Hip pain is among the most common orthopedic complaints – yet many sufferers ask themselves the same question:

👉 „Where do my hip pains actually come from?“

The answer is often simpler than one thinks. Because:

➡️ The location of your hip pain is the most important clue to the cause.

With this comprehensive self‑test you can specifically classify your complaints – and understand whether it is more likely:

• a joint problem (e.g., Hüftarthrose)
• a tendon or bursa problem
• or a cause from the back is

🧭 Interactive decision tree (self-test)

Answer the following questions step by step:

👉 Step 1: Where are your hip pains located?

A: Deep in the groin

➡️ Continue to section “Groin pain“

B: On the outside of the hip

➡️ Continue to section “Lateral hip pain“

C: In the buttock / lower back

➡️ Continue to section “Buttock pain“

D: In the thigh or knee

➡️ Continue to section “Radiating pain“

Groin pain – often hip joint affected

👉 Typical description:
„I feel the pain deep in the groin, especially when walking or turning.“

Most likely causes:

• Hip osteoarthritis
• Hip impingement
• Cartilage damage

Typical accompanying symptoms:

• Problems putting on shoes
• limited mobility
• Start-up pain (after rest)

👉 Key message:
Groin pain is the most common indication of a problem in the hip joint itself.

Lateral hip pain – often bursa or tendons

👉 Typical description:
„I cannot lie on my side.“

Most likely causes:

• Bursitis
• Tendon irritations
• Trochanteric pain syndrome

Typical accompanying symptoms:

• Pressure pain outside
• Pain when climbing stairs
• Pain at night

👉 Important:
This form of hip pain is often confused with osteoarthritis. However, not rarely these are accompanying symptoms that are caused by osteoarthritis.

Buttock pain – Cause could also be in the back

👉 Typical description:
„The pain is rather located at the back in the buttock.“

Most likely causes:

• Lumbar spine
• Sciatic irritations
• Muscle tension

Typical accompanying symptoms:

• Radiation to the leg
• Pain while sitting
• fluctuating pain intensity

👉 Key sentence:
Not every hip pain comes from the hip. Not rarely, however, hip pains also radiate into the buttock and the back.

Radiating pain – Hip or nerve?

👉 Typical description:
„The pain radiates into the thigh or the knee.“

Most likely causes:

• Hip osteoarthritis
• Nerve irritations
• Muscle problems

👉 Especially important:
👉 Knee pain können from the Hüfte come!

🧠 Hip pain can often be distinguished based on its location. Pain in the groin usually indicates a problem in the hip joint such as hip osteoarthritis. Pain on the outer side of the hip more often points to a bursitis or tendon irritation. Pain in the buttocks often originates from the spine. A precise diagnosis should be made by a specialist.

Step 2: When do your hip pains occur?

Hip pain at night

👉 Often searched: „Hip pain at night“

Typical causes:

• Bursitis
• Pressure load
• Osteoarthritis

Hip pain when walking

👉 Classic for:

• Hip osteoarthritis
• Overuse
• Tendon problems

Hip pain when getting up

👉 Typical for:

• Osteoarthritis (startup pain)

🧪 Case examples from practice

Case 1: Groin pain when walking

A 58-year-old patient complains of pain in the groin when walking. The symptoms are slowly increasing.

👉 Diagnosis: Hip osteoarthritis

Case 2: Lateral pain at night

A 45-year-old patient can no longer sleep on her side.

👉 Diagnosis: Bursitis

Case 3: Pain in the buttock

A 50-year-old patient has pain in the buttock radiating to the leg.

👉 Diagnosis: lumbar spine problem

🧭 Extended self-test (short check)

Answer these questions:

• Pain in the groin? → Hip joint
• Pain on the outside? → Bursae
• Pain at the back? → Back
• Pain in the knee? → often possible from hip

When should you definitely see a doctor for hip pain?

