Where does it hurt?
- Groin and front of the hip: usually the hip joint itself. Common with early osteoarthritis and with irritation of the hip after sport.
- Outside of the hip: often the tendons and bursa around the bony point of the hip, aggravated by lying on that side, stairs and long walks.
- Buttock and back of the hip: frequently referred from the lower back or sacroiliac joint, or from tight buttock muscles. If it runs down the leg, see our sciatica page.
Hips and lower backs are close neighbours and often sore together. Part of the first appointment is working out which one is driving the pain, because treating the wrong one does not help.
What happens at your first appointment
Your first appointment takes about 30 to 40 minutes. It includes:
- Your history. Where the pain sits, how it started, what it stops you doing, and any previous injuries or diagnoses.
- A physical examination. Hip range of motion, strength around the hip and pelvis, tests that load the hip joint and the tendons, and examination of the lower back and sacroiliac joints.
- Posture and gait. Digital posture analysis for adults, and a look at how you walk and stand on one leg.
- An explanation. What we think is going on, what we recommend and what to expect.
- Your first treatment, when clinically appropriate.
If the examination suggests significant osteoarthritis, a stress fracture or a problem that needs imaging, we refer you to your GP.
How we treat hip pain
- Mobilisation of the hip joint and adjustment of the lower back and pelvis where they are stiff or contributing.
- Soft tissue work for the buttock, hip flexor and outer hip muscles.
- A strengthening programme for the hip and buttock muscles, which is the best-supported treatment for most hip problems, including osteoarthritis.
- Advice on sleeping position, stairs, walking distances and the activities that keep stirring it up.
If you have hip osteoarthritis, we work alongside your GP. Exercise and weight management remain the foundation, and we will tell you if we think a specialist opinion is warranted.
When to get hip pain looked at
Hip pain that has lasted more than a fortnight, that is limiting how far you can walk, or that wakes you at night is worth assessing. Sudden hip or groin pain after a fall needs to be seen the same day.
- A fall followed by inability to put weight on the leg, especially if you are over 65 or have osteoporosis (possible fracture).
- A hot, swollen hip with fever, or feeling generally unwell.
- A child or teenager with hip or knee pain and a limp, which needs a GP assessment promptly.
- Numbness around the groin or buttocks, or loss of bladder or bowel control.
What the research says
Research has found that manual therapy delivered by a chiropractor, combined with patient education, can reduce pain from hip osteoarthritis. A trial involving 118 people found that this combination reduced pain more than a minimal intervention involving home stretching. The difference was approximately 1.9 points on a 0 to 10 pain scale after six weeks.
Poulsen, E., Hartvigsen, J., Christensen, H. W., Roos, E. M., Vach, W., & Overgaard, S. (2013). Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial. Osteoarthritis and Cartilage, 21(10), 1494-1503. doi.org/10.1016/j.joca.2013.06.009More on the research we rely on.
ACC and hip injuries
Hip and groin injuries from sport, a fall or a lifting accident may be covered by ACC. We are ACC registered, so no GP referral is needed. Your chiropractor assesses the injury at your first appointment and lodges a claim if it qualifies, or sees you under an existing claim.