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Hip Problems, Age 12 and Older

Topic Overview

Hip pain can make it hard to walk, go up and down stairs, squat, or sleep on the side that hurts. A clicking or snapping feeling or sound around your hip joint (snapping hip) may bother you or cause you to worry. But if your hip is not painful, in many cases the click or snap is nothing to worry about. Home treatment may be all that is needed for minor hip symptoms.

To better understand hip problems, it may be helpful to know how the hip works. It is the largest ball-and-socket joint in the body. The thighbone (femur) fits tightly into a cup-shaped socket (acetabulum) in the pelvis. The hip joint is tighter and more stable than the shoulder joint but it does not move as freely. The hip joint is held together by muscles in the buttock, groin, and spine; tendons; ligaments; and a joint capsule. Several fluid-filled sacs (bursae) cushion and lubricate the hip joint and let the tendons and muscles glide and move smoothly. The largest nerve in the body (sciatic nerve) passes through the pelvis into the leg.

Hip problems

Hip problems may develop from overuse, bone changes with age, tumors, infection, changes in the blood supply, or a problem that was present from birth (congenital). Oddly enough, a person who has a hip problem often feels pain in the knee or thigh instead of the hip. The type of hip pain you have may help your doctor determine the cause of your pain.

  • Pain when resting does not increase with motion or standing. This type of pain is usually caused by a less severe problem, unless the pain does not go away or awakens you from sleep.
  • Pain with movement increases when you move the hip or leg but does not increase when you stand or bear weight. This type of pain is most often caused by a muscle injury, inflammation, or infection.
  • Pain with weight-bearing increases when you stand or walk and may cause you to limp. This type of pain usually means you have a problem with the hip joint itself. Pain that is severe enough to prevent any weight-bearing is more likely to mean a serious bone or joint problem.

Pelvic, groin, thigh, or knee pain (referred pain) may be present along with a sore, painful, or tender hip. Hip pain can have many causes.

  • Snapping pain on the outside of the hip and sometimes the knee may be caused by iliotibial band syndrome.
  • Pain in the hip, thigh, or knee of an older child or teen may be caused by conditions such as slipped capital femoral epiphysis, in which the upper end of the thighbone (femur) slips at the growth plate (epiphysis), or Legg-Calve-Perthes disease.
  • Pain that is worse in the morning and improves during the day may be caused by bones rubbing together, such as with osteoarthritis, rheumatoid arthritis, or lupus.
  • Pain may be a sign of inflammation of the large sac that separates the hipbones from the muscles and tendons of the thighs and buttocks (trochanteric bursitis).
  • Pain can occur with signs of infection in a joint (septic arthritis), bursa (septic bursitis), or bone (osteomyelitis).
  • Pain and stiffening in the hip may be caused by lack of blood flow to the hip joint (avascular necrosis). Pain in the knee may also be present.
  • Pain that shoots down the leg from the hip or lower back may be caused by an irritated or pinched nerve (sciatica).
  • Pain with weight-bearing that gradually worsens over several months may be caused by transient osteoporosis. This is more common in middle-aged men but also can affect women in the later part of pregnancy (third trimester). Osteoporosis related to pregnancy usually goes away on its own within 12 months of delivery.
  • Some types of bone cancer (osteosarcomas) and the spread of cancer to the bone (metastatic disease) can cause bone pain.

Treatment for a hip problem depends on the location, type, and severity of the problem, as well as your age, general health, and activities (such as work, sports, hobbies). Treatment may include first aid measures; application of a brace, cast, harness, or traction; physical therapy; medicines; or surgery.

Check your symptoms to decide if and when you should see a doctor.

Check Your Symptoms

Do you have a hip problem?
This includes symptoms like pain and trouble moving the hips normally.
Yes
Hip problem
No
Hip problem
How old are you?
Less than 12 years
Less than 12 years
12 years or older
12 years or older
Are you male or female?
Male
Male
Female
Female
Have you injured the hip in the past month?
Yes
Hip injury in the past month
No
Hip injury in the past month
Have you had hip surgery in the past month?
If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.
Yes
Hip surgery in the past month
No
Hip surgery in the past month
Is the problem mainly in your low back or buttock rather than your hip?
Yes
Back Problem
No
Back Problem
Is the leg blue, very pale, or cold and different from the other leg?
If the leg is in a cast, splint, or brace, follow the instructions you got about how to loosen it.
Yes
Leg is blue, very pale, or cold and different from other leg
No
Leg is blue, very pale, or cold and different from other leg
Do you have any pain in your hip?
Yes
Hip pain
No
Hip pain
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?
8 to 10: Severe pain
Severe pain
5 to 7: Moderate pain
Moderate pain
1 to 4: Mild pain
Mild pain
How long has the pain lasted?
Less than 2 full days (48 hours)
Pain less than 2 days
2 days to 2 weeks
Pain 2 days to 2 weeks
More than 2 weeks
Pain more than 2 weeks
Has the pain:
Gotten worse?
Pain is getting worse
Stayed about the same (not better or worse)?
Pain is unchanged
Gotten better?
Pain is getting better
Do you think the problem may be causing a fever?
Some bone and joint problems can cause a fever.
Yes
Possible fever
No
Possible fever
Are there any symptoms of infection?
Yes
Symptoms of infection
No
Symptoms of infection
Are there red streaks leading away from the area or pus draining from it?
Yes
Red streaks or pus
No
Red streaks or pus
Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps.
Yes
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
No
Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area
Are you having trouble moving your hip or leg?
Yes
Difficulty moving hip or leg
No
Difficulty moving hip or leg
Is it very hard to move or somewhat hard to move?
"Very hard" means you can't move it at all in any direction without causing severe pain. "Somewhat hard" means you can move it at least a little, though you may have some pain when you do it.
Very hard
Very hard to move
Somewhat hard
Somewhat hard to move
How long have you had trouble moving your hip?
Less than 2 full days (48 hours)
Difficulty moving for less than 2 days
2 days to 2 weeks
Difficulty moving for 2 days to 2 weeks
More than 2 weeks
Difficulty moving for more than 2 weeks
Has the loss of movement been:
Getting worse?
Difficulty moving is getting worse
Staying about the same (not better or worse)?
Difficulty moving is unchanged
Getting better?
Difficulty moving is improving
Have you had hip problems for more than 2 weeks?
Yes
Symptoms for more than 2 weeks
No
Symptoms for more than 2 weeks

