Why does your hip hurt in different places?

Why does the groin feel sore?

Deep groin soreness often comes from inside the joint. Arthritis is one possible cause when you also feel stiff. A low chair may be hard to leave. Putting on a shoe or turning your leg may hurt too.

An X-ray can show wear in the joint. It can't show how much that wear bothers you. During the exam, the clinician moves your hip to see whether the same spot hurts. It's more likely to be arthritis when the sore spot also matches the wear on the X-ray.

Why does the outside of the hip hurt?

Outer soreness may begin in the tendons beside your hip. A tendon connects a muscle to a bone. Sleeping on the sore side presses those cords near the bone. Stairs, hills, crossed legs, and long walks can make them hurt more.

Rest may calm the soreness for a short time. Too much rest can weaken the muscles that steady your hip. Start with easy leg exercises, then check how you feel the next morning. Do fewer repeats if your soreness is clearly worse that day.

Platelet-rich plasma is often shortened to PRP. The clinic spins a blood sample from you, then saves its platelet-rich part. QC Kinetix may call PRP a regenerative treatment; here, that means non-surgical care made at the clinic after its medical providers examine you. Ask why they think it fits the sore area before you decide.

Could the soreness come from your back?

Yes, it can. Soreness from your lower back may be felt in the buttock, groin, or outer hip. Tingling, numbness, weakness, or pain below the knee makes the back more likely. Your hip and back can also hurt together.

Tell the clinician which back position changes the soreness. Don't assume every ache near your pocket is arthritis. An exam of both areas can keep care aimed at the true cause. New weakness or bladder trouble needs urgent medical care.

Sources

1. A systematic review of 60 imaging studies found radiographic signs of femoroacetabular impingement are common in athletes, asymptomatic people AND symptomatic patients; cam morphology was significantly more common in symptomatic than asymptomatic subjects (p=0.009) and mean alpha angle was significantly higher in the symptomatic group, but the overlap is large enough that imaging alone cannot make the diagnosis.

   Mascarenhas VV, et al. — Imaging prevalence of femoroacetabular impingement in symptomatic patients, athletes, and asymptomatic individuals: A systematic review.. European Journal of Radiology, 2016. DOI: 10.1016/j.ejrad.2015.10.016.

2. Hip dysplasia is a leading precursor of hip osteoarthritis and is present in 20% to 40% of patients with hip OA; associated femoral deformities occur in more than 50%, so the structural anatomy of a dysplastic hip must be assessed in multiple planes. Acetabular osteotomy is the usual treatment in the pre-arthritic dysplastic hip.

   Gala L, Clohisy JC, Beaule PE — Hip Dysplasia in the Young Adult.. Journal of Bone and Joint Surgery (Am), 2016. DOI: 10.2106/JBJS.O.00109.

3. Analysis of the Johnston County Osteoarthritis Project (n=3068) estimated the lifetime risk of symptomatic hip osteoarthritis - radiographic Kellgren-Lawrence >=2 plus pain, aching or stiffness on most days in the same hip - at 25.3% (95% CI 21.3-29.3) by age 85. Risk was similar across sex, race, education and hip-injury history.

   Murphy LB, et al. — One in four people may develop symptomatic hip osteoarthritis in his or her lifetime.. Osteoarthritis and Cartilage, 2010. DOI: 10.1016/j.joca.2010.08.005.

4. A JAMA review of hip and knee osteoarthritis reports OA affects more than 240 million people worldwide and more than 32 million in the US, names pain elicited with internal hip rotation as a diagnostically useful hip examination finding, identifies exercise, weight loss where appropriate and education as the cornerstones of management complemented by topical or oral NSAIDs, notes intra-articular steroid gives short-term relief, and states that opiates should be avoided.

   Katz JN, Arant KR, Loeser RF — Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review.. JAMA, 2021. DOI: 10.1001/jama.2020.22171.

5. The Cochrane review of topical NSAIDs for chronic musculoskeletal pain (39 studies, 10,631 participants) found topical diclofenac and ketoprofen give good pain relief for a minority of people with osteoarthritis (NNT 9.8 and 6.9), but states plainly that these efficacy results were 'almost completely derived from people with knee osteoarthritis' - which is why hip-specific guidance on topical NSAIDs is weaker than knee guidance.

   Derry S, et al. — Topical NSAIDs for chronic musculoskeletal pain in adults.. Cochrane Database of Systematic Reviews, 2016. DOI: 10.1002/14651858.CD007400.pub3.