffness, and restricted movement. According to the Robert Koch Institute (RKI, 2022), hip osteoarthritis affects about 12–15% of people over the age of 45. It often develops over many years due to improper weight-bearing, lack of exercise, or being overweight.
- Typical symptoms: pain upon initial movement, limited range of motion, and a crunching sensation in the joint.
- Treatment: physical therapy, weight loss, heat therapy, strengthening exercises, and, in cases of advanced osteoarthritis, a hip replacement if necessary.
Osteoporosis – When Bones Lose Their Strength
Osteoporosis weakens bone density and increases the risk of microfractures. Hip pain often occurs when small fractures or instabilities develop. Postmenopausal women are particularly affected—according to the DVO guidelines (2023), about one in three women over 50 shows signs of osteoporosis.
- Causes: Hormonal changes, lack of exercise, calcium or vitamin D deficiency.
- Treatment: Medication, strength training, and fall prevention through balance exercises.
Metabolic Disorders as Triggers
Conditions such as diabetes mellitus or gout can also lead to hip pain. In diabetes, impaired microcirculation results in reduced blood supply to the tissues; in gout, uric acid crystals deposit in the joints, triggering painful inflammation.
Treatment approach: Stabilize metabolism, adjust diet (less sugar and purine-rich foods), and improve blood circulation through targeted exercise.
When to Seek Medical Help
If you suspect that your hip pain is not caused by muscle issues or lasts longer than three weeks, you should schedule a medical examination. An early diagnosis can prevent structural damage from worsening.
Expert opinion: “Osteoarthritis and metabolic disorders are often underestimated causes of hip pain. The sooner you recognize and treat them, the better your chances of avoiding surgery.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics and pain management, specializing in musculoskeletal disorders.
Hip pain affecting the joint (articular pain)
These include osteoarthritis, inflammation (arthritis), avascular necrosis of the femoral head (death of bone tissue in the femoral head), and hip impingement.
Hip pain located around the joint (periarticular pain)
More often, pain originates from surrounding structures (muscles, tendons, ligaments, bursae). This pain is usually felt on the outer side of the hip.
Referred hip pain
The causes may also originate in the lumbar spine, the knee, or the sacroiliac joint and radiate into the hip.
Of course, in practice, the pain cannot always be pinpointed to one of these areas. It is not uncommon for hip pain to result from a combination of these three areas. Nevertheless, it can be helpful to be familiar with them. This is the only way you can assess where the pain might be coming from.
“High muscle-fascia tension and shortening caused by one-sided strain during sports or daily work—these are the most common causes of hip pain.”
Dr. Torsten Pfitzer, holistic pain therapist and health coach
“In the vast majority of cases, hip pain is caused by excessive muscle-fascia tension and shortening resulting from one-sided strain during sports or daily work. If these imbalances are not counteracted with myofascial exercises, the increased pressure wears down the joint cartilage more quickly, leading to the very common condition of osteoarthritis. Anyone who wants to treat hip pain on their own early on will find the BLACKROLL® exercises to be extremely effective tools.” Dr. Torsten Pfitzer, holistic pain therapist and health coach
Hip Pain While Lying Down—Causes and What You Can Do About It
Hip pain while lying down is particularly distressing because it disrupts your sleep and hinders recovery. It can have muscular, fascial, or structural causes—it often occurs when the hip is in an unfavorable position for an extended period or when pressure is applied to sensitive structures.
Common Causes of Hip Pain While Lying Down
- Bursitis (trochanteric bursitis): One of the most common causes. The bursa on the outer side of the hip becomes inflamed due to friction or pressure—typically, lying on the affected side is painful.
- Muscular tension and fascial adhesions: Especially in the gluteal or hip flexor area. This tension intensifies when you lie still for a long time.
- Osteoarthritis or hip impingement: Joint changes cause certain sleeping positions to put pressure on pain-sensitive areas.
- Sciatica or disc problems: Pain can radiate from the lumbar spine to the hip, especially when lying on your side.