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for color and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal color returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don't have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.
Postoperative Problems
Hip Injuries, Age 12 and Older
Hip Problems, Age 11 and Younger

Call 911 Now

Based on your answers, you need emergency care.

Call911or other emergency services now.

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines, herbal remedies, and supplements can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.
Back Problems and Injuries

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can't stand it for more than a few hours, can't sleep, and can't do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it's severe when it's there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Home Treatment

Home treatment may help relieve hip pain, swelling, and stiffness.

  • Rest. Try to rest and protect a sore area. Stop, change, or take a break from any activity that may be causing your pain or soreness.
  • Ice will help your pain and swelling. Put ice or cold packs on the sore area immediately. Put ice on for 20 minutes out of every hour, and do this 4 or more times in the first 1 to 2 days. Wrap the ice in a wet towel. Do not put the ice right on the skin. Do not fall asleep with an ice pack on your skin.
  • Sleep on your unaffected hip with a pillow between your knees, or sleep on your back with pillows beneath your knees.
  • Gently massage or rub your hip to relieve pain and help blood flow.
  • If the swelling is gone, you can put heat on the area. Moist heat with a hot water bottle, warm towel, or a heating pad set on low may feel good on your hip. You can carefully begin normal activities and gentle stretching.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:
Safety tips
Be sure to follow these safety tips when you use a nonprescription medicine:
  • Carefully read and follow all directions on the medicine bottle and box.
  • Do not take more than the recommended dose.
  • Do not take a medicine if you have had an allergic reaction to it in the past.
  • If you have been told to avoid a medicine, call your doctor before you take it.
  • If you are or could be pregnant, do not take any medicine other than acetaminophen unless your doctor has told you to.
  • Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.

Do not smoke. Smoking may delay healing because it interferes with blood supply and tissue healing. For more information, see the topic Quitting Smoking.

Cast care tips

If you have a cast, see cast care tips.

Symptoms to watch for during home treatment

Call your doctor if any of the following occur during home treatment:

  • Pain develops.
  • Signs of infection develop.
  • Pale, white, blue, or cold skin develops.
  • Symptoms do not get better with home treatment.
  • Symptoms become more severe or more frequent.

Prevention

The following tips may prevent hip problems or injuries.

Keep bones strong

  • Eat foods rich in calcium, like yogurt, cheese, milk, and dark green vegetables. Eat foods rich in vitamin D, like eggs, fatty fish, cereal, and fortified milk.
  • Exercise and stay active. It is best to do weight-bearing exercise, such as walking, jogging, stair climbing, dancing, or lifting weights, for 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. In addition to weight-bearing exercise, experts recommend that you do resistance exercises at least 2 days a week. Talk to your doctor about an exercise program that is right for you. Begin slowly, especially if you have not been active. For more information, see the topic Fitness.
  • Don't drink more than 2 alcohol drinks a day if you are a man, or 1 alcohol drink a day if you are a woman. People who drink more than this may have a higher chance for developing osteoporosis. Alcohol use also increases your chance of falling and breaking a bone.
  • Stop or do not begin smoking. Smoking also increases your chance for developing osteoporosis. It also interferes with blood supply and healing. For more information, see the topic Quitting Smoking.

Exercises to keep your hip and back area strong

Warm up and stretch before exercising to prevent problems.

Preparing For Your Appointment

To prepare for your appointment, see the topic Making the Most of Your Appointment.

You can help your doctor diagnose and treat your condition by being prepared to answer the following questions:

  • What are your main symptoms? How long have you had your symptoms?
  • Have you had this problem in the past? If so, do you know what caused the problem at that time? How was it treated?
  • Do you have hip pain when you walk? How far can you walk without discomfort? Does the pain get better or worse as you continue to walk?
  • Have you had X-rays of your hip? When and what were the results?
  • What activities make your symptoms better or worse?
  • What sports activities are you involved in? Have you recently started a new activity?
  • Do you think that activities related to your job or hobbies caused your symptoms?
  • Have you had any recent illness or fever?
  • What home treatment measures have you tried? Did they help?
  • What nonprescription medicines have you tried? Did they help?
  • What prescription and nonprescription medicines do you take?
  • Do you have any health risks that may increase the seriousness of your symptoms?

Credits

By Healthwise Staff
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
H. Michael O'Connor, MD - Emergency Medicine
Last Revised August 1, 2012

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