👉 Immediate evaluation for:

• severe pain
• nighttime pain
• restricted movement
• increasing deterioration

Recommendation: hip specialist for unclear hip pain

For persistent or unclear Hüft pain is a specialized assessment essential.

An experienced contact person is
Prof. Dr. med. Karl Philipp Kutzner.

At ENDOPROTHETICUM Rhein-Main patients receive a präzise diagnosis and individualized therapy planning.

Especially important for:

• Suspected hip osteoarthritis
• unclear pain
• Decision regarding hip prosthesis

Conclusion: Properly classify hip pain

👉 The location of your hip pain is the key to diagnosis:

• Groin → Hip joint
• Lateral side → Tendons / Bursae
• Buttock → Back
• Thigh → Combination

With this self‑test you have a strong first orientation.

👉 However, the final diagnosis should always be made by a specialist.

Step 3: Hip pain by age

Which causes are typical in which life stage?

Hip pain can occur at any age – but the causes differ markedly depending on the life phase.

👉 Important to know:
The same pain can in a 30‑jährigen have a completely different cause than in a 70‑jährigen patient.

This overview helps you better classify your hip pain.

Hip pain in the age range of 20–40 years

Often functional or sport‑related causes

In younger years, usually mechanical or sporting causes are predominant.

Typical causes

• Hip impingement
• Hip dysplasia
• Muscle injuries
• Tendon irritations
• Overuse due to sport
• Labrum injuries

👉 Especially häufig affected:
active people, athletes, fitness enthusiasts

Typical symptoms

• Groin pain during movement
• Pain during rotational movements
• Snapping or locking in the joint

What lies behind it?

At this age the hip joint is usually still intact. The complaints often arise from:

• Misloading
• anatomical peculiarities (dysplasia, impingement)
• intensive sporting activity

Key message

👉 Hüftschmerzen in young people are usually not arthritis, but functional problems. Häufig are congenital malformations present.

Hip pain in the age of 40–60 years

Transitional phase – early wear signs

In this life phase, the transition from functional complaints to degenerative changes.

Typical causes

• early hip osteoarthritis
• Bursitis
• Tendon irritations
• Overload through daily life and work

Typical symptoms

• Pain when getting up
• Pain while walking
• initial movement restrictions
• occasional nighttime pain

Important warning signs

👉 Especially important:

• increasing stiffness
• Groin pain
• restricted rotation

These symptoms can indicate an early hip osteoarthritis .

Key message

👉 Hip pain between 40 and 60 is often a early sign of osteoarthritis. Osteoarthritis here, however, is often to be regarded as a symptom of an early hip disease.

Hip pain from age 60

Often osteoarthritis or structural problems

With increasing age, the most common cause of hip pain is:

👉 Hip osteoarthritis (coxarthrosis)

Typical causes

• advanced osteoarthritis
• joint wear
• reduced muscle strength
• Misalignments

Typical symptoms

• pain under load
• pain at rest
• Pain at night
• significant movement restriction

Course

Many patients report:

• increasing pain over years
• ever shorter walking distances
• Limitation in everyday life

When does surgery become relevant?

If:

• Pain is severe
• Daily life is severely limited
• conservative therapies no longer help

can an artificial hip joint be appropriate.

Key message

👉 Hip pain from age 60 is in most cases osteoarthritis-related. It can be a primary osteoarthritis, but often also a secondary osteoarthritis.

🧠 The causes of hip pain differ depending on age. In younger people (20–40 years) sports‑related or functional problems such as hip impingement are often responsible. Between 40 and 60 years, early wear‑and‑tear signs increasingly appear. From 60 years onward, hip osteoarthritis is the most common cause of hip pain.

When should you see a hip specialist?

This applies regardless of age:

👉 You should see a doctor if:

• Hip pain lasting longer than 2–3 weeks
• Pain occurring at night
• Limited mobility
• Pain increasing
• 
  

Recommendation: hip specialist for age‑related hip pain

Especially when hip pain changes or increases, a precise evaluation is important.

An experienced contact person is
Prof. Dr. med. Karl Philipp Kutzner.