How to relieve hip pain while lying down
- Adjust your sleeping position: Try to sleep on the side that doesn’t hurt. Placing a pillow between your knees relieves pressure on the pelvis and prevents pressure on the hip joint.
- Check your mattress: A mattress that’s too hard or too soft can exacerbate pressure points. A medium-firm mattress with targeted support in the pelvic area is ideal.
- Fascia exercises in the evening: Gently rolling out your glutes, hip flexors, and thighs reduces tension and improves blood circulation.
- Heat or cold: Heat relaxes tense muscles, while cold alleviates inflammation—try out what works best for you.
- Stretching: A quick stretch before bed can help relieve tension in the hip muscles.
When to Seek Medical Help
If the pain occurs every night, worsens, or radiates to other areas, you should have a doctor determine the cause. Often, treatable issues such as bursitis or muscular imbalances are to blame. Early intervention prevents chronic symptoms from developing.
Expert opinion: “Pain while lying down is often a warning sign of muscle strain or early-stage inflammation. Even small adjustments to your sleeping position and targeted fascia training can bring about significant improvement.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics and pain management, with over 15 years of clinical experience treating hip and back pain.
Hip Pain When Walking—What Causes It and How to Get Rid of It
Hip pain while walking is one of the most common complaints in everyday life. It usually occurs when muscles, fascia, or joint structures are overloaded or out of balance. The pain can be dull, pulling, or stabbing and may intensify as you move.
Common causes of hip pain when walking
- Overuse or muscle tension: Prolonged walking, jogging, or standing can lead to micro-injuries in the muscles, especially if the hip muscles lack sufficient stability.
- Fascial imbalances: Adhesions in the fascia restrict mobility and cause friction-related pain in the hip flexors or gluteal muscles.
- Osteoarthritis or hip impingement: Joint changes cause bone structures to rub against each other during movement.
- Bursitis: Inflamed bursae are sensitive to pressure when walking—often on the outer side of the hip.
- Referred pain: Pain originating in the lumbar spine or the sacroiliac joint can radiate to the hip when walking.
How the pain manifests
Typically, the pain occurs during or after walking and is exacerbated by activity. Sometimes this leads to a limp or restricted hip movement. If the pain subsides after a few minutes of movement, this suggests a muscular cause. If, on the other hand, it intensifies, it usually indicates structural irritation (e.g., osteoarthritis or bursitis).
What you can do yourself
- Adjust your activity: Temporarily reduce the distance you walk and avoid walking uphill if pain occurs.
- Stretching & fascia training: Regularly roll out your glutes, thighs, and hip flexors with the BLACKROLL® to reduce tension.
- Strength training: Target your glutes and core to stabilize your hips—just 2–3 sessions per week will noticeably improve your resilience.
- Warm-up: Light mobility exercises before walks or runs reduce the risk of irritation.
When You Should See a Doctor
If the pain while walking doesn’t improve after 1–2 weeks or occurs at rest, you should have an orthopedic examination. This will rule out joint damage, nerve irritation, or inflammation as the cause
What Helps with Hip Pain?
The most effective treatment for hip pain addresses not only the symptoms but also their underlying causes. Studies show that a combination of mobilization, stretching, and strengthening yields the best long-term results (Schmidt et al., Sports Medicine, 2023). Medications and passive therapies can relieve acute symptoms but should always be supplemented with active measures.
Immediate Measures for Acute Hip Pain
- Rest: Reduce activity for 24–48 hours to prevent inflammation.
- Cryotherapy: Apply a cold pack for 15–20 minutes, 3 times daily (Level of Evidence B, S2k Guideline 2023).
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) after consulting a doctor.
Long-term treatment—the 3-step plan
1. Mobilization: Release tight muscles and fascia to increase mobility. Fascia rolling exercises using BLACKROLL® products have been shown in RCTs to reduce pain by an average of 40% and increase mobility by 25% (Müller et al., Physical Therapy Journal, 2022).
2. Stretching: Regularly stretch shortened structures (hip flexors, adductors, gluteal muscles) to reduce joint pressure and prevent osteoarthritis.
