Osteoarthritis
The most common cause of hip pain in adults over 50. Cartilage gradually wears down, leading to stiffness, aching, and reduced range of motion. Learn more about Hip Arthritis.
Common Causes of Hip Pain
Hip pain can originate from the joint itself, the surrounding muscles and tendons, or even from the lower back through a process called referred pain. The source matters because it determines the most effective treatment. Some of the most frequently diagnosed causes include:
Bursitis
Inflammation of the fluid-filled sacs (bursae) that cushion the hip. Trochanteric bursitis causes pain on the outer hip and thigh, especially with activity or lying on the affected side.
Tendinitis & Tendon Tears
Overuse or strain of the tendons around the hip, including the hip flexors and gluteal tendons, can cause pain that worsens with walking, climbing stairs, or rising from a seat.
Labral Tears
Damage to the ring of cartilage (labrum) lining the hip socket. Labral tears can cause a catching or clicking sensation deep in the groin, along with pain and stiffness.
Referred Pain from the Spine
Lumbar disc herniations, spinal stenosis, or sacroiliac joint dysfunction can produce pain that mimics hip pain. A careful examination helps distinguish the two, sometimes both contribute simultaneously.
Avascular Necrosis (Osteonecrosis)
Loss of blood supply to the femoral head causes bone tissue to die and can eventually lead to joint collapse. Risk factors include corticosteroid use, excessive alcohol, and certain blood disorders.
Fractures
Falls or trauma can cause hip fractures requiring urgent evaluation. Stress fractures from repetitive activity can also occur, particularly in athletes and older adults with osteoporosis.
Inflammatory Arthritis
Conditions such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis can affect the hip joint and may require coordination with a rheumatologist in addition to orthopedic care.
Symptoms to Pay Attention To
Hip pain presents differently depending on its cause, and the location of your pain often provides important diagnostic clues. Groin pain typically points to the hip joint itself, while outer hip or buttock pain may suggest bursitis, tendon problems, or a referred source.
- Groin pain or a deep ache in the front of the hip
- Pain on the outside of the hip or thigh (lateral hip pain)
- Buttock pain that may radiate down the leg
- Stiffness after sitting or the first thing in the morning
- A limp or noticeable change in your walking pattern
- Difficulty with stairs, getting in or out of a car, or putting on shoes and socks
- A catching, clicking, or locking sensation in the hip
- Pain that wakes you at night or prevents you from lying on the affected side
- Reduced ability to walk longer distances or participate in activities you enjoy
Symptoms may develop slowly over months or appear more suddenly. Either way, persistent hip pain that limits your daily activities deserves a thorough evaluation rather than watchful waiting alone.
How Hip Pain Is Diagnosed
Accurate diagnosis is the foundation of effective treatment. Dr. Zalikha uses a structured evaluation process to identify the specific source of your pain before discussing any treatment options.
Personalized Patient Assessment
Dr. Zalikha begins with a detailed conversation about your symptoms, activity level, medical history, prior treatments, and functional goals. A focused physical examination assesses range of motion, strength, alignment, and specific provocation tests that help pinpoint the source of your discomfort.
Targeted Diagnostic Imaging
Standing X-rays of the hip and pelvis are typically the most informative first study, particularly when arthritis or structural abnormality is suspected. An MRI or CT scan may be ordered to evaluate soft tissue injury, bone quality, or complex anatomy. Lab work is occasionally appropriate to rule out infection or inflammatory conditions.
Clarity for Confident Decision-Making
The goal of this workup is a clear, specific diagnosis. Once you understand what is causing your pain, you can make informed decisions about how to treat it, whether that involves conservative measures, injections, or surgery. Dr. Zalikha takes time to explain your imaging findings in plain language and answer all your questions.
Treatment Pathways for Hip Pain
Treatment is guided entirely by your diagnosis, overall health, activity goals, and how much your symptoms are affecting your daily life. In most cases, the first approach involves non-surgical treatment options:
Physical Therapy & Exercise
Targeted strengthening, flexibility, and movement retraining to reduce pain and improve function. Learn about Physical Therapy for Arthritis.
Activity Modification
Identifying and adjusting movements or activities that aggravate your hip while maintaining as much function as possible during recovery.
Medications
Over-the-counter anti-inflammatories, topical treatments, or prescription options when appropriate to manage pain and swelling.
Joint Injections
Corticosteroid, hyaluronic acid, or PRP & biologic injections may provide meaningful relief for arthritis, bursitis, or other specific conditions.
Weight Optimization
For patients with arthritis, even modest weight reduction meaningfully lowers joint stress. Learn about Weight Optimization & Prehab.
Assistive Devices
Canes, walkers, or orthotics may reduce joint load and improve safety during periods of significant pain or functional limitation.
When Surgery Becomes Appropriate
When conservative measures have been given a fair trial and hip pain continues to significantly affect your quality of life, surgical options may be appropriate. Depending on your diagnosis, this could range from total hip replacement using the direct anterior approach or robotic-assisted technique, to more specialized procedures. Dr. Zalikha will walk you through every option, including expected recovery timelines, so you can make a fully informed decision.
When to Seek Urgent Care
Most hip pain can be evaluated in the office. However, the following symptoms may indicate a fracture, dislocation, infection, or vascular emergency requiring immediate attention:
If you are experiencing any of the above, please call emergency services or go to your nearest emergency department.
Why Patients Choose Dr. Zalikha for Hip Pain
30+Publications
StanfordFellowship
Stanford FellowshipMeet your surgeon
Leo Zalikha, MD
- Stanford Fellowship, Adult Reconstruction
- Hip & Knee Specialist
- 30+ Peer-Reviewed Publications
- Long Beach · Greater LA · Orange County
- Virtual Second Opinions
Dr. Zalikha completed fellowship training in adult reconstruction at Stanford University, where his focus was on hip and knee conditions including complex primary and revision cases. He has authored over 30 peer-reviewed publications in orthopedic surgery and arthroplasty, and his research has been cited hundreds of times by other surgeons and researchers in the field.
He practices at Memorial Orthopaedic Surgical Group in Long Beach, CA, serving patients from across greater Los Angeles and Orange County. His philosophy is straightforward: provide an honest diagnosis, clearly explain every option, and build a treatment plan that fits the patient’s life, whether that plan involves surgery or not.
For patients who cannot travel to the Long Beach office, Dr. Zalikha offers virtual second opinion consultations, allowing a thorough review of your imaging, records, and symptoms from anywhere.
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