Common in later lifeStrong evidence
About 1 in 5 people aged 65 and over in an Oxfordshire survey (19.2% of 3,341) had hip pain on most days for a month or longer in the past year, and 40.7% had hip or knee pain. In a US survey of 6,596 adults aged 60 and over, 14.3% had significant hip pain on most days for 6 weeks, women more often than men. In 7,878 people aged 50 and over in North Staffordshire, most kinds of pain became less common with age, but pain in the hips, knees and feet didn't.
"Hip pain is common, especially as you get older," the NHS says. Common isn't the same as untreatable: what helps, and how much, is below.
Sources 1, 2, 3, 4
Osteoarthritis comes first, and it isn't the hip wearing outStrong evidence
The NHS says joints meet a constant low level of everyday damage that the body usually repairs; osteoarthritis is when that repair falls behind, it is more common in women, and it doesn't necessarily get worse over time and can sometimes gradually improve. Arthritis UK describes "a normal cycle of wear and repair" and says the hip is the second most commonly affected joint. Worldwide it is far less common at the hip than at the knee (about 418 against 4,307 in every 100,000 people in 2020, in modelled estimates adjusted for age). Arthritis UK's 2026 report puts the number of people in the UK with hip osteoarthritis at 4.5 million, with symptoms usually starting at about 55.
The National Institute for Health and Care Excellence (NICE) diagnoses osteoarthritis without an X-ray in people aged 45 or over with pain on activity and morning stiffness of 30 minutes or less. Hip osteoarthritis usually hurts in the groin or the outside of the hip, and can make it hard to put on shoes and socks or get in and out of a car (the NHS). Pain and X-rays often disagree: in the Framingham study, only 15.6% of hips that hurt on most days showed osteoarthritis on an X-ray, and only 20.7% of hips with osteoarthritis on an X-ray hurt on most days.
Sources 5, 6, 7, 8, 9, 10, 11
The outer hip: tendon pain, often called hip bursitisEmerging evidence
Pain on the bony point of the outer hip usually comes from the gluteal tendons there (gluteal tendinopathy), and it is often called hip bursitis. In 3,026 US adults aged 50 to 79, it affected about 23.5% of women and 8.5% of men (on one or both sides, our sums of the study's figures); women had 3.37 times the odds, age within that range made no difference, and it went with low back pain and knee osteoarthritis. The study counted tenderness on examination, which overcounts.
It often hurts after a long rest, lying on the painful side and climbing stairs, sometimes spreading down the outside of the thigh, an NHS trust says. It often lasts: in 164 people in Dutch general practice (average age 55), at least 36% still had pain at a year and 29% at 5 years, more often with osteoarthritis in the legs.
Sources 12, 13, 4, 14
The back can be felt in the hip, and the hip below the kneeEmerging evidence
Pain felt in the hip can come from the lower back, even when your back doesn't hurt, NHS inform says: people often describe pins and needles, or sharp, hot or burning pain, usually in the leg. Arthritis UK adds that a back problem may be felt only in the buttocks, down the back of the legs or over the outer hip. In 97 people with leg pain at a spine clinic, a limp, groin pain and limited inward turning of the hip pointed to the hip rather than the spine, and of 200 people seen by a spine surgeon for low back pain, 12.5% had a hip problem. No study has measured how often this happens in older adults generally.
The hip joint itself can be felt well away from the groin. Comparing 60 people waiting for a hip replacement with 60 waiting for spinal stenosis surgery, groin pain was present in 84.3% of those with hip arthritis and absent in 70.3% of those with stenosis, and 47% of the hip group had pain below the knee. In 51 people whose pain was confirmed to come from the hip joint, it was felt in the buttock in 71%, the thigh in 57%, the groin in 55% and below the knee in 22%, but in the knee itself in only 2%.
Sources 15, 16, 17, 18, 19, 20
A broken hip: common in later lifeStrong evidence
A broken hip usually happens because of a fall or injury, and it's more common in older people and people with osteoporosis. The NHS signs are pain in the hip, upper leg and groin, not being able to stand or put weight on the leg, difficulty moving the hip and leg, the leg at an odd angle or looking shorter, and swelling and bruising. "You will need urgent medical help for a broken hip or hip pain after a fall," the NHS says.
There were 71,885 broken hips in England, Wales and Northern Ireland in 2024; in England the average age was 82, and 69% were in women. Surgery is usually on the day of arrival or the day after, and 94% of people survive the first month. A quarter of people who break a hip have another fracture within 5 years, and the NHS says a fracture liaison service can help anyone over 50 who has broken a hip to prevent further breaks.
Sources 21, 22
Not every broken bone after a fall stops you walkingEmerging evidence
The American Academy of Orthopaedic Surgeons says that with some broken hips it may be possible to take part of your weight on the leg, though it will be severely painful. It adds that a small number may not be as painful at first, so you may still move the leg and walk on it. The NHS broken hip page doesn't say this, so this guide's line on hip pain after a fall when you can still walk (NHS 111 the same day) is our suggestion.
A break can also hide on the first X-ray. In 35 studies of 2,992 older adults (average age 76.8) who were still suspected of a broken hip after X-rays showed no definite break, a magnetic resonance imaging (MRI) scan found a break needing surgery in 39%, and in 44% of those aged 80 and over. That figure applies only to this selected group, not to all broken hips. NICE asks for an MRI scan when a broken hip is still suspected after normal X-rays, or a computed tomography (CT) scan if MRI isn't available within 24 hours.
The pelvis can break too, usually after a simple fall: in German data there were 22.4 first pelvic fractures for every 10,000 people aged 60 and over each year, 2.38 times as often in women, and more often with age. Pain can make walking very hard, and plain X-rays often miss breaks at the back of the pelvis, which a CT scan shows better.
