Hip Pain That Travels Down the Leg

Hip pain may sometimes radiate or be referred to the knee or lower in the leg. Pain in the lower limb(s) is usually associated with joint stiffness and makes daily activities hard to perform. Activities such as putting on shoes, standing up after sitting, walking, and/or driving are commonly affected.

Hip pain can occur in the front, side, or back of the hip. ¹ Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34. The nerves from the hip that travel down the leg commonly cause radiating pain in the thigh, knee, and/or lower in the leg. ² Lam S, Amies V. Hip arthritis presenting as knee pain. BMJ Case Rep. 2015;2015:bcr2014208625. Published 2015 Feb 19. doi:10.1136/bcr-2014-208625 Pain may also be referred from muscles or joints. Here are some potential causes of hip pain that travels down the leg.

Pain That Originates in the Front of the Hip

Hip pain that occurs in the front of the hip and groin area is usually caused by conditions that affect the hip joint. ¹ Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34. A few examples are discussed below.

Hip osteoarthritis

Wear-and-tear of the hip joint, called hip osteoarthritis, commonly causes deep aching pain in the hip and groin region. ¹ Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34. ^{, 2} Lam S, Amies V. Hip arthritis presenting as knee pain. BMJ Case Rep. 2015;2015:bcr2014208625. Published 2015 Feb 19. doi:10.1136/bcr-2014-208625 The pain may spread to the front of the thigh and knee, sometimes including areas below the knee. ² Lam S, Amies V. Hip arthritis presenting as knee pain. BMJ Case Rep. 2015;2015:bcr2014208625. Published 2015 Feb 19. doi:10.1136/bcr-2014-208625 The pain is usually worse in the morning, after prolonged sitting or resting, and/or physical activity. A locking, sticking, or grinding sound may occur during hip movements. ³ Lespasio MJ, Sultan AA, Piuzzi NS, et al. Hip Osteoarthritis: A Primer. Perm J. 2018;22:17–084. Published 2018 Jan 3. doi:10.7812/TPP/17-084

See Hip Osteoarthritis Symptoms

Hip labral tear

When the labrum or the cartilaginous ring around the hip socket (acetabulum) tears, the symptoms can be variable. Most often, labral tears cause pain in the groin. Pain can also occur along the side of the hip or buttocks.

Initially, the pain from a labral tear may be felt during or after exercise and other vigorous activities. Over time, pain may also be felt during less strenuous activities, such as sitting.

Read more about Hip Labral Tears on Sports-health.com

Hip impingement (femoroacetabular impingement)

Read more about Hip Impingement on Sports-health.com

Hip osteoarthritis and/or labral tears may result from abnormal contact between the hip joint’s bones, resulting in hip impingement. Hip impingement pain may travel down from the front and side of the hip to the front of the thigh and knee. Sitting, driving, squatting, or performing hip movements and rotations typically aggravates this pain. ⁴ Pun S, Kumar D, Lane NE. Femoroacetabular impingement. Arthritis Rheumatol. 2015;67(1):17–27. doi:10.1002/art.38887

Iliopsoas bursitis

Inflammation of the iliopsoas bursa (small, thin fluid-filled sac in the front of the hip) can cause hip pain. This pain is usually felt in the groin while actively bending the knee toward the chest. ⁵ Di Carlo M, Draghessi A, Carotti M, Salaffi F. An Unusual Association: Iliopsoas Bursitis Related to Calcium Pyrophosphate Crystal Arthritis. Case Rep Rheumatol. 2015;2015:935835. doi:10.1155/2015/935835

The condition may also cause snapping hip syndrome, where a pop, click, or snap occurs when the hip is moved. ⁶ Luca Di Sante, Marco Paoloni, Stefano De Benedittis, Lucrezia Tognolo, Valter Santilli. Groin pain and iliopsoas bursitis: Always a cause-effect relationship? BMR. 2014;27(1):103-106. doi:10.3233/BMR-130412 This snap is typically felt and/or heard while moving the hip from a flexed to straightened position, such as while standing up from a chair.

Read more about Snapping Hip Syndrome on Sports-health.com

Pain That Originates from the Side of the Hip

Certain conditions may cause hip pain to originate from the side of the hip and travel down to the thigh. A few examples are discussed below.

External snapping hip

When a muscle or tendon slides over the bony protrusion (greater trochanter) at the top of the thigh bone (femur), it creates a snap, pop, or clicking sound. This condition causes pain that increases with direct pressure over the side of the hip. The pain may also travel down the side of the thigh. ¹ Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34.

Read more about 3 Types of Snapping Hip Syndrome on Sports-health.com

Hip bursitis (greater trochanteric bursitis)

Inflammation of the large trochanteric bursa located on the side of the hip joint may cause hip pain. The pain typically increases upon direct pressure on the side of the hip and may travel down the side of the thigh. ¹ Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34. ^{, 7} Nurkovic J, Jovasevic L, Konicanin A, et al. Treatment of trochanteric bursitis: our experience. J Phys Ther Sci. 2016;28(7):2078–2081. doi:10.1589/jpts.28.2078

See Hip (Trochanteric) Bursitis

Both these conditions belong to a spectrum of hip disorders called the greater trochanteric pain syndrome. This syndrome also includes tears of the gluteus minimus and/or medius muscles located on the side and back of the hip that may cause pain in these areas. ¹ Wilson JJ, Furukawa M. Evaluation of the patient with hip pain. Am Fam Physician. 2014;89(1):27-34.

Nerve Pain from the Hip to Leg

Sometimes, hip pain may radiate through the nerves from the back of the hip down to the front, back, or side of the legs. This type of pain may be caused due to the irritation of certain lumbar and/or sacral nerve roots, also called sciatica. Musculoskeletal conditions, such as sacroiliac joint dysfunction or piriformis syndrome, may also cause sciatica-like pain.

Read more about Sciatica on Spine-health.com

Severe hip pain that starts suddenly or does not subside with self-care must be evaluated by a doctor. Additionally, associated symptoms such as swelling, leg numbness and/or weakness, nausea, and/or fever may indicate a serious underlying condition and require immediate medical attention.

Learn More:

Is My Hip Pain From Arthritis or Bursitis?

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