Hip Pain Physiotherapy Treatment | What Causes Hip Pain?

Hip Pain Physiotherapy Treatment | What Causes Hip Pain?

One-sided hip pain is a common presentation for our physiotherapists across our Hong Kong Central and Wong Chuk Hang clinics, and it’s no surprise. Our hips are constantly providing crucial support to our body. As we walk, run or jump, our hips provide a stable base for our spine to keep our body in an upright position, while also supporting the often fast-paced movement of our lower legs - and the tension and forces that come with it.

You don’t have to be active to develop hip pain. While hip pain has been found to affect between 30% to 40% of adults who play sports, one in ten people in the general population are also affected, with the incidence increasing with age.

If your hip pain is making it difficult for you to stay comfortable at home or work, or if you’re finding yourself postponing the activities you love outside of work, we can help. Our physiotherapists use an evidence-based, timely approach to treating a range of hip conditions. Our goal is not only to support you in recovering to your pre-injury state, but where possible, enhance your performance while reducing your risk of future injury. Here are six of the top causes of hip pain that our physiotherapists treat.

Hip Bursitis (Trochanteric Bursitis)

A bursa is a small fluid-filled sac that sits between bones and muscles or tendons. They work to help reduce friction as our muscles move, preventing them from painfully rubbing over areas of bone. We have over 150 bursae all around our body - including the hip. Specifically, there is a bursa in the outer area of the hip called the greater trochanter. Excessive pressure on the bursa (often linked to muscle tightness) leads to it becoming inflamed, and hip pain can develop, notably on the outside of the hip.


There are a number of different muscles and tendons that attach to and around the hip joint. When a tendon is overloaded and placed under excess strain, pain can result. This is what we mean when we say tendinopathy. We often see these injuries when a person starts a new exercise routine and goes too hard too fast over a period of time - or similarly, from having a big weekend of physical activity where significant demand is placed on the body that it’s not used to. There is often an element of muscle weakness or an imbalance involved too - something we’ll always assess for and discuss with you at your appointment.

The most common tendinopathies that lead to hip pain affect the gluteus medius and the iliotibial band, both of which present with pain at the outer hip. It is also not uncommon for this pain to come on gradually, starting as a mild niggle and then worsening over time.

Hip Osteoarthritis

Hip osteoarthritis affects between 7% and 25% of adults aged over 55 years, with the prevalence growing with age. Hip osteoarthritis describes a process by which the joint cartilage that covers the head of the femur (thigh bone) and the hip socket thins and roughens. This increases the likelihood of joint pressure as the hip moves, which can then cause further changes to the joint. Ultimately, the joint can become stiff and painful, and regular movement can become more difficult. The most common initial symptoms of hip osteoarthritis include hip stiffness and a pain that is described as a deep pain within the hip, particularly when standing and bearing weight.

Hip Dysplasia

In hip dysplasia, the ball-and-socket joint where the top of the femur attaches to the surrounding curved socket in the pelvis either doesn’t line up normally, or the socket itself isn’t quite deep enough to effectively hold the top of the thigh bone in place. This makes the joint unstable, and this instability can progress to painful consequences for the hip joint and the surrounding tissues over time. Hip dysplasia is routinely screened for in childhood, but can often go undiagnosed. A Hong Kong review of those presenting for x-rays for undiagnosed hip pain found that 17.2% had hip dysplasia.

To learn more about hip dysplasia, the types, causes and treatment, read our article on hip dysplasia.

Labral Tear

The labrum is a specialised piece of cartilage that runs along the rim of the hip socket to provide a suction seal and stability to the hip joint, absorbing shock and distributing pressure during hip motion. Disruption or a tear of the labrum can occur as a result of trauma, repetitive movements or even genetic factors. Labrum tears may create deep, internal hip pain that can be accompanied by feelings of catching or clicking. The pain may also radiate to the groin.

Hip Fracture

A hip fracture is a crack or break in one of the bones of the hip, most often in the neck of the femur. It often occurs as a result of trauma, which in older adults may occur following a fall if they have weak or fragile bones (including osteoporosis), and in younger adults if they have a car accident where their knees come in contact with the dashboard. Hip fractures are serious, and our physiotherapists keep you supported through any surgeries or other treatments you may require. This includes both pre-surgical and post-surgical care to help you get the best outcomes.

Signs You Should See A Physiotherapist For Hip Pain

While experiencing pain from time to time may be common, ongoing hip pain is not a normal occurrence, and should be investigated to find the underlying cause. We recommend booking an appointment if you notice:
  • Niggling pain in your hip for several days in a row with no specific cause
  • Stiffness in your hip
  • Hip pain when weight bearing, or the inability to bear weight on the affected side of the hip
  • Hip pain during rest at night
  • A distinct popping or clicking sound
  • Sharp hip pain
  • Any swelling, warmth or redness around the joint


Our physiotherapists are highly experienced in treating a range of hip injuries. A consultation with us means:
  • You benefit from our comprehensive understanding of the intricate anatomy of the hip joint. This means we take a wide range of factors into account to dive deeper into the likely causes and your mechanism of injury. This helps create a more detailed treatment plan to best support you in getting the best results for your recovery.
  • Each consultation includes extensive testing that allows us to distinguish your true cause of hip pain, even with various conditions having similar symptoms.
  • We always look at your whole body and how it functions as a unit with your hips, as opposed to looking at your hips in isolation. This means that every aspect of your care is carefully considered in terms of the effects it will have on your body, and your quality of life.
  • We’re experienced in treating hip pain in children, adults and older adults - and understand your unique needs and goals at every age.
  • We have an extensive range of evidence-based treatment approaches and practitioners to give you the very best physiotherapy care across Hong Kong.



  1. https://www.uptodate.com/contents/approach-to-the-adult-with-unspecified-hip-pain
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022067/
  3. https://ard.bmj.com/content/80/4/487
  4. https://www.hkjr.org/system/files/v23n1_34young.pdf