Hip Pain: who to see and what helps

Hip Pain · Kitchener, Waterloo & Cambridge

Hip pain can come from the joint itself, from the tendons and muscles around it, or from the lower back, and where you feel it is the first clue to which. For the common causes, guidelines and trials put exercise and changes to how you load the hip first. At CARESPACE the first visit is with a physiotherapist or a chiropractor, who assesses the hip and starts treatment that day.

What hip pain usually is

“Hip pain” covers several different problems, each with its own page here. A review written for family physicians sorts them by where the pain sits, and the NHS adds a caution: do not try to diagnose the cause yourself. This page is about adults. A child or teenager with hip pain or a limp should see a physician or nurse practitioner, because the causes at that age are different.

Where it hurts, and what that suggests

• Front of the hip or groin. The hip joint itself (osteoarthritis, impingement, a labral tear) or the muscles that lift the leg. It can also be pain referred from the abdomen or pelvis.
• Outside of the hip. Mainly the tendons and bursa over the bony point of the hip, known together as greater trochanteric pain syndrome.
• Back of the hip and buttock. Pain referred from the lower back, or a problem with the deep buttock muscles or the hamstring tendon.

Common causes of hip pain, and how they differ

• Hip osteoarthritis. In older adults, the most common cause of pain at the front of the hip. The NHS pattern is being over 45, with pain that is worse when walking and stiffness after moving.
• Hip impingement. One of the most common causes of hip pain in young adults, arising from the shape of the ball of the joint, the socket or both.
• Hip labral tear. A tear in the rim of cartilage around the socket, which can pop, catch or click.
• Hip flexor strain. A pulled muscle at the front of the hip, from a sudden injury or from overuse.
• Groin strain. The inner-thigh muscles: they are tender, and squeezing the legs together against resistance hurts.
• Snapping hip syndrome. A tendon flicking over bone with a snap you can feel or hear. Usually painless and harmless.
• Hip bursitis and gluteal tendinopathy. The most common cause of pain on the outside of the hip, most often in women aged 40 to 60, and typically worse when lying on that side.
• Piriformis syndrome. Buttock pain thought to come from the piriformis muscle trapping the sciatic nerve.
• Hip replacement. For a damaged joint when other treatments have not helped.

How hip pain is diagnosed

Mostly from your description and an examination. When a picture is needed, an X-ray of the hip and pelvis should come first, with MRI for a suspected labral tear, a stress fracture at the top of the thigh bone, or early loss of blood supply to the bone. Osteoarthritis is the exception: the UK’s national guideline (NICE) says to diagnose it without imaging in people who are 45 or over, have activity-related joint pain and have morning stiffness that is absent or lasts no longer than 30 minutes.

A scan result needs reading against your symptoms: in a pooled analysis of eight MRI studies, 54% of people with no hip pain had a labral tear. One cause should not wait: a stress fracture in the neck of the thigh bone, which typically does not show on an X-ray. Its sign is in the warning signs below, with what to do.

When hip pain is an emergency

The warning signs below are the ones the NHS, the UK’s health service, lists for hip pain, with the Ontario equivalent of what it tells people to do. Call 911 or go to an emergency department if you have severe hip pain after a fall or injury, you are unable to walk or put weight on your leg, or you have any tingling or loss of feeling in your hip or leg after an injury. Severe pain and being unable to walk after a fall can mean a broken hip. Do not drive yourself.

Go to an urgent care clinic or an emergency department the same day if you have severe hip pain that started suddenly without a fall or injury, your hip is swollen and feels hot, the skin around your hip has changed colour, or you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery). A hot, swollen hip with a fever can be a joint infection.

Hip or groin pain that comes on with running or hard training needs medical assessment the same day, at an urgent care clinic or emergency department if you cannot reach a physician or nurse practitioner. It can be a stress fracture in the neck of the thigh bone, which can shift out of place and then needs surgery. A normal X-ray does not settle it, because X-rays alone cannot rule out a stress fracture. Protect the leg with crutches until the diagnosis is confirmed. Stress Fractures has more.

The emergency departments in Waterloo Region are:

• WRHN @ Midtown (formerly Grand River Hospital), 835 King St. W., Kitchener
• WRHN @ Queen’s Blvd. (formerly St. Mary’s General Hospital), 911 Queen’s Blvd., Kitchener
• Cambridge Memorial Hospital, 700 Coronation Blvd., Cambridge

If you cannot get there safely, call 911.

