What is hip and leg pain?

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 of 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. 

When to see a doctor

You should see your GP if: 

• Your hip and leg pain worsens 
• Your hip and leg pain doesn’t get better after a few days of rest
• Your hip joint is red, swollen or warm to touch
• Your hip pain persists at night or when resting

Seek urgent medical attention if you have severe hip and leg pain and/or any of the following symptoms: 

• A popping noise on injury of your hip
• Inability to move your hip or leg 
• Inability to bear weight on your leg
• Numbness in your hip, leg and/or genitals
• Your hip joint is bleeding
• Your hip joint is deformed

You should also seek urgent medical attention if your hip and leg pain started suddenly or after a fall or injury. 

Causes of hip and leg pain

Arthritis

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. 

Avascular necrosis

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).

Bursitis

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

Cancer (eg leukaemia) can start in or spread to your bones, including your hip bones, forming tumours that cause pain.

Hernia

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.

Hip fracture

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.

Neuropathy

Damaged nerves can cause a burning or tingling sensation in your buttocks, hips, legs and feet.

Osteoporosis

Also known as brittle bone disease, osteoporosis causes your bones to weaken, which can be painful.

Pregnancy

Changes in hormones during pregnancy widen the pelvis, which can cause pain in your hips, pelvis and/or legs.

Sacroiliitis

Inflammation of one or both of your sacroiliac joints (where your spine meets your pelvis) can cause hip and leg pain.

Sciatica

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.

Tendonitis

Repetitive activities and overuse of your hip can cause the tendons attached to your hip bones to become inflamed (tendonitis), resulting in hip pain.

Diagnosis and tests for hip and leg 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: 

• Blood tests
• CT scan
• MRI scan
• X-ray

Hip and leg pain relief

Hip and leg pain caused by a strained muscle or tendon, osteoarthritis or tendonitis can be relieved by: 

• Applying ice packs for 20 minutes three to four times a day
• Resting the affected joint
• Taking a warm bath or shower
• Taking over-the-counter pain medication eg paracetamol and ibuprofen

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.

Treatments for pain in leg and hips

Treatment for hip and leg pain depends on the underlying cause. Your doctor may recommend: 

• Anti-inflammatory medication
• Ice or heat therapy
• Painkillers
• Physiotherapy
• Rest
• Surgery — surgery is usually only recommended when other treatments have not been successful and/or if you have a dislocated hip, fractured hip, severe osteoarthritis or a badly damaged hip joint

Severe osteoarthritis can cause intense pain and deform your hip joint. Surgery called arthroplasty can be performed to replace your hip joint.

Preventing hip and leg pain

If you have persistent hip and leg pain, you can reduce or prevent your symptoms by:

• Avoiding sudden movements or repetitive movements that cause strain
• Following a healthy diet to reduce inflammation
• Getting plenty of sleep and rest
• Performing regular hip strengthening exercises
• Using a cane to relive some of the pressure on your hip