The hip is a deep, stable ball-and-socket joint built to handle enormous load. When it works well you barely think about it. When it stops moving properly, the consequences show up somewhere else entirely. Most often as low back pain, because the lumbar spine starts contributing rotation and extension the hip is no longer providing.
Modern life is particularly hard on hips. Sitting for hours holds the hip flexors short and the glutes lengthened and inactive, and that combination, tight in front, weak behind, is behind a remarkable share of the hip, back, and knee pain we see.
Symptoms we hear about
- Deep groin pain, especially with squatting or getting out of a car
- Pain on the outside of the hip, worse lying on that side
- Pinching in the front of the hip at the top of a squat
- Stiffness after sitting or driving
- Clicking or catching with rotation
- Buttock pain that may travel down the leg
What usually causes it
- Femoroacetabular impingement (hip impingement)
- Gluteal tendinopathy and trochanteric bursitis
- Labral irritation or tearing
- Hip flexor tightness from prolonged sitting
- Weak gluteus medius and poor pelvic control
- Sacroiliac joint dysfunction referring to the hip
- Osteoarthritis of the hip joint
Is it the hip, the SI joint, or the low back?
These three refer pain into overlapping territory and get confused constantly. True hip joint pain is usually felt in the groin and often described with a C-shape gesture around the side. Sacroiliac pain tends to sit just below the belt line to one side. Lumbar referred pain often travels further down the leg.
Our exam separates them with specific orthopedic testing, and getting this right at the outset determines whether treatment works.
Mobility and strength are not the same problem
Patients almost always assume tight hips need stretching. Sometimes true, but a great deal of what feels tight is actually a muscle that is overworking to compensate for a neighbor that is not doing its job. Stretch it and you get temporary relief followed by the same tightness tomorrow.
We determine whether you have a genuine range-of-motion restriction, a strength and control deficit, or a structural limitation like bony impingement, because the treatment for each is entirely different.
Treatment plan
Hip and pelvic adjustments restore joint motion where it is restricted. Our muscle protocol addresses adhesion in the deep rotators, glutes, and hip flexors. Laser and StemWave handle the inflammatory and degenerative tendon component in gluteal tendinopathy, which is far more common than true bursitis.
Then we build the glutes properly, progressive, specific, and boring in the best way. Hip pain that keeps returning is nearly always a strength problem that was never addressed.
How we treat hip pain in Frisco
Your plan is built from your exam findings, not from a template. These are the tools we most often combine for this condition.
Hip Pain: common questions
Why does my hip hurt when I sleep on that side?
Lying on your side compresses the gluteal tendons and bursa against the greater trochanter, the bony point of your hip. It is the hallmark of gluteal tendinopathy. A pillow between your knees reduces the compression while we address the underlying tendon problem.
Is hip pain related to my back pain?
Very often, and in both directions. Hips that do not extend force the lumbar spine to make up the difference on every step. Conversely, lumbar nerve irritation refers pain into the hip and buttock. We assess both regardless of which one you came in for.
Can I avoid a hip replacement?
Depends entirely on how much joint surface remains. Early to moderate arthritis often responds well to conservative care aimed at motion, strength, and load management. Bone-on-bone changes with severe functional loss usually progress to replacement eventually, and we will be straight with you about where you are.
