The causes of hip and leg pain are varied. This is partly because the movement of your lower back, hips and legs is connected, so pain in one area can cause pain in another area (referred pain).
Your hip joint is the largest joint in your body and in addition to your ankle and knee joints, is load-bearing, which means it carries the weight of your body. It is also a ball and socket joint, which means it can move in multiple directions and enables fluid movements.
When you use your hips, cartilage that surrounds the joints helps reduce friction as your hip bones move. However, over time, this cartilage can be worn down or damaged. Muscles and tendons in your hip can also be overused and bones broken during an injury or fall. All of these can cause hip and leg pain.
Symptoms vary depending on the underlying cause and consequently your symptoms can help your doctor diagnose the condition causing your hip and leg pain. You may experience pain or discomfort in your outer hip, inner hip, buttocks, groin, thighs and/or legs. Pain originating in your lower back or groin can also radiate to your hip.
Nerve conditions, such as sciatica, can cause sharp, shooting pain in your lower back, buttocks and legs. Lower back strain or a hernia can also cause shooting pain down your legs.
Nerve damage can cause a burning or tingling sensation in your legs and feet.
Sacroiliac joint dysfunction can cause pain in your lower back and legs, predominantly on one side of your body. A problem with your hip joint itself can cause pain inside your hip or groin. Strained muscles, ligaments or tendons around your hip can cause pain in your outer hip area, upper thigh and/or outer buttocks.
Arthritis can cause hip pain that worsens on activity, as well as a reduced range of motion or limp from chronic (long-term) hip pain.
You should see your GP if:
Seek urgent medical attention if you have severe hip and leg pain and/or any of the following symptoms:
You should also seek urgent medical attention if your hip and leg pain started suddenly or after a fall or injury.
The most common cause of hip and leg pain is arthritis, particularly osteoarthritis and rheumatoid arthritis, and especially in older people. Arthritis causes the cartilage of the hip joint to wear down and become inflamed, which allows your hip bones to rub against each other, causing increasing pain over time. Other symptoms of hip pain caused by arthritis include stiffness and reduced range of motion.
Also known as osteonecrosis, avascular necrosis occurs when blood flow to your hip bones is reduced, causing the bone tissue to die. It usually affects the hip and can be caused by a variety of conditions, including a dislocated hip, hip fracture or long-term use of high-dose steroids (eg prednisolone).
Your hip joint contains four fluid-filled sacs called bursae, which reduce friction and allow smoother movement of your hip joint. Overuse and repetitive movements of your hip joint can irritate these bursae, causing them to become inflamed (bursitis), which leads to hip pain.
Cancer (eg leukaemia) can start in or spread to your bones, including your hip bones, forming tumours that cause pain.
This occurs when part of one of your organs, usually your intestines, pokes through a weakness in your abdominal wall. This can cause groin pain that radiates to your hips and legs.
Aging weakens your bones, which makes them more likely to break (fracture) during an injury or fall.
Hip labral tear
The labrum is a ring of cartilage along the outer rim of your hip socket. It acts as a cushion and also helps to hold the ball of your thigh bone in your hip socket. Repetitive twisting of your hip joint, common in athletes, can tear the labrum, causing pain.
Damaged nerves can cause a burning or tingling sensation in your buttocks, hips, legs and feet.
Also known as brittle bone disease, osteoporosis causes your bones to weaken, which can be painful.
Changes in hormones during pregnancy widen the pelvis, which can cause pain in your hips, pelvis and/or legs.
Inflammation of one or both of your sacroiliac joints (where your spine meets your pelvis) can cause hip and leg pain.
Damage or pressure applied to the sciatic nerve (sciatica) can cause hip and leg pain.
Strained muscle or tendon
Repetitive activities can strain the muscles and tendons around your hip, causing inflammation and hip pain.
Repetitive activities and overuse of your hip can cause the tendons attached to your hip bones to become inflamed (tendonitis), resulting in hip pain.
Your doctor will ask about your symptoms and medical history, and perform a physical examination. Depending on your age, general health, the severity of your symptoms and the suspected underlying cause of your pain, they may also refer you for tests including:
Hip and leg pain caused by a strained muscle or tendon, osteoarthritis or tendonitis can be relieved by:
Hip pain caused by rheumatoid arthritis can be relieved by prescription medications, including anti-inflammatories such as corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs) such as methotrexate and sulphasalazine, and biologics that target the immune system.
Arthritic hip pain can also be relieved through low-impact exercise (eg brisk walking) and hip stretching and strengthening exercises. This will improve your hip flexibility, range of movement and strength, which together will reduce your hip pain. A physiotherapist can put together a tailored exercise programme for you.
Treatment for hip and leg pain depends on the underlying cause. Your doctor may recommend:
Severe osteoarthritis can cause intense pain and deform your hip joint. Surgery called arthroplasty can be performed to replace your hip joint.
If you have persistent hip and leg pain, you can reduce or prevent your symptoms by:
What causes hip pain that radiates down the leg?
Common causes of pain in the hip that spreads down the leg include a hernia, lower back strain, sciatica or any damage or pressure applied to a nerve.
Can hip problems cause leg pain?
Yes, as the hips and legs move together, pain in the hip can spread to the leg — this is called referred pain.
How do I know if my hip pain is serious?
If your hip pain gets worse or doesn’t get better after a few days of rest, you should see your GP. You should also see your GP if your hip joint is red, swollen or warm to touch. You should seek urgent medical attention if you have severe hip pain, can’t move your hip or leg, can’t bear weight on your leg, are bleeding from your hip, are numb in your hip, leg and/or genitals, or if your hip joint is deformed.
What helps hip and leg pain?
Over-the-counter pain medication, hip stretching and strengthening exercises, rest, applying ice packs for 20 minutes three to four times a day, physiotherapy and low-impact exercise such as brisk walking can all help ease hip and leg pain.
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