Hip pain when walking

Key Takeaways

• Typical causes are osteoarthritis, bursitis, labral tears, tendinitis, and stress fractures — each needs a different approach.

• A focused history, gait exam, and imaging (X‑ray, MRI, or ultrasound) help identify the pain source.

• Start with rest, activity modification, low‑impact exercise, ice/heat, and short‑term OTC pain relievers.

• Physical therapy that strengthens the hip abductors, flexors, and core often eases pain and improves walking.

• See a specialist if pain continues, imaging shows advanced damage, or everyday function is significantly limited.

What Causes Pain in the Hip Joint When Walking

Why does walking hurt? Different problems stress the hip joint structures in different ways. Osteoarthritis wears down cartilage and causes inflammation, usually felt as a dull groin or thigh ache. Bursitis inflames the small fluid sacs (bursae) around the hip from repetitive movement or a direct knock, producing tenderness at the outer hip with each step. Labral tears damage the rim of the socket and often cause deep groin or side pain with catching or locking. Tendinitis irritates hip tendons after overuse, creating burning, sharp, or stabbing pain while you walk. Stress or fragility fractures cause sudden, intense pain, especially in people with osteoporosis or after high‑impact activity. These different mechanisms create the varied pain patterns you may notice while walking and help guide treatment choices.

How Hip Pain Is Diagnosed

How do clinicians figure out the cause when walking becomes painful? It starts with a focused medical history and physical exam to document when the pain began, exactly where it’s felt, how it behaves, and to assess range of motion, strength, gait, and provocative maneuvers. Targeted tests help separate intra‑articular (inside the joint) from extra‑articular sources and spot referred pain from the spine or knee. Imaging supports the clinical exam: X‑rays check joint space, bone changes, and impingement, while MRI shows cartilage, labral tears, and soft‑tissue injuries; ultrasound can confirm bursitis. Bone density testing (DEXA) is considered when a fragility fracture is possible. Lab tests or nerve studies are used selectively. A clear differential diagnosis that combines history, exam, and imaging directs treatment and whether a specialist referral is needed.

Non-Surgical Treatments and Home Care for Hip Pain

Once the likely cause of hip pain when walking is identified, most people begin with non‑surgical care and home strategies. This typically means reducing or modifying activities, choosing low‑impact options like swimming or cycling, and protecting the joint while staying active. Physical therapy focuses on improving range of motion, strengthening the hip abductors, flexors and core, and retraining gait. Apply ice or heat for 15–20 minutes a few times a day to manage inflammation and pain. Short‑term over‑the‑counter medicines (ibuprofen, naproxen, acetaminophen) can help but should be used with awareness of contraindications. If symptoms don’t improve, imaging or guided injections may be considered, but many patients respond well to conservative, structured care that emphasizes mobility and strength.

• Slow, gentle leg movements while floating in a pool

• Applying an ice pack followed by a warm compress to the joint

• Guided hip abductor strengthening using a resistance band

When Surgery or Specialist Care Is Recommended

If conservative care fails to restore function or imaging shows advanced joint damage, referral to an orthopedic specialist or consideration of surgery may be appropriate. Typical indications include significant osteoarthritis, severe femoroacetabular impingement, or a large labral tear that causes ongoing mechanical symptoms despite optimal nonoperative treatment. Total hip replacement is considered when joint degeneration severely limits daily activity and conservative measures don’t help. For focal intra‑articular problems with preserved joint surfaces, arthroscopic procedures can repair or trim a damaged labrum or address selected cartilage lesions. Specialists weigh age, activity goals, bone quality, and other health issues before recommending surgery. Postoperative rehabilitation is essential and tailored to control pain, restore range of motion, build strength, and gradually return to daily activities over weeks to months.

Preventing Hip Pain During Daily Activities and Walking

After assessment or surgery, practical steps can reduce hip pain during everyday life and while walking. Prevention focuses on lifestyle habits and targeted exercises: keeping a healthy weight reduces joint load; routine checkups monitor bone health and osteoarthritis risk; and warming up prepares soft tissues for activity. A focused program of hip strengthening and stability exercises (clamshells, bridges, lateral leg raises) improves gait mechanics and lowers strain. Supportive footwear with good cushioning and arch support helps absorb impact. Consistency and gradual progress are key, and clinicians tailor plans to each person’s needs, balancing protection with progressive loading to restore function and prevent recurrence.

With the right assessment, simple lifestyle changes, focused hip strengthening, and supportive footwear, most people reduce pain and regain walking confidence.

• Lacing up cushioned shoes before a walk

• Doing clamshells on a mat

• Gentle hip rolls as a warm‑up