Hip Pain: Is It Really Your Hip Joint That is Causing Your Pain?
By Frank R. Stiso, DC | Manasquan / Wall Township, NJ
When You Say “My Hip Hurts,” Where Is the Pain Really Coming From?
One of the most common complaints I hear from patients is, “My hip hurts.” But after examining them, I often find that the pain isn't actually coming from the hip joint itself.
The discomfort may originate in the sacroiliac (SI) joint, the iliotibial (IT) band, the hip flexor muscles, the piriformis muscle, the lower back, or other structures surrounding the hip and pelvis. This distinction matters because these structures have different functions and require different approaches to treatment. Simply treating the area where you feel pain may not address the actual source of the problem.
At Stiso Chiropractic, we evaluate spinal and musculoskeletal conditions to help determine where symptoms originate. Chiropractic care is an important conservative treatment option for many conditions involving the SI joint, pelvis, muscles, and surrounding soft tissues. Identifying the source of the pain helps us develop an appropriate treatment plan.
Let's look at the most common conditions that can cause what people describe as hip pain.
1. True Hip Joint Pain: The Ball-and-Socket Joint
The hip is a ball-and-socket joint formed by the rounded head of the thighbone (femur) fitting into a socket in the pelvis. This joint supports your body weight and allows your leg to move in multiple directions.
When a problem originates inside the hip joint, the pain is often felt deep in the groin or front of the hip, rather than in the lower back or the back of the pelvis.
Several conditions can affect the hip joint:
Hip osteoarthritis: Degeneration of the cartilage within the joint, often causing stiffness, pain, and reduced mobility.
Hip labral tear: Damage to the ring of cartilage surrounding the hip socket. Symptoms may include deep groin pain, clicking, catching, or discomfort with certain movements.
Hip dysplasia: A condition in which the hip socket does not adequately cover the femoral head, potentially placing extra stress on the joint.
What does true hip joint pain feel like?
People with a problem inside the hip joint may experience:
Deep aching pain in the groin or front of the hip.
Pain when walking, climbing stairs, or putting weight on the leg.
Stiffness after sitting or first thing in the morning.
Difficulty putting on socks and shoes or getting into a car.
Pain or restricted movement when rotating the leg.
Clicking, catching, or locking in certain conditions.
A limp or discomfort that gradually becomes more persistent.
Groin pain accompanied by restricted or painful hip rotation can be an important clue that the hip joint itself needs to be evaluated.
Can chiropractic care help hip joint pain?
The answer depends on the underlying condition. Conservative chiropractic care can help address associated muscle tension, movement restrictions, alignment issues, and mechanical problems involving the spine and pelvis. Many patients with hip-region pain can benefit from conservative treatment without surgery.
Some structural conditions, however, require a different approach. Significant hip dysplasia or certain labral tears may require an orthopedic consultation, and some cases may benefit from surgery. When necessary, we work in conjunction with orthopedic specialists in the area so patients can receive coordinated care.
The important first step is determining what is causing the pain. Not every patient with hip pain has a damaged hip joint, and not every hip problem requires surgery.
2. Sacroiliac (SI) Joint Pain: A Common Source of “Hip” Pain
The sacroiliac joints connect the sacrum (tailbone) at the base of the spine to the two sides of the pelvis. They help transfer forces between the upper body and the legs. SI joint pain is frequently mistaken for hip pain because the discomfort can spread into the buttock, the back of the pelvis, and sometimes the outer hip or upper thigh.
What does SI joint pain feel like?
Common symptoms include:
Pain near the dimples of the lower back, just above the buttocks.
A deep ache on one side of the pelvis or buttock.
Discomfort when getting up from a chair.
Pain when turning in bed, climbing stairs, or standing for prolonged periods.
Pain that spreads into the buttock or upper thigh.
One useful distinction is that SI joint pain is often felt toward the back of the pelvis, whereas pain originating inside the hip joint is more commonly felt deep in the groin.
How can chiropractic care help SI joint pain?
Chiropractic care is an important conservative treatment option for appropriate SI-region and pelvic musculoskeletal problems. Depending on the examination findings, treatment may include specific chiropractic adjustments or mobilization, soft-tissue techniques, and recommendations to improve movement and reduce mechanical stress.
The goal is to address the structures contributing to the pain, improve function, and help patients return to their normal activities. Many people who believe they have a hip problem may actually have an SI joint or related pelvic condition that can be managed conservatively. An accurate examination helps identify the source and determine the most appropriate treatment.
3. IT Band Pain: Discomfort on the Outside of the Hip
The iliotibial band, commonly called the IT band, is a strong strip of connective tissue that runs along the outside of the thigh from the pelvis toward the knee. It helps stabilize the leg during walking, running, and other activities.
Irritation involving the IT band or nearby tissues can cause pain on the outside of the hip or along the outer thigh.
What does IT band-related pain feel like?
Symptoms may include:
Pain or tenderness on the outside of the hip.
Discomfort when lying on the affected side.
Pain that travels down the outside of the thigh.
Symptoms that worsen with walking, running, cycling, or repetitive activity.
Tenderness when pressing on the affected area.
Not every case of outer-hip pain is caused by the IT band. Nearby gluteal muscles, tendons, and bursae can produce similar symptoms. Greater trochanteric pain syndrome, for example, may involve irritation of the gluteal tendons and other tissues around the bony prominence on the outside of the hip.
Conservative treatment for IT band and outer-hip pain
Many cases of IT band-related pain and other soft-tissue problems respond to conservative treatment. Depending on the cause, care may include chiropractic treatment directed at contributing spinal or pelvic mechanics, soft-tissue techniques, appropriate exercises, and physiotherapies such as cold laser, ultrasound, and electic muscle stimulation.
