Why does your hip keep hurting?

What to notice about the ache

A deep groin ache often comes from the hip joint itself. Arthritis can also bring stiffness after rest and make daily movement harder.

Soreness on the outer hip often involves a nearby tendon instead. It may worsen when you lie on that side in bed.

Back trouble can send an ache toward the hip and upper leg. That's why the sore spot and timing matter during an exam.

Write down whether rest eases the ache or walking brings it back. This timing helps the examiner compare the possible causes.

What to try while the hip settles

Gentle daily movement can keep the hip from growing even stiffer. Several brief walks may feel better than one long walk.

Warmth may ease stiffness, while cold may calm soreness after activity. Don't repeat a movement that clearly raises the ache afterward.

At QC Kinetix, orthobiologics means care that uses material from your own body, such as blood. PRP is prepared by spinning a blood sample before placing its platelet-rich part in the sore area.

When to have the cause checked

Arrange a visit when soreness keeps disturbing sleep or makes ordinary walking harder. A sudden change after a fall deserves quicker medical care.

Ask what the examiner found that supports the likely cause. Facts about knee care may not answer a question about your hip joint.

Ask when relief might begin and how long it may last. The answer should include risks, total cost, follow-up, and other sensible choices.

Evidence sources

1. A network meta-analysis restricted to LARGE intra-articular trials (57 RCTs, 22,795 participants, >=100 patients per group) found treatment effects were consistently larger in the 35 high-risk-of-bias trials than in the 22 low/unclear-risk trials. Excluding high-risk trials, triamcinolone had the highest probability of exceeding the minimal important difference at weeks 2 and 6; hyaluronic acid had no effect on pain (SMD -0.04, 95% CI -0.19 to 0.11) with higher odds of dropouts due to adverse events (OR 2.01) and serious adverse events (OR 1.86) than placebo. Effects of 16 of 18 interventions were smaller than the MID.

   Pereira TV, et al. — Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis.. Osteoarthritis and Cartilage, 2025.

2. A 2025 Level I systematic review of intra-articular hyaluronic acid RCTs in the hip (982 patients, mean follow-up 6.4 months) found both high- and low-molecular-weight HA improved WOMAC and VAS scores from baseline, with high-molecular-weight HA scoring lower on VAS than placebo at 4-6 months (MD -1.6, 95% CI -2.1 to -1.1). It sits in direct tension with the placebo-controlled hip RCT and the AAOS strong-against recommendation, and its stated conclusion refers to knee OA symptoms - a reporting inconsistency worth noting rather than papering over.

   Migliorini F, et al. — Intra-articular hyaluronic acid injections for hip osteoarthritis: a level I systematic review.. European Journal of Orthopaedic Surgery & Traumatology, 2025.

3. A 2025 systematic review and meta-analysis of PRP with versus without hyaluronic acid in hip OA (2 RCTs plus 1 cohort, 190 patients) found the combination produced significantly HIGHER pain scores than PRP alone at 3 months (SMD 0.35, 95% CI 0.06-0.64) and at 12 months (MD 11.92 points, 95% CI 3.87-19.97) - that is, adding HA made pain worse, not better.

   Santiago MS, et al. — Platelet-rich plasma with versus without hyaluronic acid for hip osteoarthritis: a systematic review and meta-analysis.. Frontiers in Bioengineering and Biotechnology, 2025.

4. A 2025 systematic review restricted to medium/high-quality low-risk-of-bias RCTs found only four interventions with demonstrated efficacy in gluteal tendinopathy: exercise and education (moderate strength, medium short-term effect on pain SMD 0.95 and function SMD 0.91), corticosteroid injection (small short-term pain effect SMD 0.51), PRP (superior to corticosteroid for short-term function), and focused shockwave therapy (long-term pain superiority over corticosteroid). Exercise and education is the recommended core.

   Bremer T, et al. — The efficacy of gluteal tendinopathy treatments: A systematic review.. Clinical Rehabilitation, 2025.

5. The NIHR RUbICOn study followed 23,899 UK osteoarthritis patients who received intra-articular corticosteroid injections (40% received more than one). Injection was associated with a lower five-year cumulative incidence of KNEE replacement (NNT 17), but NOT of HIP replacement. Injections appeared generally safe, with numerically higher but non-significant signals for diabetes and cardiovascular events.

   Whitehouse MR, et al. — RecUrrent Intra-articular Corticosteroid injections in Osteoarthritis: the RUbICOn mixed-methods study.. Health Technology Assessment, 2025.

6. A 2025 review of mesenchymal stem cell injection research in orthopaedics identified 449 registered clinical trials, of which only 159 (35.4%) were complete and only 56 (12.5%) had published results in peer-reviewed journals. Hip and knee osteoarthritis were the most common indications (37.6%). Reported cell concentrations spanned three orders of magnitude and 55.5% of protocols did not specify a concentration at all.

   Bezuglov E, et al. — Mesenchymal stem cells injections in traumatology and orthopaedics: common practice or still a promising area with many uncertainties?. BMC Musculoskeletal Disorders, 2025.

7. A systematic review of five randomized trials of intra-articular PRP for hip OA (43-111 patients each) reported significant pain reduction and functional improvement in every included study with no major adverse events, but methodological quality ranged from low to high risk of bias and PRP preparation methods differed between studies - so this positive summary rests on a small and heterogeneous base and does not override the placebo-controlled network meta-analysis.

   Almutairi AN, Alazzeh MS — Efficacy and Safety of Platelet-Rich Plasma (PRP) Intra-articular Injections in Hip Osteoarthritis: A Systematic Review of Randomized Clinical Trials.. Cureus, 2024.