Every day, people visit orthopedic surgeons complaining of hip pain but often, what they’re feeling isn’t coming from the hip joint at all. Surprised? It’s because what many people refer to as their “hip” is actually a different part of the body.
The hip joint is a ball-and-socket joint located deep in the groin, where the femur (thigh bone) meets the pelvis. Most people, however, point to the outer side of their hip—near the beltline or where a police officer’s holster might sit, when asked about hip pain. This misunderstanding is what leads us to distinguish between true hip pain (originating in the joint) and false hip pain (coming from nearby structures like the back or soft tissues).
True Hip Pain
True hip pain is usually felt in the groin and occasionally in the thigh or knee due to referred pain. (Referred pain is when pain is felt in a part of the body that is different from the actual source of the problem.) It’s often accompanied by limping and limited range of motion, making it difficult to bend, tie shoes, or pick things up off of the ground.
Common Causes of Hip Pain (True Hip Pain)
The most common cause of hip joint pain is osteoarthritis of the hip, a degenerative joint condition that breaks down the cartilage protecting your bones. This can lead to stiffness, pain, and loss of mobility. While early-stage arthritis may be managed with medication and assistive devices, advanced cases may require surgery.
Two common surgical solutions include:
- Hip Arthroscopy – A minimally invasive procedure used to reshape bone and treat soft tissue damage, often performed in early arthritis or in cases like a torn hip labrum.
- Total Hip Replacement – One of the most successful surgeries in orthopedics, offering significant pain relief and functional improvement for those with advanced arthritis.
Other causes of true hip pain include:
- Rheumatoid arthritis – An autoimmune form of arthritis that can also damage the hip joint.
- Avascular necrosis – When blood supply to the femoral head is interrupted, often due to steroids, alcohol use, or trauma.
- Hip infections, slipped capital femoral epiphysis in adolescents, and stress fractures in runners are additional causes.
False Hip Pain
False hip pain refers to discomfort felt on the outer side of the hip, lower back, buttock, or even the upper thigh—but it’s not actually coming from the hip joint itself. Much like some of the symptoms of “True Hip Pain, this type of pain is often “referred pain”, meaning it’s caused by an issue in another part of the body.
Common Causes of False Hip Pain
- Lumbar spine conditions such as disc herniation, spinal arthritis, or nerve impingement can cause pain that radiates to the hip, thigh, or even knee. This pain is often due to sciatica or radiculopathy, where spinal nerve roots are irritated.
- Trochanteric Bursitis, which causes tenderness on the side of the hip. It’s often caused by pressure from prolonged sitting and can be treated with physical therapy, lifestyle changes, or cortisone injections.
- Polymyalgia Rheumatica, less common, is an inflammatory condition that causes diffuse joint and muscle stiffness, especially in the hips and shoulders. It is typically seen in older adults and responds well to oral steroids.
So, what actually causes hip pain?
Hip pain isn’t always as straightforward as it seems. While many assume the pain is coming from the hip joint itself, that’s not always the case.
True hip pain typically originates in the ball-and-socket joint and is often the result of conditions like osteoarthritis, labral tears, or avascular necrosis. This type of pain is usually felt deep in the groin area and may come with stiffness or difficulty with movement.
However, many people experience what’s known as false hip pain—discomfort that feels like it’s coming from the hip, but actually originates outside the joint. Common sources include the lumbar spine, bursae, or surrounding muscles and soft tissues. For example, a spinal issue may cause pain that radiates to the hip or thigh, even when the hip joint itself is healthy.
That’s why getting an accurate diagnosis is so important. Whether you’re dealing with hip joint pain, wondering about a torn labrum, managing osteoarthritis, or experiencing symptoms that may be spine-related, understanding the true source of your discomfort is the key to effective treatment—whether that involves physical therapy, hip arthroscopy, joint replacement, or spine-focused care.
At OrthoConnecticut, our expert team works closely with patients to identify the cause of pain and create personalized treatment plans that deliver real results.
Don’t ignore hip pain. Schedule a consultation with OrthoConnecticut today and take the first step toward lasting relief.
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