Hip Pain in Women: Common Causes

Hip pain is common in women, and “hip pain” can mean a lot of different things. The good news is that the location of your pain is one of the most useful clues to what's actually going on — and getting that right is the first step toward the right treatment.

Where is your pain? (it matters)

• Groin / front of the hip — most often the hip joint itself (arthritis, impingement, labral problems).
• Outer / side of the hip — often bursitis or gluteal tendon problems.
• Buttock / radiating down the leg — frequently referred from the lower back or SI joint, not the hip at all.

Hip-joint causes (usually groin pain)

• Hip osteoarthritis — cartilage wear causing groin pain, stiffness, and lost motion; a leading cause of true hip pain.
• Hip impingement (FAI) and labral tears — abnormal contact or a torn cartilage rim, often in younger, active women.
• Hip dysplasia — a shallow socket that overloads the joint and can lead to earlier arthritis.
• Avascular necrosis — loss of blood supply to the femoral head.
• Inflammatory arthritis — such as rheumatoid arthritis.

Explore these in more depth: hip osteoarthritis, hip impingement (FAI), hip dysplasia in adults, and avascular necrosis.

Outer-hip causes: bursitis & tendons

Pain on the bony prominence on the side of the hip — especially when lying on that side — is frequently greater trochanteric bursitis or a gluteal tendon problem, both more common in women. These are usually managed without surgery, with activity modification, physical therapy, and sometimes an injection.

When it's actually the back

One of the most important distinctions is that not all “hip” pain comes from the hip. Pain in the buttock, pain that radiates down the leg, or pain that changes with back movements often comes from the lumbar spine or SI joint. Hip and back problems can also coexist, which is why a careful exam matters — treating the wrong source is a common reason people don't get better.

Causes more common in women

• Hip dysplasia — more frequently diagnosed in women; can drive earlier arthritis.
• Greater trochanteric bursitis — outer-hip pain, more common in women.
• Rheumatoid and inflammatory arthritis — affects women more often.
• Bone health — in older women, osteoporosis-related stress fractures can present as new hip or groin pain and warrant prompt evaluation.

When to get evaluated

See a doctor if your hip pain:

• Persists or keeps coming back
• Limits walking, stairs, or daily activities
• Wakes you at night
• Followed an injury or fall
• Isn't improving with rest and basic measures

A focused exam plus an AP pelvis X-ray — which shows both hips at once — clarifies most cases. If it turns out to be hip arthritis, it helps to know the signs it may be time to consider treatment and the non-surgical options that almost always come first.

From Dr. Harb

Most hip pain in women is not an emergency and not an automatic path to surgery — but it does deserve an accurate diagnosis. The location of your pain, a good exam, and the right imaging usually make the picture clear, and the great majority of causes are managed without an operation.