Hip Pain
Hip pain is common, and the first useful thing to establish is whether it is actually coming from the hip.
A great deal of what people call hip pain originates somewhere else — the tendons on the outside of the hip, the lower back, or structures deep in the buttock. Each needs a different treatment, which is why the location of your pain is the first question an assessment answers.
Pain at the front of the hip or in the groin, pain over the outside, and pain in the buttock are three different problems. This page takes them in turn.
Pain at the front of the hip or groin
Pain felt at the front of the hip or in the groin is the pattern most likely to be coming from the hip joint itself.
Hip osteoarthritis
Hip osteoarthritis commonly causes groin or front-of-hip pain, stiffness, and movement that gradually reduces.
People notice it putting on shoes and socks, getting in and out of a car, walking any distance, or turning on that leg.
Osteoarthritis is not simply a worn-out joint. Symptoms are influenced by what is happening inside the joint, but also by strength, activity levels, body weight and general health — which is why two people with similar X-rays can be in very different positions.
Treatment usually starts with education, exercise and physiotherapy. A steroid injection into the hip joint can be considered where symptoms remain troublesome or are preventing rehabilitation.
Where osteoarthritis is advanced and significantly affecting quality of life despite appropriate non-surgical treatment, referral to consider hip replacement may be appropriate.
Labral and other hip joint problems
The labrum is a ring of cartilage around the edge of the hip socket. Labral changes or tears can contribute to groin pain, clicking or catching — though labral abnormalities also show up on imaging in people with no symptoms at all.
Other causes of front-of-hip pain include femoroacetabular impingement (FAI), iliopsoas-related pain and, less commonly, stress injury or other bone and joint conditions.
Where the problem is deep inside the hip joint, MRI or X-ray is usually more informative than ultrasound.
Pain over the outside of the hip
Pain on the outside of the hip is very common, and it does not mean the hip joint is arthritic. One of the commonest causes is greater trochanteric pain syndrome, or GTPS.
Gluteal tendinopathy
The gluteus medius and gluteus minimus tendons attach around the greater trochanter — the prominent bone you can feel on the outside of the hip. These tendons can develop tendinopathy and, sometimes, partial or more significant tears.
The giveaway symptom is pain lying on that side at night. It is also aggravated by walking, climbing stairs and standing on one leg.
Treatment usually starts with physiotherapy: modifying what is aggravating it, and a progressive strengthening programme.
Trochanteric bursitis
Several bursae sit around the tendons on the outside of the hip — small fluid-containing structures that help tissues slide over one another.
Bursal irritation often occurs alongside gluteal tendinopathy. The label “trochanteric bursitis” is widely used, but lateral hip pain frequently involves the tendons as well as, or instead of, the bursa. That distinction matters, because it changes what the treatment should target.
Where pain is significant or preventing rehabilitation, an ultrasound-guided steroid injection may be considered.
Pain in the buttock or back of the hip
Pain felt mainly in the buttock is less likely to be coming from the hip joint.
The lower back
The lumbar spine is an important and frequently overlooked source of pain around the buttock and hip. It can refer pain there even when back pain itself is relatively minor.
If a nerve is irritated, symptoms may travel further down the leg, with pins and needles, numbness or weakness.
Proximal hamstring tendinopathy
The hamstring tendons attach to the pelvis deep in the lower buttock. Tendinopathy here causes pain around the sitting bone, typically during prolonged sitting, running, lunging, or anything involving repeated hip flexion.
Rehabilitation and progressive tendon loading are the main treatments.
Other causes
Pain in this area can also come from the sacroiliac joint, from deep gluteal structures, or from irritation around the sciatic nerve. Less commonly it is referred from elsewhere entirely.
Which is why location alone narrows the field but does not settle the diagnosis.
Do I need an ultrasound scan?
Not everybody with hip pain needs a scan, and ultrasound is not always the right one.
Diagnostic ultrasound is well suited to the soft tissues around the outside of the hip — the gluteal tendons and the bursae in particular. It can also assess some structures at the front and identify fluid within the joint.
It cannot adequately assess everything inside the hip joint. For suspected osteoarthritis a weight-bearing X-ray is usually more useful, and MRI is better where detail about the joint, labrum, bone or deeper structures is needed.
So the decision to scan — and which scan — follows the clinical assessment, rather than every painful hip being scanned as a matter of routine.
How is hip pain treated?
Physiotherapy first
For most causes of hip pain, physiotherapy and exercise are the starting point.
What that involves depends on the diagnosis, and may include restoring movement, progressive strengthening, and building the capacity of the muscles and tendons around the hip, while temporarily reducing what is aggravating things.
It should also account for your general health, your activity, and what you actually need the hip to do for work, daily life and sport.
Steroid injections
A steroid injection, sometimes called a cortisone injection, may be considered where pain is significant or persistent, or is blocking progress with rehabilitation.
The injection has to target the structure responsible. An injection into the hip joint for osteoarthritis is an entirely different procedure from one around the outside of the hip for bursal pain, and the two are not interchangeable.
An injection can occasionally be informative as well as therapeutic. Where it is unclear whether pain is coming from the hip joint or the structures around it, the response to a carefully targeted injection adds real clinical information.
At Meyer Physio these are performed under ultrasound guidance, so the intended target is identified and the needle placed in it.
When is further investigation needed?
Further imaging or medical assessment may be appropriate where the diagnosis remains uncertain, symptoms are not behaving as expected, or there is significant loss of movement or function.
Particular care is needed where hip pain follows significant trauma, where you cannot weight-bear, where night pain is severe or progressive, where there are unexplained systemic symptoms, or where there are significant neurological symptoms. In those situations an X-ray, MRI, blood tests or a specialist referral may be more appropriate than ultrasound.
What does it cost?
Every appointment lasts a full hour. Where a diagnostic scan is needed, that appointment is charged at the scan rate, which replaces the standard consultation fee rather than being added to it. Current prices are on our prices page.
Hip pain assessment in Weybridge
“Hip pain” covers a wide range of conditions. Groin pain, lateral hip pain and buttock pain have different causes and need different treatment, and getting that wrong is the commonest reason a hip fails to improve.
Meyer Physio assesses and treats hip problems at its clinic on Baker Street in Weybridge, Surrey, combining clinical examination, diagnostic ultrasound, ultrasound-guided injection and rehabilitation in one place. The clinician who examines you is the one who scans, performs any procedure and manages the rehabilitation afterwards.
You can come to us directly — no GP referral is needed to book, and there is no waiting list.
Written by Suegnet Meyer, Advanced Practice Musculoskeletal Physiotherapist and MSK Sonographer. HCPC registered [PH55635]. Chartered Society of Physiotherapy member [66175]. Last reviewed: 29 October 2026.