Most people put a hand on the side of the pelvis when they say hip. The hip joint sits deeper and further forward, so true hip joint pain is usually felt in the groin, not on the side. That one distinction sorts most cases. The hip pain location diagram below maps eight areas: what each feels like, the likely causes, and what worsens it. Find your area, then read the section under the table.
| Where it hurts | What it usually feels like | Most likely causes | Worse when |
|---|---|---|---|
| Groin and front of hip | Deep ache, catching | Hip osteoarthritis, labral tear, impingement | Standing up, twisting |
| Outer hip, over the bony point | Sore to touch, burning | Greater trochanteric pain syndrome (gluteal tendons) | Lying on that side, stairs |
| Buttock | Deep ache, tightness | Deep gluteal or piriformis problems, sacroiliac joint, referred back pain | Sitting, driving |
| Back of hip and upper buttock | Ache beside the spine base | Sacroiliac joint, lumbar facet joints | Standing, leaning back |
| Front of thigh | Ache spreading toward the knee | Hip joint referral, hip flexor problems, lumbar nerve root | Stairs, lifting the knee |
| Pain travelling down the leg | Shooting, burning, past the knee | Nerve root in the lower back | Sitting, coughing, bending |
| Deep and hard to locate | Vague, out of reach | Joint surface wear, other problems inside the joint | Weight bearing, night |
| Sitting bones | Sore spot where you sit | Hamstring origin tendinopathy, ischial bursitis | Hard chairs, long drives |
Groin and front of the hip
This is where true hip joint pain lands, because the joint sits deep behind the groin crease. Hip osteoarthritis is wear of the cartilage lining the joint. A labral tear damages the ring of cartilage sealing the socket rim. Femoroacetabular impingement means the ball and socket pinch at their edges when the hip bends. All three ache after activity and catch when you rotate the leg or put on socks.
Outer hip, over the bony point
The bony point on the side is the greater trochanter, the top of the thigh bone. Pain there is usually greater trochanteric pain syndrome, previously called trochanteric bursitis, and it usually involves the gluteal tendons anchoring to that bone rather than the fluid sac. It is tender to lie on, worse on stairs and worse after standing on one leg. It is also the area most often mislabelled as arthritis. Our guide to hip exercises you can do at home covers strengthening.
Buttock
Buttock pain rarely comes from the hip joint. Three sources cover most of it: deep gluteal problems, including piriformis irritation where the sciatic nerve passes; the sacroiliac joint, where the base of the spine meets the pelvis; and referred pain from the lower back, felt in the buttock with no back pain.
Back of the hip and upper buttock
Pain beside the base of the spine points to two structures. The sacroiliac joint is usually sore on one side, and many people cover the spot with one finger. The lumbar facet joints, the small paired joints at the back of the spine, hurt more on standing or leaning backwards.
Front of the thigh
Thigh pain often starts elsewhere. The hip joint refers pain down the front of the thigh, sometimes as far as the knee, which is why a knee complaint sometimes turns out to be a hip, as our knee pain location chart explains. Hip flexor problems give a pulling ache high at the front, and a lumbar nerve root, irritated where it leaves the lower spine, can send pain here.
Pain that travels down the leg
Pain running below the knee, particularly if it burns or feels electric, is more likely a nerve root in the lower back than the hip joint. The hip refers pain to the groin, buttock and front of the thigh, but rarely past the knee. Our post on what sciatica feels like sets out that pattern.
Deep pain you cannot pinpoint
Some people cannot point to their hip pain with one finger, and describe something deep and out of reach. That usually means the problem is inside the joint rather than around it: wear of the joint surfaces, or another intra-articular problem, meaning one inside the joint capsule. Deep pain present at rest is worth assessing.
Sitting bones
The sitting bones are the two bony points you rest on in a hard chair. Pain exactly there is usually hamstring origin tendinopathy, irritation where the hamstring tendons anchor to the bone, or ischial bursitis, inflammation of the fluid sac over the same point. It is worse on hard chairs and long drives, and a cushion helps more than stretching.