See a physician or nurse practitioner if hip pain is stopping you doing normal activities or affecting your sleep, is getting worse or keeps coming back, has not improved after two weeks of looking after it yourself, or comes with hip stiffness that lasts more than 30 minutes after you wake up.

What the evidence says about treating hip pain

• Where these points come from. The UK’s osteoarthritis guideline (NICE), the American guideline for physiotherapists on impingement and labral tears, and trials of pain on the outside of the hip. “Offer” and “should” are a panel’s firm words; “consider” and “may” mean it is less confident.
• Exercise and activity changes come first for the common causes. For osteoarthritis: offer exercise tailored to the person. For impingement and labral tears: clinicians should use activity modification and hip-strengthening exercise. For pain on the outside of the hip: in a trial of 204 people, education plus exercise came out ahead of both a corticosteroid injection and waiting.
• Hands-on treatment is an addition to exercise. For hip osteoarthritis: consider manual therapy (manipulation, mobilisation or soft tissue techniques) only alongside exercise. For impingement: joint and soft-tissue mobilisation may be used, on expert opinion.
• Acupuncture and dry needling. For osteoarthritis the instruction is not to offer either. For pain on the outside of the hip, one trial of 43 people found dry needling no worse than a cortisone injection over six weeks.
• Injections give short-term relief. For an arthritic joint, a corticosteroid injection can be considered when other medicines are ineffective or unsuitable, with relief lasting 2 to 10 weeks. Injections, stronger pain medicine and surgical referral all come through a physician or nurse practitioner.
• Surgery has a place. Referral for joint replacement is to be considered when osteoarthritis symptoms are substantially affecting quality of life and non-surgical management is ineffective or unsuitable. Keyhole surgery is an option for impingement. Each condition’s page has the detail.

How each CARESPACE service treats hip pain

Physiotherapy

A physiotherapist can work out which of the causes above fits, from where the pain is, which hip movements bring it on and how strong the muscles around the hip are. Treatment is built on an exercise program and changes to the activities and positions that aggravate the hip, and hands-on mobilisation may be added. Some CARESPACE physiotherapists offer dry needling; the evidence list above says where it stands.

See our physiotherapy team →

Chiropractic

A chiropractor can assess the hip together with the pelvis and lower back, which matters because pain at the back of the hip can be referred from the spine. Treatment can include joint mobilisation or manipulation, soft-tissue work and exercises; for hip osteoarthritis the hands-on part is supported only alongside exercise. Chiropractors can also order X-rays.

See our chiropractic team →

Massage Therapy

A Registered Massage Therapist works on the muscles around the hip and lower back. Soft tissue techniques are among the hands-on treatments to consider for hip osteoarthritis, only alongside exercise, and soft tissue therapy is one of the early measures listed for pain on the outside of the hip. Massage is an addition to an exercise plan.

See our massage therapy team →

Kinesiology

A kinesiologist can take you through a strengthening program for the hip and leg and progress it toward stairs, a full shift on your feet or a season of hockey. Supervised exercise sessions are an option to consider for osteoarthritis.

See our kinesiology team →

Other services people ask about

Osteopathy. None of the sources listed here tested it by name; the nearest guidance is the position on manual therapy for hip osteoarthritis, an addition to exercise and not a replacement. Acupuncture. The osteoarthritis guideline says not to offer it, and none of the sources report a trial of it for the other hip conditions.

Where most people start

Book with a physiotherapist or a chiropractor. Both assess and treat at the first visit.

How your team works together

The physiotherapist or chiropractor you start with sets the exercises. Massage therapy can be added while the muscles around the hip are sore, and a kinesiologist can take over the strengthening later. Your practitioner can also tell you when to ask a physician about a scan, an injection or surgery.

Browse by service: physiotherapists, chiropractors, registered massage therapists and kinesiologists.

What to expect at your first visit

1. Where and when. Groin, outside of the hip or buttock; what brings it on; whether anything started it.
2. A physical assessment of how the hip moves and how strong it is, with a look at the lower back.
3. What they found, including whether anything needs a physician’s attention.
4. Treatment at that visit, and a plan to leave with.

