Why Does My Hip Hurt When Walking?

Short answer: Hip pain when walking may come from osteoarthritis inside the joint, gluteal tendons at the side of the hip, muscles around the groin or thigh, hip impingement or labral irritation, bone stress, or referred pain from the lower back and nerves. The location and timing matter: pain at the first steps, during single-leg loading, after a predictable distance or while turning can suggest different clinical questions.

“Why does walking hurt my hip?” sounds simple, but patients use the word hip for the groin, outer hip, buttock and upper thigh. Those areas contain different structures, and the hip joint can even refer pain towards the knee. A useful assessment starts by locating the pain and observing what happens during the walking cycle rather than assuming every painful hip is arthritis.

When hip pain while walking needs urgent assessment

Seek urgent medical assessment if:

• you cannot stand or bear weight after a fall, collision or sudden injury;
• the leg appears shortened, rotated or visibly deformed;
• the hip or surrounding area is intensely painful, hot or swollen, particularly with fever or serious illness;
• pain is severe and rapidly worsening without a clear reason;
• there is new major leg weakness, loss of bladder or bowel control, or numbness around the groin or saddle region;
• the leg becomes cold, pale or blue, or suddenly develops substantial one-sided swelling;
• pain is accompanied by chest pain, breathlessness, fainting or coughing blood;
• there is progressive rest or night pain, unexplained weight loss, an enlarging mass or a history of cancer.

Older adults and people with osteoporosis can sustain a hip fracture after a relatively minor fall. Continuing to walk does not completely exclude a fracture. For a life-threatening emergency in Singapore, call SCDF 995.^[1]

Where is the pain?

Use one finger to indicate the main area, then note whether symptoms spread:

• Groin or front of the hip: may suggest the hip joint, hip flexors, adductors or nearby structures.
• Outer hip: may involve the gluteal tendons and tissues around the greater trochanter.
• Buttock: may arise from deep gluteal structures, the lower back, sacroiliac region or hip joint.
• Upper thigh or knee: hip-joint pain can sometimes be felt away from the joint itself.
• Burning or electric pain down the leg: raises a nerve or referred-pain question.

Location narrows the possibilities but does not confirm a diagnosis. More than one source can coexist, particularly in persistent pain.

When during walking does the hip hurt?

• First few steps after rest: joint stiffness, osteoarthritis or a sensitive tendon may be relevant.
• As weight first moves onto the leg: the joint, bone and load-sensitive tissues must absorb force.
• During single-leg stance: the gluteal muscles and tendons help keep the pelvis level.
• With a long stride or push-off: the hip moves into extension and anterior structures may become symptomatic.
• When turning: rotation may provoke a joint, impingement or labral pattern.
• Only after a predictable distance: cumulative load, reduced capacity, referred nerve symptoms or circulation-related problems may need consideration.

Also record hills, stairs, speed, surface, footwear and what happens over the following 24 hours.

1. Hip osteoarthritis

Hip osteoarthritis can cause groin, front-thigh, buttock or knee pain, stiffness and reduced movement. Walking, rising from a chair, putting on shoes and turning may become difficult. A limp may develop as the person shortens the painful stance phase or avoids moving the hip fully.

AAOS describes groin pain as a common presentation and notes that hip osteoarthritis can restrict walking and hip movement.^[2] Symptoms often develop gradually, although a flare may feel sudden. Pain and X-ray changes do not always correspond closely, so treatment should respond to function and goals as well as imaging.

NICE advises that osteoarthritis can often be diagnosed clinically in people aged 45 or over who have activity-related joint pain and either no morning stiffness or morning stiffness lasting no longer than 30 minutes, unless atypical features suggest another diagnosis.^[3]

2. Greater trochanteric pain and gluteal tendons

Pain at the outer hip may arise from the gluteus medius or minimus tendons and adjacent tissues. It may be aggravated by walking, hills, stairs, standing on one leg or lying on the painful side. Some patients call this “hip bursitis”, although tendon-related pain is frequently part of the presentation.

The side hip works hard during single-leg stance to control the pelvis. A rapid increase in walking, repeated hills or a change in strength and movement capacity can exceed current tolerance. Local tenderness supports but does not prove the diagnosis, because the region can also receive referred pain.

Treatment may involve reducing sustained compression and adjusting load, followed by progressive strengthening and walking exposure. Repeated stretching into painful hip adduction may aggravate some lateral-hip presentations.