Sources 23, 24, 25, 26, 27
Polymyalgia rheumatica: both hips and shoulders, stiff in the morningStrong evidence
Polymyalgia rheumatica causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips, and its main symptom is morning stiffness that lasts longer than 45 minutes; extreme tiredness, loss of appetite, weight loss and depression can come with it. Most people diagnosed are over 65, it's very rare under 50, and it's more common in women, the NHS says. In 125 people with new polymyalgia rheumatica, 73% had aching around both hips, and 57% had hip pain or limited hip movement when examined.
In the UK, about 96 in every 100,000 people over 40 are diagnosed with it each year, and the lifetime risk was about 2.4% for women and 1.7% for men in a US population. Steroid treatment usually lasts 12 months to 2 years (the NHS), and blood tests for inflammation are usually raised (the British Society for Rheumatology's 2026 guideline).
Some people with polymyalgia rheumatica develop temporal arteritis (giant cell arteritis): up to 1 in 5, the NHS says, while the British Society for Rheumatology's guideline gives about 5% to 10%. Either way, a new headache, jaw pain when eating or a change in your sight needs a GP or NHS 111 immediately, and suddenly losing sight in 1 or both eyes needs 999 (the warning signs).
Sources 28, 29, 30, 31, 32, 33, 34
Infection, a hernia, cancer and rare bone problems: the causes not to missStrong evidence
A joint infection brings sudden severe pain in one joint, difficulty moving or putting weight on it, hot, swollen or red skin, and usually a high temperature, although not everyone has one; an artificial joint raises the risk. Of 623,253 first hip replacements in England and Wales, 2,705 were redone for infection over about 4.6 years of follow-up (about 4 in 1,000, our arithmetic). A replaced hip can also dislocate, though not commonly, soon after surgery or many years later (the NHS).
A femoral hernia is a small lump, about the size of a grape, at the top of the thigh in the groin, with aching that comes and goes. It mainly happens in women over 50, and most become tightly squeezed (strangulated), so it needs treating in hospital, the NHS says. NICE asks GPs to offer blood tests for myeloma, a cancer of the bone marrow, to people aged 60 and over with persistent bone pain, particularly back pain, or an unexplained fracture, and the NHS lists bone pain in the back, hips, shoulders or ribs among its symptoms.
Two bone problems are rare. Avascular necrosis, a loss of blood supply to the bone, was recorded in about 1.4 to 3 in every 100,000 people a year in UK GP records, three-quarters of them at the hip, often linked with steroid tablets. Unusual thigh bone fractures happen rarely, mainly after years of bisphosphonate bone tablets; some people have thigh or groin pain for weeks or months first, so the medicines regulator asks people on these tablets to report thigh, hip or groin pain. The tablets still prevent far more breaks than they cause: in 196,129 women, 3 years of treatment prevented 149 hip fractures for every 2 unusual fractures (in white women).
Sources 35, 36, 37, 38, 39, 40, 41, 42, 43, 44
Hip pain and fallsEmerging evidence
Hip osteoarthritis itself wasn't linked with more falls across 21 studies, unlike knee osteoarthritis (risk ratio 1.35). Even so, the World Falls Guidelines count pain and arthritis among the risk factors for falling, and the NHS says falls are more likely if you're older or have mobility problems. A broken hip usually follows a fall, which is why the plan builds balance as well as strength, and the written steps below cover what to do if you fall.
Sources 45, 46, 47
When a scan or test helpsStrong evidence
Usually not for osteoarthritis: NICE diagnoses it from symptoms from 45, doesn't routinely use imaging to diagnose it or to guide treatment, and keeps imaging for features that don't fit, such as a recent injury, rapid worsening, a hot swollen joint or a worry about infection or cancer. X-ray changes and hip pain often disagree (above).
Tests answer specific questions. A suspected broken hip needs an X-ray in hospital, and if a break is still suspected after normal X-rays, NICE asks for an MRI scan (or CT if MRI isn't available within 24 hours); CT also shows breaks at the back of the pelvis better. Blood tests for inflammation help when polymyalgia rheumatica is suspected, and NICE's blood tests for myeloma are for people aged 60 and over with persistent bone pain or an unexplained fracture. Anyone taking bisphosphonates who has thigh, hip or groin pain should be checked for an incomplete thigh fracture, the medicines regulator says. Groin pain that lasts beyond 6 weeks with a normal X-ray is a reason to ask about an MRI scan (the warning signs).
Sources 9, 11, 21, 25, 27, 32, 40, 43
How it usually goesEmerging evidence
New hip pain, or a flare of a long-standing problem, usually begins to settle within 6 weeks, NHS inform says. Over years, osteoarthritis pain follows different courses. In 588 Dutch people aged 45 to 65 followed for 10 years from their first hip pain, 1 in 9 had a hip replacement, and in the rest, pain and function stayed on average the same even as X-ray changes rose. In the same cohort, pain followed four distinct courses over 5 years, and the X-ray didn't predict which. A review of 15 studies found the course too varied to summarise, though inactivity and not doing supervised exercise predicted worse pain (weak evidence). These were mostly middle-aged people, not later life.
Outer hip pain is often slow: at least a third of people in Dutch general practice still had pain at a year, and an NHS trust says recovery with exercise can take 6 to 12 months. After a broken hip, people usually spend 1 to 4 weeks in hospital, and some need a walking stick or frame afterwards. Polymyalgia rheumatica usually needs steroids for 12 months to 2 years. No one can promise a timescale.
Sources 15, 48, 49, 50, 14, 13, 21, 28
