Why does my hip hurt if I'm young? Causes and what to do

Hip pain in young people is almost never osteoarthritis. Most often it's overload of the tendons and muscles around the hip, a problem with the shape of the joint (such as femoroacetabular impingement) or pain coming from the lower back or sacroiliac joint. The most useful clue is where it hurts: the groin, the side or the buttock.

If it hurts in the groin

It usually comes from the hip joint itself:

Femoroacetabular impingement: the shape of the femur or pelvis makes them knock together when you bend the hip. It hurts sitting for a long time, squatting, getting into a car or crossing your legs. Common in young athletes.
Labral tear (the cartilage ring around the joint): pain with clicking or a catching feeling.
Hip dysplasia: a shallow socket, more common in young women. It can cause groin pain and a tired hip when walking.
Adductor or hip flexor overload, typical in football, dance or after a big jump in training.

If it hurts on the side

Gluteal tendinopathy (what used to be called "trochanteric bursitis"): pain over the bone on the side of the hip, worse lying on that side, climbing stairs or standing on one leg. More common in women.
Snapping hip: a click on the side when walking or turning, usually painless.

If it hurts in the buttock or at the back

Pain coming from the lower back or the sacroiliac joint.
Piriformis syndrome or buttock overload, sometimes with pain down the leg.

Why does my hip hurt as a young woman?

As well as the above, in young women it's worth considering:

Hip dysplasia and gluteal tendinopathy, both more common in women.
Pregnancy and the postpartum period, because of changes in the pelvic ligaments.
Endometriosis, which can cause pelvic, lower back or hip pain that worsens with your period.
Femoral neck stress fractures in runners who train a lot and eat too little for what they burn.

Other causes to consider

Inflamed sacroiliac joints (spondyloarthritis): buttock or low back pain in under-40s, with morning stiffness lasting more than 30 minutes that improves with movement and worsens with rest. A rheumatologist assesses it.
Too much sitting: long hours seated leave the hip stiff and the buttocks weak.

What helps

Adjust your load: temporarily cut back what triggers it (deep squats, changes of direction, mileage) without stopping moving.
Strengthen your buttocks and trunk: glute bridges, side-lying hip abduction, side planks.
Avoid positions that set it off: crossing your legs, standing with your weight on one leg, sleeping on the painful side (put a pillow between your knees).
Get up often if you sit for long hours.

How we treat it at the clinic

We examine the hip, lower back, sacroiliac joint and how you move, to find where the pain comes from. We combine mobilisation and gentle manual techniques with a progressive exercise programme and advice for your sport or work. If the examination points to impingement, a labral tear or an inflammatory cause, we refer you to a specialist.

When to see a doctor

Pain after a fall that stops you bearing weight.
Runners with groin pain that gets worse when running and comes on earlier each time: possible stress fracture, stop and get it checked.
Fever with hip pain, or a hot, swollen hip.
Long morning stiffness that improves with movement, especially under 40.
A limp or hip or knee pain in children and teenagers.
Pain that wakes you at night and nothing changes.

Frequently asked questions

Is it normal for my hip to hurt in my 20s or 30s? It's common, and almost never osteoarthritis. Most of the time it's overload or a hip-shape problem that's managed without surgery.

Can it come from my back? Yes. Lower back and sacroiliac pain are often felt in the buttock and hip.

Can I keep playing sport? In most cases yes, adapting whatever triggers the pain.

Do I need an MRI? Not always. It's requested if a labral tear or stress fracture is suspected, or if you're not improving.

Why does it hurt when I sleep on my side? It's usually gluteal tendinopathy. Put a pillow between your knees and avoid sleeping on that side for a while.