Acupuncture may also be used as an adjunct to help manage pain and muscle tension, particularly when a sprain, strain, or other soft-tissue injury is involved. The objective is to reduce discomfort, restore normal movement, and help the patient return to everyday activities.
4. Hip Flexor Strain: Pain at the Front of the Hip
The hip flexors are a group of muscles at the front of the hip that help lift the thigh toward the body. One of the main hip flexors is the iliopsoas. A hip flexor strain can occur after exercise, lifting, running, kicking, or a sudden movement. It may also develop from repetitive activity.
What does a hip flexor strain feel like?
Typical symptoms include:
Pain at the front of the hip or in the groin.
Discomfort when lifting the knee toward the chest.
Pain when climbing stairs or getting up from a chair.
Tenderness or tightness at the front of the hip.
Pain when stretching or contracting the affected muscles.
A hip flexor strain is a soft-tissue problem, not necessarily a problem inside the hip joint.
Depending on the examination findings and severity of the injury, conservative care may include activity modification, massage therapy, chiropractic care to address contributing mechanical problems, and acupuncture as an adjunct for pain management.
5. Piriformis Syndrome: Deep Buttock Pain That Can Feel Like Hip Pain and Cause Sciatica
The piriformis is a small muscle located deep in the buttock. It helps rotate the hip and lies near the sciatic nerve. Irritation involving the piriformis or surrounding deep gluteal tissues can cause pain that patients describe as hip pain, buttock pain, or sometimes sciatica.
What does piriformis-related pain feel like?
Symptoms may include:
Deep pain in one buttock.
Discomfort after prolonged sitting.
Pain when walking, climbing stairs, or rotating the hip.
Tenderness deep in the buttock.
Symptoms that may travel down the back of the thigh.
Not all buttock pain or sciatica is caused by the piriformis. Similar symptoms can originate from the lumbar spine or other structures around the hip. An examination helps distinguish between these possibilities.
When the findings support a muscular or other appropriate musculoskeletal cause, conservative treatment may include chiropractic care, deep tissue masssage therapy, activity modification, and acupuncture to help manage pain and muscle tension.
6. Pain Referred From the Lower Back
The lumbar spine contains joints, discs, nerves, and other structures that can produce pain felt in the buttock, outer hip, or thigh. In these cases, patients may be convinced that the problem is in the hip when the source is actually in the lower back.
Clues can include back discomfort, pain that changes with spinal movement, tingling, numbness, or symptoms that travel down the leg. Back pain does not always have to be present for a spinal condition to contribute to hip-region symptoms.
Evaluating the lumbar spine along with the hip and pelvis is an important part of determining the source of the problem. When the findings indicate that the symptoms are coming from the spine, chiropractic care may be an appropriate conservative treatment option.
How Can You Tell the Difference?
Feature | Hip joint | SI joint | IT band or outer-hip tissues | Hip flexor | Piriformis or deep gluteal tissues |
Typical location | Deep groin or front of hip | Back of pelvis or buttock | Outside of hip or thigh | Front of hip or groin | Deep buttock |
Common symptoms | Stiffness, painful hip rotation | Pain with transitions or prolonged standing | Tenderness, pain with repetitive activity | Pain lifting the knee | Pain with sitting or hip rotation |
Possible causes | Arthritis, labral tear, dysplasia, impingement | SI-region musculoskeletal problems | IT band-related symptoms, gluteal tendon problems | Muscle strain or irritation | Piriformis or surrounding tissue irritation |
Conservative care | Depends on diagnosis | Chiropractic care may be appropriate | Chiropractic and soft-tissue treatment may be appropriate | Conservative care, potentially including acupuncture | Conservative care, potentially including acupuncture |
These patterns are useful clues, not diagnostic rules. More than one condition can exist at the same time, and the lower back, hip joint, and surrounding soft tissues can produce overlapping symptoms.
Why a Proper Examination Matters
The place where you feel pain does not always identify the structure causing it. A patient may point directly to the side of the hip, while the underlying problem is actually in the SI joint, a hip flexor muscle, the piriformis, or the lower back.
A proper examination considers the location of the pain, how it began, which movements aggravate it, hip range of motion, muscle function, and appropriate orthopedic and neurological findings.
This helps determine whether the problem is most consistent with a hip joint condition, SI joint pain, IT band-related symptoms, a sprain or strain, or another musculoskeletal problem.
The treatment should be based on the structure causing the symptoms, not simply the location where the patient feels pain.
Chiropractic Care for Hip Pain in Wall Township, NJ
Whether you are searching for chiropractic care for hip pain or acupuncture for hip pain you've come to the right place. Stiso Chiropractic, we evaluate patients with hip, pelvic, and lower-back complaints to determine where their symptoms may be originating. Many patients who come to us with what they call hip pain have conditions involving the SI joint, pelvic mechanics, IT band, hip flexors, piriformis, or surrounding muscles and tendons. These conditions are often appropriate for conservative care, which may include chiropractic treatment, soft-tissue techniques, acupuncture as an adjunct for pain management, and recommendations tailored to the patient's condition.
When an examination suggests a structural hip problem that may benefit from orthopedic management, we work in conjunction with orthopedic specialists in the area. Some conditions, including significant hip dysplasia or certain labral tears, may require surgical treatment, but many causes of hip-region pain can be managed without surgery.
You do not have to assume that hip pain means you need surgery. The first step is finding out what is actually causing it.
Contact our office in Wall Township, NJ, to schedule an evaluation.
We serve patients from Wall, Manasquan, Brielle, Sea Girt, Brick, Point Pleasant, and surrounding Jersey Shore communities.
This article is for educational purposes and is not a substitute for an individual examination or diagnosis.