3. Femoroacetabular impingement or labral symptoms

Femoroacetabular impingement (FAI) describes particular hip shapes that can create contact during movement. Some people have these shapes without pain. When symptomatic, FAI may produce groin pain, stiffness or limping, and turning, twisting or squatting can cause a sharper sensation.^[4]

The labrum is a ring of fibrocartilage around the hip socket. A symptomatic labral problem may cause deep groin pain, clicking, catching or pain with rotation. These symptoms overlap with other hip conditions, and an imaging finding should be interpreted alongside examination rather than treated in isolation.

4. Hip flexor, adductor or other muscle and tendon pain

A strain or load-related tendon problem can follow sprinting, kicking, a slip, a sudden long walk or unfamiliar exercise. Pain may be felt at the front of the hip, groin, inner thigh or buttock and reproduced by a resisted movement or stretch.

AAOS notes that hip strains can involve muscles and tendons around the hip, commonly after overuse, overstretching or a direct injury.^[5] A gradual tendon problem requires a different loading plan from a sudden tear. Marked bruising, a palpable gap or substantial loss of strength needs assessment.

5. Bone stress injury or occult fracture

Bone stress injury develops when repeated loading exceeds the bone’s capacity to recover. It can affect active people after a sharp rise in running or walking, and risk may be influenced by low energy availability, reduced bone density, menstrual disturbance, previous stress injury and certain medicines.

Deep groin or thigh pain may initially occur only during activity, then begin earlier and persist after exercise or at rest. AAOS notes that early stress fractures may not appear on initial X-rays and that MRI can show associated bone swelling.^[6]

Femoral-neck stress injury can be clinically important. Focal, progressively worsening weight-bearing pain should not be repeatedly tested or treated only as muscular tightness.

6. Lower-back or nerve-related pain

The lumbar spine can refer pain to the buttock, outer hip, groin or thigh. Nerve involvement may produce burning, electric pain, tingling, numbness or weakness. Some people develop symptoms after walking or standing that ease when sitting or bending forwards.

A normal hip scan does not rule out a spinal or nerve source. Examination may need to include back movement, neurological testing and comparison of hip and spinal symptom reproduction.

7. Sacroiliac and deep buttock sources

Pain near the back of the pelvis may involve the sacroiliac region, deep gluteal muscles or referred structures. Walking asymmetry, prolonged standing or a recent change in activity may influence symptoms. No single palpation point confirms the source, and the hip joint and lower back should remain in the differential.

8. Less common inflammatory, infectious or circulation-related causes

Inflammatory arthritis can affect the hip, often with prolonged stiffness or symptoms in other joints. Infection may cause severe pain, inability to bear weight, fever or systemic illness, although presentations vary. Osteonecrosis—loss of blood supply to part of the femoral head—is another important but less common cause of deep hip pain.

Vascular disease can cause exertional buttock, thigh or calf pain that eases with rest. A clinician may assess pulses and circulation when the walking pattern or risk factors suggest this possibility.

Why does the pain make me limp?

A limp is the body’s attempt to reduce pain, compensate for stiffness or manage weakness. A person may take a shorter step, spend less time on the painful leg, lean the trunk or allow the pelvis to drop. These strategies can be useful briefly but may increase demand elsewhere if they persist.

The gait pattern does not diagnose the condition by itself. Hip-joint pain, gluteal weakness, leg-length difference, nerve weakness and fear of loading can create overlapping appearances.

Does walking pain mean the hip is wearing out?

No. Walking pain may reflect sensitivity, inflammation, reduced capacity, tendon overload, referred pain or a structural injury. Even when osteoarthritis is present, pain is influenced by sleep, stress, confidence, previous experiences, general health and the nervous system’s sensitivity.

This biopsychosocial explanation does not mean the pain is imaginary. It explains why two people with similar X-rays may function differently and why treatment should address both the suspected tissue and barriers to recovery.

Why generic hip exercises may fail

An exercise may be reasonable in general yet poorly matched to a particular patient. Common problems include:

• starting with a dose that is too high for current walking tolerance;
• repeatedly compressing an irritable side-hip tendon;
• stretching a joint or tendon aggressively when it is already sensitive;
• strengthening without retraining the painful walking or stair task;
• failing to progress once the early exercises become easy;
• treating the hip when the main driver is spinal, neurological or bone-related;
• continuing the same programme despite progressive night pain, weakness or loss of function.

Reassessment should ask whether the working diagnosis, exercise selection, dose and patient priorities remain appropriate.