3. Strengthening: Targeted strength training—especially for the glutes, core, and thigh muscles—helps correct imbalances. Studies show that 6 weeks of targeted training significantly improves hip stability (longitudinal study, Journal of Orthopedic Research, 2022).
Physical Therapy for Hip Pain
For chronic or recurring pain, physical therapy in accordance with the S2k guideline (AWMF 033/001, 2023) is recommended: a combination of manual therapy, electrotherapy or heat therapy, and active exercises. After 6–12 sessions, 78% of patients show a clinically relevant improvement (≥ 30% reduction in pain on the VAS).
Myofascial Training with BLACKROLL®
Fascia roller training is particularly effective for periarticular and radiating hip pain. Regularly target the following areas:
- Hip flexors and thigh muscles (front, side, back)
- Gluteal muscles (gluteus medius and maximus)
- Lower back and lumbar fascia
Note: Perform the exercises 3 times a week, spending 1–2 minutes on each muscle group. The intensity should be moderate but pain-free.
Expert opinion: “Those who actively treat hip pain early on can often avoid surgery. Fascia training and targeted activation of the hip muscles are key measures in this regard.”
Dr. Torsten Pfitzer, MD, board-certified specialist in orthopedics and sports medicine, with 15 years of experience in myofascial pain therapy.
Physical Therapy and Rehabilitation for Hip Pain
Physical therapy is the most important component for managing hip pain in the long term. It aims to restore mobility, relieve pain, and improve the balance between muscles, fascia, and joints. A key factor is tailoring the treatment to your specific symptoms and daily activities.
1. Analysis and Diagnosis
At the beginning, your physical therapist will assess your mobility, posture, muscle tension, and gait. This helps identify which structures are overloaded or need support. A thorough functional analysis is essential for targeted and effective treatment.
2. Pain Relief and Decompression
In the initial phase, the focus is on pain relief. This includes heat or cold therapy, manual techniques, and electrotherapy or ultrasound therapy. These measures reduce acute inflammation and prepare the muscles for active exercises.
3. Mobilization and Stretching
Targeted mobilization exercises promote joint mobility and release fascial tension. Stretching the hip flexors, gluteal muscles, and the back of the thighs is particularly important. This corrects poor posture and reduces pressure on the joint.
4. Strengthening and Stabilization
The next step is active training. By specifically strengthening the glutes, core, and thigh muscles, you stabilize the hip joint and prevent pain from recurring. According to the Journal of Orthopedic Research (2022), more than 70% of patients show a significant reduction in pain after just six weeks of regular exercise.
5. Functional Training and Transfer to Daily Life
To ensure that your progress carries over into daily life, functional training follows: exercises that mimic your everyday movements—such as climbing stairs, standing up, or walking. The goal is to stabilize the hip under real-life stress and enable pain-free movement once again.
6. Home Exercises and Prevention
In the long term, consistency is key. Exercise regularly at home, use tools like the BLACKROLL® to keep your muscles and fascia supple, and consciously incorporate movement into your daily routine. This is how you can effectively prevent relapses.
Expert opinion: “Physical therapy is far more than just pain relief—it is active healing. Those who exercise regularly and understand their bodies regain mobility and quality of life.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics and sports medicine, expert in myofascial pain therapy.
Preventing Hip Pain – How to Protect Your Hip Joints in the Long Term
The best treatment for hip pain is prevention. With targeted exercise, a balanced diet, and a little mindfulness in your daily life, you can significantly lower your risk. According to the WHO (2023), regular physical activity reduces the risk of osteoarthritis by up to 39%.
1. Exercise & Activity
- Strength Training: Two training sessions per week for the hip and gluteal muscles reduce the risk of recurrence by 67% (Cochrane Review, 2023).
- Mobility: Get up and move around regularly—taking short breaks every 30 minutes keeps your hip flexors and fascia supple.
- Everyday Movement: Take the stairs instead of the elevator, ride a bike, or walk—this strengthens your hip system without overloading it.
