Where does hip arthritis hurt?

The hip joint sits deep, in front, behind the crease of the groin. So the classic spot is the groin. People often cup a hand around the side of the hip in a C shape when they describe it.

• Groin pain when you stand up, walk, or swing your leg into the car.
• Stiffness putting on socks and shoes, or reaching your toenails on that side.
• Knee pain with a normal knee. The hip and the knee share nerves, so a worn hip can ache at the knee.
• Buttock pain that gets called sciatica.
• A limp after a long walk or a day of shopping.

Why is hip arthritis mistaken for back pain?

Because almost every adult has a lumbar MRI that shows something. Disc bulges and worn facet joints are common in people with no pain at all. Once a report lists them, the back gets the blame and the hip never gets examined. We meet patients who had two or three back injections for what turned out to be a worn hip.

The reverse happens too. A pinched nerve at L3 or L4 can cause groin and thigh pain that feels like the hip. And many people over 55 have both. The job is to rank them. See how we tell the hip from the back.

One quick clue: lie on your back, bend the knee, and roll the leg inward. If that brings on your groin pain, the hip joint moves up the list. Walking pain that eases when you lean on a shopping cart points more toward spinal stenosis.

How do we confirm the hip is the problem?

We examine the hip at every back visit. A worn hip is stiff, most of all when the leg turns inward. X-rays show the joint space and bone spurs. But pictures alone do not prove where pain comes from, because many people with worn-looking hips feel fine.

When it is unclear, a numbing injection into the hip joint under image guidance answers the question. If your usual pain fades for a few hours, the hip is a main source. If nothing changes, we look elsewhere. That one test can save months of the wrong treatment.

Which injections help hip arthritis?

• Cortisone calms a flare fast. The effect often fades in weeks, and repeated doses are hard on cartilage.
• Hyaluronic acid is a lubricant. Results in the hip are modest.
• PRP uses your own platelets. Their growth signals calm inflammation inside the joint and support the tissue that lines it. The effect builds over weeks and tends to last longer than cortisone.
• Bone marrow concentrate is drawn from the back of the pelvis and spun down. It carries cells and signals that PRP does not. We consider it for more advanced wear.
• Microfragmented fat is taken from a small area of belly or flank fat and processed so it can cushion and signal inside the joint.

Which one fits depends on how worn the joint is, how you responded before, and what you want your hips to do. Results depend on the dose of platelets or cells delivered and on the rehab around it. They do not depend just on the name of the product.

Who is a good candidate for PRP in the hip?

The best fit is mild to moderate wear, a hip that still moves, and pain that has not settled with exercise, weight work and pills. People told they are too young for a replacement are a common group. So are people who want to put off surgery for work or family reasons.

A hip that has collapsed, or a ball that has lost its blood supply, needs a surgical opinion, and we will tell you so. Hip PRP is a service we perform routinely. It is not something we save for last.

Over 90% of our accepted case-study patients see significant improvement. These are practice-reported figures from our own population, not trial outcomes, and individual results vary.

What does the research show for PRP in hip arthritis?

A 2026 review of seven trials with 465 hip arthritis patients compared PRP with hyaluronic acid. PRP gave better pain relief at six months and better pain scores at twelve months. The gain in function scores was smaller. Leukocyte-poor PRP and more than one injection did better than a single shot.

A 2024 network review of 16 trials with 1,735 people found cortisone helped most at three months. PRP combined with hyaluronic acid did best for function at six months. That fits what we see. Cortisone is fast and short. Platelets are slow and longer. In 2026 an international panel of joint experts reached consensus on using PRP for hip arthritis. The panel also noted that dose and preparation still vary too much between clinics.

Dose is the part most clinics skip. In knee trials, high-platelet PRP gave clearly better and longer relief than low-platelet PRP. We expect the hip to behave the same way, which is why we measure what we inject.

What is the day of a hip injection like?

You stay awake. Local anesthetic numbs the skin and the path to the joint. There is no sedation, so most people drive home. Ultrasound or X-ray guides the needle into the joint. That is because a hip injection placed by feel can easily miss. Expect a deep ache for about 48 hours. We ask you to hold off on ibuprofen and similar pills for a while, so they do not blunt the platelet signal.

These procedures are done at our regenerative clinic, 4477 Woodson Rd in St. Louis. Check in at the front desk and staff will route you. PRP is not covered by insurance, and HSA and FSA funds are generally eligible. How many injections you need is a clinical call made as we see your response.

Why does the rest of your body matter for hip arthritis?

Cartilage does not wear out from use alone. In people with high insulin, high blood sugar and belly fat, the joint lining runs inflamed all the time. Fat tissue sends out signals that reach every joint. That is why arthritis also shows up in hands that carry no weight. Injecting a hip while ignoring that fire is half a plan. We check the metabolic side and treat it, along with strength work for the hip muscles. Weight and the lumbar spine covers the same chain for the back.

Frequently asked questions

Can hip arthritis cause lower back pain?

Yes. A stiff hip forces the low back to twist and bend more with each step. Over time that strains the back joints. Restoring hip motion often eases the back.

Can PRP help bone-on-bone hip arthritis?

It can ease pain in some people, but results are best with mild to moderate wear. For severe wear we discuss bone marrow concentrate and, honestly, whether a replacement makes more sense.

How long does PRP last in the hip?

In trials, the benefit over comparison treatments showed at six and twelve months. Some people go longer. The rehab and metabolic work you do afterward affects how long it holds.

Is walking good for hip arthritis?

Yes, in amounts you can recover from. Cartilage gets its nutrition from movement. Short, regular walks beat one long painful one. Cycling and water exercise are easier on a sore hip.

Do I need a hip replacement?

That depends on pain, function and imaging together, not an X-ray alone. Many people with arthritis on X-ray do well for years without surgery. When a replacement is the right call, we will say so.

Why does my knee hurt if the problem is my hip?

The hip and knee share nerves, so pain from the hip joint can be felt at the inner knee. If your knee exam and X-ray look normal, the hip is worth checking.

Related reading

• Hip pain or back pain?
• Hip bursitis
• Spinal stenosis
• Sacroiliac joint pain
• Weight and the lumbar spine
• Orthobiologics for back, spine and hip pain: PRP, bone marrow and fat

Bring your X-rays and tell us where you point when the hip hurts. We examine the hip and the back at the same visit.