How hip pain while walking is assessed

The history should clarify:

• groin, side, buttock, thigh or knee location;
• sudden injury or gradual onset;
• first-step pain, single-leg pain, turning pain or distance-to-pain;
• stiffness, clicking, catching, weakness or neurological symptoms;
• rest and night symptoms;
• recent changes in walking, sport, work or footwear;
• falls, osteoporosis, steroid exposure and relevant medical history;
• effects on commuting, caregiving, stairs, sleep and desired activities.

Clinical examination may include walking, standing alignment, balance, active and passive hip movement, strength, local tenderness and selected functional tasks. Tests such as flexion-adduction-internal rotation or FABER may reproduce symptoms but are not interpreted alone. The knee, lower back, nerves and circulation may also be examined.

A gait assessment can identify stride length, stance time, trunk lean, pelvic control and the exact phase that provokes pain. The aim is not to declare one “perfect” walking style, but to find modifiable contributors and safe ways to rebuild capacity.

When may an X-ray be considered?

X-rays may be appropriate when osteoarthritis, fracture, hip shape, alignment or another bone-related cause is suspected. For chronic hip pain, the American College of Radiology rates pelvis and hip radiography as usually appropriate initial imaging.^[7]

An X-ray cannot directly show every tendon, labral or early bone-marrow problem. Imaging findings should still be matched to symptoms and function.

When may MRI be considered?

MRI can assess bone marrow, cartilage, labrum, tendons, muscles and other soft tissues. It may be considered for persistent unexplained symptoms, suspected stress injury or occult fracture, osteonecrosis, a management-changing tendon or labral question, or concerning features not answered by X-ray.

MRI uses magnetic fields rather than ionising radiation. It is not required for every walking-related hip pain presentation. The appropriate protocol—with or without contrast or arthrographic contrast—depends on the question and individual suitability.

When may ultrasound help?

Ultrasound may assess superficial gluteal or hip-flexor tendons, bursae, fluid and selected dynamic problems. It can guide certain diagnostic or treatment procedures. It does not provide the same overview of bone marrow, deep joint cartilage and labrum as MRI.

What can you do for mild symptoms without warning features?

• Temporarily reduce the distance, speed, hills or long strides that clearly provoke pain.
• Break one long walk into shorter bouts if this keeps symptoms manageable.
• Use a handrail and avoid carrying heavy loads if the gait feels unsafe.
• Maintain comfortable movement rather than complete bed rest.
• Track the 24-hour response, including sleep and next-morning stiffness.
• Arrange assessment if pain persists, progresses or limits ordinary walking.

A walking stick may reduce load and improve confidence for selected patients when correctly sized and used. Medication should be considered only after reviewing allergies, pregnancy, other medicines and stomach, kidney, heart or bleeding risks.

Treatment is matched to the cause and the person

Progressive loading is a foundation of care for many non-urgent hip conditions. The initial walking and exercise dose should be tolerable, then build strength, balance, stride control, stairs and distance according to the patient’s response. A gluteal tendon plan differs from one for osteoarthritis, a muscle strain or referred back pain.

For osteoarthritis, NICE recommends tailored therapeutic exercise and weight management where appropriate as core care.^[3] AAOS also describes individualised physical therapy, activity changes and walking supports among nonsurgical options for hip osteoarthritis.^[2]

Medication, a walking aid, manual care, injections or selected physical modalities may support symptom control. Each should have a defined goal, risks and review point. A passive treatment does not automatically rebuild walking capacity or address every diagnosis.

Surgical assessment may be appropriate for fracture, selected FAI or labral conditions, advanced osteoarthritis with substantial disability, or other structural problems that have not responded to suitable nonsurgical care. Surgery is not selected from pain location alone.

Patient-specific scenarios

If pain is mainly in the groin and the hip feels stiff

Hip-joint causes such as osteoarthritis or impingement become more relevant. Examination of range and gait, followed by X-ray where indicated, may clarify whether joint changes match the symptoms.

If pain is on the outer hip during single-leg stance

Gluteal tendon-related pain may be considered, especially with side-lying or stair pain. Management may begin with reducing aggravating compression, then progressive hip loading and walking retraining.

If pain starts only after a fixed distance

Record the threshold and whether sitting, standing still or bending forwards changes symptoms. This helps distinguish cumulative hip load from possible spinal, nerve or circulation patterns. A graded walking plan may start below the threshold once urgent causes are excluded.

If walking pain began after increasing exercise

Review the size of the load change and recovery. A muscle or tendon overload is possible, but deep focal pain that begins progressively earlier or continues at rest should be assessed for bone stress injury.

If you have already tried physiotherapy

Review whether the programme targeted the likely source, used an appropriate dose and progressed towards walking and stair goals. Persistent deep groin pain, worsening night symptoms, marked weakness or failure despite a well-delivered plan may justify diagnostic reassessment and imaging rather than repeating the same exercises.

