Hip pain: when to see a physiotherapist, and what helps

When to see a physiotherapist for hip pain

For new, mild hip pain, the NHS self-help advice is a sensible first step (NHS, 2025):

• Keep moving gently, but don't overdo it.
• Use an ice pack wrapped in a towel for up to 20 minutes every 2 to 3 hours.
• Take paracetamol, or ibuprofen gel or tablets, if they are suitable for you.
• Wear comfortable, shock-absorbing shoes and try gentle hip stretches.
• Avoid carrying heavy things and sitting in low chairs.

If it is no better after 2 weeks, or any of the points above apply, get it assessed. Private physiotherapy is one route; in many areas you can also refer yourself to NHS community musculoskeletal (MSK) services without seeing a GP (NHS, 2025).

Where is your hip pain? A rough guide

Where you feel the pain is a useful first clue, though the patterns overlap.

Sources: Kingston and Richmond NHS Foundation Trust (2024); Mersey Care NHS Foundation Trust (n.d.); Griffin et al. (2016); NHS (2024).

Common causes of hip pain

Outer hip pain: greater trochanteric pain syndrome

Greater trochanteric pain syndrome (GTPS) affects the muscles and tendons on the outside of the hip. It causes an ache on the outside of the hip and upper thigh that is often worse lying on that side, on stairs or getting up from a chair (Kingston and Richmond NHS Foundation Trust, 2024). It is more common in women: a US study of over 3,000 adults aged 50 to 79 found it in 23.5% of women, on one or both sides, compared with 8.5% of men (Segal et al., 2007).

A trial of 204 people with gluteal tendinopathy compared 14 physio-led education and exercise sessions over 8 weeks with one steroid injection or waiting to see. At 8 weeks, 51 of 66 people in the exercise group rated themselves a success, compared with 38 of 65 after the injection and 20 of 68 who waited. At one year, exercise was still ahead of the injection for overall improvement, although pain levels in the two groups were similar (Mellor et al., 2018).

In another trial of 229 people with long-standing outer hip pain, a steroid injection gave the best results at 1 month, radial shockwave did best at 4 months, and at 15 months shockwave and home exercise both did better than the injection (Rompe et al., 2009). That is why shockwave therapy can be worth considering for outer hip pain that hasn't settled.

Groin pain and pain when walking: hip osteoarthritis

Hip osteoarthritis pain is usually worst when you are weight bearing, such as walking. It is often felt deep in the groin and can spread to the outside of the hip, the buttock or the knee. Stiffness after rest, grinding or clicking, and difficulty putting on shoes and socks are common (Mersey Care NHS Foundation Trust, n.d.).

NICE says osteoarthritis can be diagnosed without an X-ray in people aged 45 or over with activity-related joint pain and no morning stiffness, or stiffness lasting no longer than 30 minutes. The core treatments are therapeutic exercise and, where needed, weight management, with manual therapy only used alongside exercise. Steroid injections can be considered when other medicines haven't worked or aren't suitable, but give short-term relief of 2 to 10 weeks (NICE, 2022). Read more about hip osteoarthritis treatment.

Groin pain in younger, active adults: FAI and hip dysplasia

The main symptom of femoroacetabular impingement (FAI) syndrome is hip or groin pain linked to certain movements or positions. Clicking, catching, stiffness or giving way can also occur. The diagnosis needs symptoms, examination findings and imaging together, because the hip shape on a scan alone is not enough (Griffin et al., 2016).

In the UK FASHIoN trial, 348 people with FAI syndrome had either keyhole hip surgery or personalised, physiotherapist-led hip therapy. Both groups improved. At 12 months the surgery group scored on average 6.8 points higher on a hip quality of life questionnaire, just above the 6.1 points judged to be clinically meaningful (Griffin et al., 2018).

Adult hip dysplasia is a shallower hip socket than usual. It usually causes groin pain that is worse with standing, walking or running, sometimes with clicking or popping, and it can lead to earlier arthritis (Calderdale and Huddersfield NHS Foundation Trust, n.d.). See our hip dysplasia page.

Pain coming from your back

Sciatica usually causes pain in the buttock and down the back of one leg, often with pins and needles, numbness or weakness, and is often worse with movement, sneezing or coughing (NHS, 2024). Lower back and hip problems often cause overlapping symptoms (Chang et al., 2026), so checking your back is part of any hip assessment. See also sciatica or piriformis syndrome.

Hip pain at night and when walking

Pain when lying on your side at night is typical of outer hip pain. Sleeping on your back or your other side with a pillow between your knees can help, along with avoiding crossing your legs, sitting in low chairs and standing with your weight on one hip. It usually improves within 3 to 6 months (Kingston and Richmond NHS Foundation Trust, 2024).

Pain when walking is more typical of osteoarthritis. Strengthening the hip muscles and building up to 150 minutes of moderate activity a week, such as cycling or brisk walking, are recommended. If there is no improvement after 4 to 6 weeks of self-management, see a physiotherapist or GP (Mersey Care NHS Foundation Trust, n.d.).

Private physiotherapy for hip pain: what to expect

A physio assessment costs £45. We ask where and when it hurts, check your back as well as your hip, test movement and strength, and explain what we think is causing the pain. Most plans are built around exercise, and where it fits we may discuss shockwave therapy (£45 per session, usually 2 to 3 sessions over 2 to 3 weeks, then a review) or a steroid injection. Diagnostic ultrasound scans are available from £80 if a scan would help.

Steroid is a prescription-only medicine, so an injection is only given after assessment by a qualified prescriber. Our Clinical Director, Jamie Fullerton, is an HCPC registered physiotherapist and independent prescriber, and every injection is given under live ultrasound guidance. It costs £150, including the guidance and medication. Further physio sessions are explained and priced before you book.

Frequently asked questions

Should I see a physio or a GP for hip pain?

For most hip pain without warning signs, a physiotherapist is a good place to start, and you don't need a GP referral to see one privately. The NHS also lets you refer yourself to community MSK services in many areas. Severe pain after a fall, being unable to put weight on the leg, or a hot, swollen hip with a high temperature need urgent medical care instead.

Can a physiotherapist help with hip arthritis?

Yes. NICE guidance says therapeutic exercise is a core treatment for hip osteoarthritis, along with weight management where needed, and manual therapy should only be used alongside exercise. A physio can confirm the likely diagnosis, set up a strengthening and activity plan that suits you, and help you decide whether other options, such as a steroid injection for short-term relief, are worth considering.

Why does my hip hurt at night when I lie on my side?

Pain lying on your side is typical of greater trochanteric pain syndrome, which affects the tendons on the outside of the hip. Sleeping on your back or the other side with a pillow between your knees can help, as can avoiding crossing your legs and sitting in low chairs. It usually improves within 3 to 6 months, and exercise-based treatment has good evidence behind it.

Is a steroid injection good for hip pain?

It can help some people in the short term. For hip osteoarthritis, NICE says steroid injections give short-term relief of 2 to 10 weeks and can be considered when other medicines have not worked. For outer hip pain, trials found an injection helped quickly but exercise did better over a year. Steroid is prescription-only, so it is given after assessment by a qualified prescriber.

Do I need a scan for hip pain?

Often not. NICE says osteoarthritis can be diagnosed without imaging in people aged 45 or over with activity-related joint pain and little or no morning stiffness. Scans are more useful when symptoms are unusual, when hip impingement or dysplasia is suspected, or when the diagnosis is unclear. Your physio will explain whether a scan would change your treatment before suggesting one.