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Dr. Zachary Weidner, M.D.
HIP & KNEE REPLACEMENT SURGEON
Home › Patient Resources › Hip Arthritis Guide
PATIENT EDUCATION
Hip Arthritis - Causes, Symptoms & Treatment
A comprehensive guide to understanding hip arthritis — what causes it, how it progresses, and what your treatment options are, from non-surgical management to advanced anterior hip replacement surgery.
On This Page
QUICK NAVIGATION
🦸 What is Hip Arthritis?
🔍 Common Causes
⚠️ Signs & Symptoms
📊 Stages of Arthritis
💊 Non-Surgical Treatments
🏥 When Surgery is the Answer
MOST COMMON CAUSES
Common Causes of Hip Pain in Adults
1
Hip Osteoarthritis
The most common cause of hip pain in adults over 50. Cartilage breaks down over time leading to bone-on-bone arthritis. Pain is typically felt in the groin, thigh, or buttock and worsens with activity. As arthritis advances, pain occurs at rest and at night. Anterior total hip replacement is highly effective for end-stage arthritis.
2
Trochanteric Bursitis
Inflammation of the bursa on the outer hip causes sharp or aching pain on the side of the hip. Often worsens when lying on the affected side. Frequently confused with arthritis but responds well to physical therapy, anti-inflammatories, and corticosteroid injections.
3
Hip Labral Tear
The labrum is a ring of cartilage that surrounds the hip socket. Tears cause deep groin pain, clicking, and a feeling of catching or locking. Common in younger active adults and athletes. Often associated with femoroacetabular impingement (FAI).
4
Femoroacetabular Impingement (FAI)
Abnormal bone growth on the femoral head or acetabular rim causes bones to pinch during movement. Pain is typically felt in the groin with flexion activities. Over time FAI can damage the labrum and cartilage, leading to early arthritis.
5
Avascular Necrosis (AVN / Osteonecrosis)
Disruption of blood supply to the femoral head causes bone death and eventual collapse. Associated with steroid use, alcohol, trauma, and sometimes hip joint cortisone injections. Progresses rapidly to joint destruction if untreated — hip replacement is often necessary.
6
Hip Flexor Strain or Tendinitis
Overuse or sudden injury to the hip flexor muscles causes pain in the front of the hip or groin. Common in runners, cyclists, and people who sit for long periods. Usually responds well to rest, stretching, and physical therapy.
7
Referred Pain from the Spine
Lumbar spine problems — including disc herniation, stenosis, and nerve compression — frequently cause pain that radiates into the hip, buttock, and thigh. Often misdiagnosed as hip arthritis. A thorough evaluation is essential to distinguish spinal from hip-originating pain.
8
Rheumatoid Arthritis
An autoimmune condition causing chronic joint inflammation. Can affect the hip at any age — typically causing bilateral pain, morning stiffness lasting over an hour, and systemic symptoms. Often managed medically, though hip replacement may be needed for advanced joint damage.
LOCATION GUIDE
Where Is Your Hip Pain?
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Thigh Pain
Hip arthritis commonly refers pain down the front or outer thigh. Spinal nerve compression can cause similar patterns. Distinguishing between these requires a careful clinical examination.
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Outer (Lateral) Hip / Side Pain
More commonly caused by bursitis, IT band syndrome, or gluteal tendinopathy — structures outside the joint. Pain that worsens lying on that side is a common bursitis pattern.
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Groin Pain
Most often indicates a problem inside the hip joint itself — osteoarthritis, labral tear, avascular necrosis, or FAI. Groin pain with activity that worsens over time is the classic presentation of hip arthritis.
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Buttock / Deep Hip Pain
Can originate from the hip joint, the sacroiliac joint, or the lumbar spine. Piriformis syndrome can also cause deep buttock pain that mimics sciatica.
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Night Pain
Pain at rest and at night strongly suggests intra-articular pathology — particularly advanced hip arthritis or avascular necrosis. Nighttime pain is one of the clearest indicators that surgery may be warranted.
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Pain with Walking
Pain that begins after a specific distance of walking — and improves with rest — is a hallmark of hip arthritis. The distance that triggers pain tends to shorten as arthritis progresses.
GETTING A DIAGNOSIS
How is Hip Pain Diagnosed?
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Medical history - onset, location, character, and aggravating factors of the pain
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Physical examination - range of motion, strength assessment, and provocation tests. Easiest way to determine hip pain from back pain.
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X-rays - first-line imaging to assess joint space / arthritis, bone quality, alignment, and evaluate for fractures
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MRI (if indicated) - evaluates soft tissue for labral tears, tendon injuries, and avascular necrosis. Not helpful in most cases of arthritis
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Diagnostic Injection - numbing the hip joint can confirm whether pain is originating from inside the joint in difficult cases