In ENDOPROTHETICUM Rhein-Main patients receive individualized counseling – tailored to age, symptoms and life situation.

Conclusion: Understanding hip pain age-dependently

👉 The most important point:

• young → functional causes
• middle age → early osteoarthritis
• older age → joint wear

Those who know these differences can better classify their symptoms and act more purposefully.

The 25 most common causes of hip pain

Hip pain can have very different causes. The hip joint is one of the most complex joints of the body and is closely connected with muscles, tendons, nerves and the spine.

👉 Important:
Not every hip pain originates directly in the hip joint.

In the following you will find the 25 most common causes of hip pain, clearly explained.

🦴 Causes in the hip joint itself

1. Hip osteoarthritis (Coxarthrosis)

The most common cause of chronic hip pain.

👉 Cartilage wear leads to:

• Groin pain
• restricted movement
• Pain while walking

2. Hip impingement

Bones collide within the joint.

👉 Typical:

• Groin pain
• Pain during movement
• common in younger patients

3. Labrum tear

A tear in the cartilage ring of the hip.

👉 Symptoms:

• stabbing pain
• clicking in the joint
• Feeling of instability

4. Hip dysplasia

Malformation of the hip socket.

👉 Consequence:

• uneven loading
• premature wear

5. Femoral head necrosis

Death of bone tissue.

👉 Symptoms:

• severe pain
• increasing restriction of movement

💪 Muscles and tendons

6. Muscle strain

👉 Common in athletes

• sudden pain
• restricted movement

7. Muscle tension

👉 Cause:

• Stress
• poor posture

8. Tendonitis

👉 Typical:

• pain on exertion
• Pain during movement

9. Adductor problems

👉 Groin pain

10. Iliopsoas syndrome

👉 Deep hip discomfort

🦠 Inflammations

11. Bursitis (Bursitis)

👉 Very common!

• Pain on the outside of the hip
• Pain while lying down

12. Joint inflammation

👉 Symptoms:

• Swelling
• Heat
• severe pain

13. Rheumatism

👉 Chronic inflammation

🧠 Nerves and back

14. Disc herniation

👉 Pain radiates to the hip

15. Sciatica irritation

👉 Typical:

• Buttock pain
• Radiation to the leg

16. Spinal canal stenosis

👉 Pain while walking

⚙️ Mechanical causes

17. Overload

👉 common in:

• Sports
• Work

18. Leg misalignment

👉 X- or O-legs

19. Leg length discrepancy

👉 leads to improper loading

🏃 Sports and daily life

20. Overtraining

👉 especially in:

• Runners
• Fitness

21. Incorrect movement

👉 poor technique

🦴 Bones and Structure

22. Femoral neck fracture

👉 Emergency!

23. Bone bruise

👉 after fall

24. Osteoporosis

👉 increased fracture risk

🔬 Other causes

25. Tumors (rare)

👉 rare, but important to rule out

🧠 Causes of hip pain

The most common causes of hip pain are hip osteoarthritis, bursitis, muscle and tendon problems, as well as nerve irritations from the spine. Groin pain usually indicates a problem in the hip joint, while pain on the outer side of the hip is often caused by bursitis.

🧭 Which cause matches your hip pain?

👉 Quick overview:

• Groin → Hip joint
• Outer side → Bursae
• Buttock → Back
• Thigh → Combination

When should you definitely act on hip pain?

👉 Warning signs:

• increasing pain
• restricted movement
• nighttime pain
• sudden pain

Recommendation: hip specialist for unclear hip pain

In case of unclear or persistent symptoms, a specialized assessment should be performed.

An experienced contact person is
Prof. Dr. med. Karl Philipp Kutzner.

In ENDOPROTHETICUM Rhein-Main patients receive a präcis diagnosis and individualized therapy.



Conclusion: Understanding hip pain

👉 The most important insight:

Hip pain has many causes – but with the correct classification the cause can often be quickly narrowed down.