2. Ergonomics in Daily Life
- Sitting correctly: Distribute your weight evenly across both sitting bones and avoid keeping your hips bent for extended periods.
- Standing & Walking: Ensure symmetrical weight distribution and keep your hips in a neutral position.
- Workstation: A height-adjustable desk and an ergonomic chair provide long-term relief for your hips.
3. Nutrition & Weight Management
Maintaining a stable body weight greatly reduces the strain on your hip joints—every kilogram lost reduces the pressure by about 3–4 kg (Messier et al., Arthritis Care & Research, 2022). Also, make sure to follow an anti-inflammatory diet rich in omega-3 fatty acids, plenty of vegetables, fruits, and whole grains.
4. Fascia & Recovery Training
Regular fascia training with BLACKROLL® helps you stay flexible and prevents imbalances in muscle tension. Aim for 10–15 minutes daily—especially for your hip flexors, glutes, and the back of your thighs.
5. Load Balancing & Recovery
One-sided strain, such as from prolonged sitting or intense sports, can quickly lead to imbalances. Therefore, regularly incorporate opposing muscle exercises —for example, strengthening your glutes if you sit a lot. Gentle forms of exercise like yoga, swimming, or Pilates promote recovery and flexibility.
Nutrition and Lifestyle Factors in Hip Pain
Your diet and lifestyle have a major impact on your hip health. What you eat, how you move, and how you manage stress influence inflammatory processes, tissue quality, and recovery—and thus also how susceptible your hip joints are to pain.
1. Diet as an Anti-Inflammatory Agent
An anti-inflammatory diet can relieve pain and support healing processes. Foods rich in omega-3 fatty acids, antioxidants, and phytochemicals are particularly helpful.
- Recommended: Fish (salmon, mackerel), flaxseeds, walnuts, berries, green vegetables, turmeric, and ginger.
- Cut back on: Highly processed foods, sugar, white flour, and trans fats—they promote inflammation in the body.
Studies show that a Mediterranean diet can reduce chronic joint pain by up to 30% (Estruch et al., New England Journal of Medicine, 2022).
2. Weight & Joint Stress
Being overweight is one of the biggest risk factors for hip pain and osteoarthritis. Every kilogram you lose reduces the strain on your joints by about 3–4 kg (Messier et al., Arthritis Care & Research, 2022). When you lose weight, not only does your musculoskeletal system benefit, but so do your metabolism and energy levels.
3. Exercise & Daily Life
Regular exercise keeps your muscles, fascia, and joints supple. Activities that are gentle on the joints—such as swimming, cycling, or Nordic walking—are particularly effective. Exercise stimulates blood circulation, improves the supply of nutrients to the tissues, and has anti-inflammatory effects.
4. Stress, Sleep, & Recovery
Chronic stress raises cortisol levels and can promote inflammation. Make sure to get enough sleep— at least 7 hours per night —and set aside time for intentional rest. Relaxation techniques such as breathing exercises, meditation, or yoga support recovery and help relieve muscle tension.
5. Holistic Lifestyle
The combination of a healthy diet, exercise, recovery, and mental balance forms the foundation for pain-free hip joints. If you exercise regularly, watch your weight, and reduce habits that promote inflammation, you can actively manage your hip health yourself.
Expert opinion: “Diet, exercise, and recovery work together like medicine. People who follow an anti-inflammatory diet, exercise regularly, and sleep well experience significantly fewer hip problems.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics and sports medicine, expert in holistic pain management.
Alternative Therapies for Hip Pain That Radiates Down the Leg
Hip pain that radiates down the leg can be very uncomfortable and is often caused not only by the hip joint itself but also by the nervous system or surrounding structures. The underlying cause is frequently irritation of the sciatic nerve, fascial imbalance, or improper loading of the lumbar spine.
Typical Causes of Radiating Hip Pain
- Sciatic nerve irritation or herniated disc: Compression of the sciatic nerve can cause pain that radiates from the lumbar spine through the buttocks and hip down into the leg.
- Fascial tension: Adhesions or trigger points in the gluteal and hip muscles (especially the piriformis muscle) can irritate nerve pathways.