If you dislike exercise or prefer passive treatment

Start by discussing what makes exercise unacceptable—pain, time, fear, fatigue or previous failure. Symptom-relief modalities, medication or selected procedures may help some patients participate, but the limitations should be clear. A small, practical loading plan can be built around essential daily tasks rather than a gym programme.

If you must return to work quickly

Clarify the required walking distance, stairs, standing, lifting and commuting. A short-term plan may combine load modification, temporary duties, an aid where appropriate and symptom control. No treatment can promise recovery within a fixed number of days, and fracture or another urgent condition must not be missed.

Integrated doctor and physiotherapy management

The Pain Relief Clinic has in-house physiotherapists for integrated management with the licensed medical doctor. Where physiotherapy is clinically appropriate, this can align the working diagnosis, pain education, gait and movement assessment, progressive strengthening, neuromuscular rehabilitation, walking retraining, stair-function rebuilding and decisions about imaging, selected modalities, other treatment or referral. Physiotherapists practising in Singapore are regulated by the Allied Health Professions Council, which maintains a public register.^[8]

The clinic can assist with clinically appropriate referrals and supporting paperwork for insurance claims. Coverage, documentation requirements, pre-authorisation and reimbursement depend on the patient’s policy and insurer. A referral, form or medical report does not guarantee approval or payment.

Frequently asked questions

Is groin pain while walking usually from the hip joint?

The hip joint is one important possibility, but muscles, tendons, hernia-related conditions and referred pain can also affect the groin. Examination is needed before attributing it to arthritis or a labral problem.

Why does the outside of my hip hurt when I walk?

Gluteal tendon-related pain is common at the outer hip, particularly during single-leg loading. Referred pain and other local structures can produce similar symptoms.

Should I stop walking?

Complete rest is not automatically required. Without warning features, temporarily reduce the aggravating dose and use a graded return. Stop weight-bearing and seek urgent assessment after significant trauma or when fracture is possible.

Do I need an MRI?

Not necessarily. X-ray may be the appropriate first test for chronic hip pain or suspected bone and joint changes. MRI is useful for selected bone-marrow, tendon, labral and soft-tissue questions when the result may change management.

Can hip pain be felt in the knee?

Yes. Hip-joint pain can be referred into the thigh or knee. This is why hip examination may be appropriate when knee symptoms are not fully explained by knee findings.

Key points

• Hip pain while walking may be felt in the groin, outer hip, buttock, thigh or knee.
• The painful phase of walking helps narrow the clinical questions.
• Osteoarthritis, gluteal tendon pain, muscle injury, impingement, bone stress and referred pain require different approaches.
• X-ray, MRI and ultrasound answer different questions; not every patient needs imaging.
• Progressive rehabilitation should rebuild the walking and stair demands that matter to the patient.
• Inability to bear weight, major trauma, fever or progressive neurological symptoms require urgent assessment.

Arrange a hip-pain assessment in Singapore

If hip pain persists, limits walking or repeatedly returns, a structured assessment can help determine whether gait rehabilitation, imaging, symptom-relief treatment or another pathway is appropriate. Seek urgent care for the warning features described above.

The Pain Relief Clinic
350 Orchard Road, #10-00 Shaw House, Singapore 238868
Call or WhatsApp: +65 9068 9605

Not every investigation or treatment discussed on this page is required, offered or recommended by the clinic. Availability and permissible use of tests, medicines, devices, injections and emerging treatments in Singapore may change with evolving Ministry of Health, Health Sciences Authority and Singapore Medical Council requirements. Individual decisions require clinical assessment and should follow current Singapore regulations and professional guidance.

References

1. Singapore Civil Defence Force. Emergency Medical Services.
2. American Academy of Orthopaedic Surgeons. Osteoarthritis of the Hip.
3. National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management (NG226).
4. American Academy of Orthopaedic Surgeons. Femoroacetabular Impingement.
5. American Academy of Orthopaedic Surgeons. Hip Strains.
6. American Academy of Orthopaedic Surgeons. Stress Fractures.
7. American College of Radiology. ACR Appropriateness Criteria: Chronic Hip Pain.
8. Allied Health Professions Council Singapore. Registers of Allied Health Professionals.

Disclaimer: This information is provided for general reference only and should be used in consultation with your licensed medical doctor. It is not a diagnosis or a substitute for personalised medical advice. Seek urgent care for severe, rapidly worsening or warning-feature symptoms.

Reviewed by Dr Terence Tan — 12 September 2026