Hip pain that starts without an injury
Hip pain often begins with no fall and no twist. Most of the conditions above build gradually as tendons and joint surfaces are loaded over months, until ordinary activity provokes them, so what feels sudden is a slow process crossing a threshold. No injury does not mean no cause.
Hip pain from sitting, and hip pain at night
These patterns point in different directions. Hip pain from sitting that eases when you stand suggests the buttock structures, the sacroiliac joint or the lower back, since sitting loads them and unloads the hip joint. Groin pain on standing up suggests the joint itself.
Hip pain at night takes two forms. Pain lying on one side fits greater trochanteric pain syndrome, since body weight presses tender tendons against bone. Deep groin pain that wakes you in any position fits joint wear. Our post on hip pain that radiates down the leg at night goes further.
Where is hip arthritis pain actually felt
Hip arthritis pain is felt mainly in the groin and front of the hip, and it often refers down the thigh toward the knee. It is not usually felt over the outer hip, despite the common assumption. Two other features fit: stiffness after rest that eases as you move, and reduced rotation, noticed putting on socks or getting out of a car.
What can be done about hip pain
Treatment follows a ladder. Load management and strengthening come first: easing what provokes the hip while building the gluteal and trunk muscles lowers the load the joint and tendons absorb. Physiotherapy guides that stage.
When pain persists, a pain clinic adds options. Image-guided injections under ultrasound or fluoroscopy (live x-ray) place medication into the exact structure, which matters in a joint this deep. Hyaluronic acid injections supplement the lubricating fluid in an arthritic hip. Platelet-rich plasma, a concentrated portion of your own blood, is used for selected tendon problems.
For persistent hip arthritis pain in people not ready for, or not suited to, a hip replacement, radiofrequency ablation targets the small sensory nerves supplying the joint. They carry pain messages and control no muscle. Under image guidance, a physician places a fine needle beside them and uses heat from radio waves to interrupt the signal. Nothing is removed and the joint is not operated on.
Warning signs that need urgent care
Most hip pain can wait for a routine appointment. These cannot:
- Inability to put weight on the leg after a fall, which can mean a fracture, particularly in older adults or anyone with osteoporosis (thinning bones).
- A hot, swollen hip with a fever, which can mean joint infection and needs emergency care.
- Hip pain with unexplained weight loss.
- Night pain that does not change when you change position.
- New groin pain after a fall, even if you can walk, since some hip fractures allow walking.
Questions patients ask about the hip pain location diagram
Where is hip arthritis pain felt?
Mainly in the groin and front of the hip, often referring down the thigh toward the knee. Stiffness after rest and reduced rotation are typical, and pain over the outer hip is more often a tendon problem than arthritis.
What does pain in the right hip area mean in women?
The same structures apply on either side and in either sex: hip joint, gluteal tendons, sacroiliac joint and lower back. In women, pelvic causes are also considered when pain sits low and forward, so groin pain with bladder, bowel or menstrual changes should be assessed rather than assumed to be the hip.
Why do I have sudden hip pain with no injury?
Most hip conditions build slowly, then reach a point where ordinary activity provokes them, so the pain feels sudden although the process was not. Pain after a fall, or with fever or weight loss, needs earlier assessment.
Why does my hip hurt after sitting for a long time?
Sitting loads the buttock, sacroiliac joint and lower back while unloading the hip joint, so pain building while seated usually comes from those structures. Groin pain in the first steps after standing points to the joint itself.
This article is general information, not medical advice. It cannot diagnose your pain. If your symptoms are new, worsening, or worrying you, speak with your family doctor or contact us for an assessment.
Getting your hip assessed
An assessment at our Toronto clinic works out which structure is producing your pain, and examines the lower back and pelvis alongside the hip, since both refer pain into it. Options are matched to the cause, not the symptom.
Most services here are covered by OHIP with a physician referral, which your family doctor can send through our physician referral page. You can also refer yourself directly.