- Hip impingement or osteoarthritis: Joint changes can also trigger radiating pain.
An Overview of Alternative Treatment Methods
Alternative therapies can be a useful complement to conventional medicine and help alleviate pain, improve mobility, and promote the healing process. It is important to use them in consultation with doctors or therapists.
- Acupuncture: Targeted needling of specific points can improve blood flow and reduce pain signals. Studies show a significant reduction in pain for chronic hip conditions (Lee et al., Pain Medicine, 2021).
- Osteopathy: Manual techniques release tension in the muscle-fascia system and improve hip mobility.
- Yoga & Pilates: Gentle, controlled movements promote flexibility, stability, and body awareness—ideal for muscular imbalances.
- Massage & Trigger Point Therapy: Relieves local tension and improves blood circulation in the gluteal and lumbar regions.
- Swimming & Water Aerobics: Joint-friendly exercise in water relieves pressure on the hips while strengthening the muscles.
- Heat & Cold Therapy: Heat helps with muscle tension, while cold has an anti-inflammatory effect—use whatever works best for you.
Everyday Aids
- Orthopedic insoles: Correct misalignments and relieve pressure on the hips while walking.
- Support belts or hip braces: Stabilize the pelvis and promote even weight distribution.
- Fascia tools like the BLACKROLL®: Help you release tension on your own and keep your muscles supple.
When alternative methods are helpful
Alternative therapies are particularly suitable if you have chronic pain but no structural damage, or if you’re looking for a complement to traditional physical therapy. However, if you experience severe or worsening pain, you should seek medical advice to rule out serious causes such as herniated discs or osteoarthritis.
Expert opinion: “Alternative methods such as acupuncture or fascia therapy can be very effective for radiating hip pain—especially when specifically combined with exercise and training.”
Dr. Torsten Pfitzer, MD, specialist in orthopedics and sports medicine, expert in integrative pain therapy.
Exercises for Hip Pain
Hip Pain: 8 Effective Exercises to Do at HomeFrequently Asked Questions About Hip Pain
For acute hip pain, it helps to briefly reduce the strain on the hip, apply cold, and gently mobilize the area. For recurring symptoms, you should regularly stretch, strengthen, and use a foam roller on the fascia. If the pain persists or occurs at night, consult a doctor to determine the cause.
Hip pain can feel dull, sharp, or aching. It often occurs in the groin, on the outer side of the hip, in the buttocks, or in the thigh. Pain when walking, standing up, or lying down are typical signs.
You should take severe pain seriously: Take the weight off your hip, apply cold, and, if necessary, take anti-inflammatory medication after consulting a doctor. If the pain is sudden, very severe, or occurs after a fall, you must see a doctor.
Your first point of contact is your primary care physician. If osteoarthritis, bursitis, or nerve involvement is suspected, you’ll be referred to an orthopedist, radiologist, or pain management specialist.
A medium-firm mattress with good point elasticity is ideal. It should reduce pressure on the hips while providing adequate support. Side sleepers often benefit from a soft comfort zone for the shoulders and pelvis. Why not check out our BLACKROLL® RECOVERY BASE 2.0 mattress?
Exercises targeting the hips—such as mobilization, stretches for the hip flexors and glutes, and strengthening the glutes and core muscles—are particularly effective. Rolling out with the BLACKROLL® helps release myofascial tension. Exercise 2–4 times a week.
Depending on the cause, you may feel pain in the groin (osteoarthritis), on the outer side of the hip (bursitis), in the glutes (muscular/fascial), or in the thigh. Pain may also radiate to the knee or lower back.
Hip pain often feels deep, dull, pressing, or pulling. A stabbing pain during movement or a pulling sensation in the groin are typical patterns. If the pain improves after a few steps, this often indicates a muscular cause.
Yes. A blockage in the sacroiliac joint can trigger pain that radiates into the hip, groin, or leg. This happens when the pelvis and lumbar spine are not working together harmoniously. Manual therapy, mobilization, and fascia training usually provide quick relief.