What you can do at home

• Keep moving if you can, without overdoing it.
• Put an ice pack wrapped in a towel on the sore area for up to 20 minutes every 2 to 3 hours.
• Wear comfortable, shock-absorbing shoes with a soft sole, and try gentle hip stretches.
• Avoid carrying anything heavy and sitting in low chairs.
• Sleep on the side that does not hurt.
• If you are overweight, losing weight is part of the advice.
• Ask a pharmacist about pain relief.

Through a Waterloo Region winter of icy sidewalks and driveways, keep the first warning sign above in mind: severe hip pain after a fall is an emergency.

How long hip pain lasts

It depends on the cause, and the sources give no single figure. Two markers: after a hip muscle strain the advice is to avoid the activity that caused it for 10 to 14 days, and for impingement the physiotherapy guideline describes a trial of non-surgical treatment lasting at least three months.

Hip pain treatment in Kitchener, Waterloo and Cambridge

Kitchener. Physiotherapy in Kitchener, Chiropractic in Kitchener, Massage Therapy in Kitchener and Kinesiology in Kitchener. Locations: Victoria North, Fischer-Hallman, Westmount East and Deer Ridge.

Waterloo. Physiotherapy in Waterloo, Chiropractic in Waterloo, Massage Therapy in Waterloo and Kinesiology in Waterloo. Locations: Weber North, Uptown Waterloo and Waterloo GoodLife.

Cambridge. Physiotherapy in Cambridge. Location: Hespeler Road.

The city pages linked above show the locations and practitioners for each service, with their next availability.

Common questions

Should I see a physiotherapist or a chiropractor for hip pain?

Either is a good first visit. Both assess the hip and treat it at that visit, and each uses a mix of exercise and hands-on treatment.

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

Pain on the outside of the hip that is worse when lying on that side fits hip bursitis and gluteal tendinopathy.

Could my hip pain be coming from my back?

It can. Pain at the back of the hip and in the buttock can be referred from the lower back, and pain that shoots down the leg may come from an irritated nerve. See Sciatica if that sounds like yours.

Do I need an X-ray or an MRI?

Not always. When a picture is needed an X-ray comes first, and an MRI is arranged through a physician or nurse practitioner.

Where can I get hip pain treatment in Cambridge?

At our Hespeler Road location, starting with Physiotherapy in Cambridge. Book online or call 519-208-2273 and our Central Reception Team will find the closest location with an opening.

Do I need a referral?

No. Book online or call 519-208-2273. You pay at each visit and receive a receipt for your extended health plan. More on fees and insurance →

Sources

• NHS. Hip pain in adults. Reviewed November 2025.
• Chamberlain R. Hip Pain in Adults: Evaluation and Differential Diagnosis. American Family Physician, 2021.
• National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management (NG226). 2022.
• Enseki KR, et al. Hip Pain and Movement Dysfunction Associated With Nonarthritic Hip Joint Pain: A Revision. Clinical practice guideline, Journal of Orthopaedic & Sports Physical Therapy, 2023.
• Mellor R, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy. BMJ, 2018.
• Brennan KL, Allen BC, Munoz Maldonado Y. Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy, 2017.
• Heerey JJ, et al. What is the prevalence of imaging-defined intra-articular hip pathologies in people with and without pain? A systematic review and meta-analysis. British Journal of Sports Medicine, 2018.
• Speers CJB, Bhogal GS. Greater trochanteric pain syndrome: a review of diagnosis and management in general practice. British Journal of General Practice, 2017.
• Weir A, et al. Doha agreement meeting on terminology and definitions in groin pain in athletes. British Journal of Sports Medicine, 2015.
• American Academy of Orthopaedic Surgeons. Hip Strains and Snapping Hip. OrthoInfo.
• Crown T, Lodhia P, McConkey M. Navigating the nonarthritic hip: Labral tears and femoroacetabular impingement. BC Medical Journal, 2023.
• Robinson PG, Campbell VBD, Murray AD, Nicol A, Robson J. Stress fractures: diagnosis and management in the primary care setting. British Journal of General Practice, 2019.
• HealthLink BC. Hip Problems, Age 12 and Older. Current as of November 2022.

Related conditions

Sciatica
Back Pain
SI Joint Pain
Osteoarthritis

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Book online with a physiotherapist or chiropractor, or call 519-208-2273 and our Central Reception Team will match you with the right person and the closest location.

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