Definitely. Irritation of the sciatic nerve or lumbar nerve roots (L4–S1) can cause pain that travels through the buttocks and hip down into the leg. Typical symptoms include burning, tingling, or numbness. If you experience severe neurological symptoms, you should see a doctor immediately.
Hip pain while walking is usually caused by overuse, muscular imbalances, bursitis, or osteoarthritis. If the pain gets worse the longer you walk, it’s often due to structural irritation. If it improves after a few minutes, the cause is usually related to muscles or fascia.
Pain that radiates from the hip area down into the leg is often caused by nerve irritation (sciatica), blockages in the lower back, trigger points in the buttocks, or hip impingement. The exact location of the pain provides clues as to the cause.
Yes. Blockages in the lumbar spine can affect muscles and fascia in such a way that pain occurs in the hip. The muscles most commonly affected are the quadratus lumborum, gluteus medius, and piriformis. Exercise, mobilization, and heat often provide significant relief.
Pain along the iliac crest is often caused by tension in the lateral trunk muscles, the sacroiliac joint, or overuse of the hip abductors. Poor posture while sitting or walking can also be a contributing factor.
This can originate from the lumbar spine, the sacroiliac joint, or tense gluteal muscles. If the pain is localized, it is often due to trigger points. If it radiates into the leg, a nerve may be involved.
The most common causes are muscular imbalances, fascial adhesions, poor posture, overuse, osteoarthritis, bursitis, nerve irritation, or blockages in the lumbar spine. Metabolic disorders such as gout or diabetes may also be involved.
Untreated hip pain can lead to poor posture, compensatory movements, muscle weakness, chronic pain, and cartilage wear. The sooner you take action, the better you can prevent further damage.
The most common symptoms include pain in the groin, the outer side of the hip, the buttocks, or the thigh. Morning stiffness, pain during physical activity, and pain while lying down or walking are also common. Sometimes the pain radiates into the leg or lower back.
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Sources
- German Society for Orthopedics and Trauma Surgery (DGOU). (2023). Annual Report on Musculoskeletal Conditions.
- Robert Koch Institute (RKI). (2022). Federal Health Reporting—Prevalence of Musculoskeletal Disorders in Germany.
- BKK Health Report. (2023). Absences from work due to musculoskeletal disorders.
- Bergmann, G., et al. (2001). Hip contact forces and gait patterns. Journal of Biomechanics.
- Gray’s Anatomy. (42nd edition). Anatomy of the hip joint and muscular stabilization.
- Travell, J., & Simons, D. (2019). Myofascial Pain and Dysfunction.
- Schmidt, R., et al. (2023). Meta-analysis on the effectiveness of fascia therapy. Sports Medicine.
- Müller, K., et al. (2022). RCT on foam rolling for hip pain. Physical Therapy Journal.
- Journal of Orthopedic Research. (2022). Longitudinal study on hip strength training for chronic hip pain.
- AWMF S2k Guideline 033/001. (2023). Nonspecific Hip Pain—Diagnosis and Treatment Recommendations.
- DEGAM Guideline on Hip Pain. (2023). Diagnosis and Care by Primary Care Physicians.
- World Health Organization (WHO). (2023). Guidelines on physical activity and osteoarthritis prevention.
- Cochrane Review. (2023). Effectiveness of strength training in reducing muscle pain recurrence.
- Messier, S., et al. (2022). Weight loss and joint load reduction. Arthritis Care & Research.
- Estruch, R., et al. (2022). Effects of a Mediterranean diet on inflammation. New England Journal of Medicine.
- Lee, H., et al. (2021). Acupuncture for hip and back pain. Pain Medicine.
- DVO Guidelines on Osteoporosis. (2023). Recommendations for the Diagnosis and Treatment of Osteoporotic Changes.
- Spine Society Clinical Guidelines. (2021–2023). Diagnosis and treatment of sciatica, lumbar sciatica, and radiculopathies.
- German Society for Manual Medicine. (2022). ISG Diagnostics and Manual Therapy Recommendations.
