You’re Not Imagining It, and It Is Not Always Just Wear and Tear
If you have started to avoid your favourite walks along the seafront or onto the Downs around Brighton, you are far from alone. Hip pain when walking is one of the most common complaints we see among people in midlife and older age. It’s worth taking seriously. What surprises many people is that often, the discomfort is often not coming from the hip joint itself at all; muscles, tendons, the lower back and the pelvis can all produce pain that feels very much like a “hip problem”.
Feeling concerned about changes in your mobility is understandable, but it is worth knowing that in the majority of cases, hip pain when walking has a clear, manageable cause and a thorough assessment can identify it and point you in the right direction.
What Do People Actually Mean by “Hip Pain When Walking”?
The Pain May Be Felt in the Groin, Side of the Hip, Buttock or Upper Thigh
“Hip pain” means different things to different people. Some feel a deep aching in the groin, others a nagging ache at the outer hip, and others still describe a dull soreness in the buttock or upper thigh. The location of your pain is actually a useful clue: groin pain on walking tends to suggest involvement of the hip joint itself, whereas outer hip pain or buttock pain is more often linked to tendons, muscles or the lower back.
Understanding where your pain sits and when it occurs helps narrow down what is likely going on, which is why coming in for a hands-on assessment is more useful than a process of internet guesswork.
Sometimes It Is Not the Hip Joint at All
Referred pain, where the source of the problem is in one place but the discomfort is felt somewhere else, is very common around the hip region. The lower back, sacroiliac joint and pelvic muscles can all produce symptoms that feel convincingly like a hip issue. This is one reason why many people unfortunately can spend months treating the wrong area.
Common Causes of Hip Pain When Walking in Midlife and Older Age
It is worth knowing that several causes can overlap; it is quite normal for more than one factor to be contributing to your symptoms.
Hip Osteoarthritis
Osteoarthritis of the hip involves gradual changes to the cartilage and joint surfaces. It typically produces a stiff, achy feeling in the groin that is worse first thing in the morning or after sitting for a while and tends to build up over longer walks. It is one of the most common causes of hip pain in people over 50 but it is also worth saying clearly that it is not inevitable. It is not always progressive and even when arthritis is present, many people find that the right management makes a significant difference to their comfort and activity levels.
Imaging findings (on X-ray or MRI) also do not always correlate neatly with symptoms: some people have considerable arthritic changes with relatively mild symptoms and vice versa.
Gluteal Tendinopathy and Pain at the Side of the Hip
Gluteal tendinopathy is now recognised as one of the most common causes of outer hip pain, particularly in women in midlife. It involves irritation or overload of the tendons that attach the gluteal (buttock) muscles to the outer part of the hip bone (the greater trochanter). Symptoms include tenderness when pressing on the outer hip, pain when walking uphill or climbing stairs and often discomfort when lying on the affected side at night.
The good news is that this condition responds well to a structured programme of load management and progressive strengthening exercises. The approach needs to be tailored carefully, as some common habits such as crossing the legs or stretching into hip adduction (that’s moving the leg inward toward the centre of the body or returning it from a wide stance to a neutral position).
Bursitis and Irritation Around the Outer Hip
The bursa is a small fluid-filled sac that sits between the tendon and the bone, designed to reduce friction. When it becomes irritated, it can produce a sharp or burning pain at the outer hip. In practice, true isolated bursitis is less common than was once thought; outer hip pain more often involves the tendons themselves. The two conditions frequently overlap, however, and the management approach is broadly similar.
Referred Pain from the Lower Back or Pelvis
Pain that radiates from the lumbar spine or sacroiliac joint can travel into the buttock, outer hip or upper thigh, often in a pattern that does not follow a neat nerve distribution. Clues that the lower back might be involved include accompanying back stiffness, symptoms that change with forward bending or prolonged standing or pain that varies with posture. This does not necessarily mean there is anything wrong with your spine; it can simply reflect muscle tension, joint stiffness or minor disc irritation.
Muscle Weakness, Reduced Hip Control and Stiffness
The hip relies on a coordinated system of muscles (the glutes, hip flexors, deep hip rotators and core) working together. When any of these become weaker or less well-coordinated, other structures are placed under greater load. This is particularly relevant in midlife and older age, when muscle mass and neuromuscular control can gradually decline. Reduced hip control often shows up as a slight drop of the pelvis on one side when walking, which over time can contribute to pain in the hip, knee and lower back.
The encouraging aspect of this is that muscle strength and control respond very well to targeted exercise and improvement can come fairly quickly with the right guidance.
Why Does Walking Bring It On When Sitting May Feel Relatively Comfortable?
Walking places repetitive compressive and sliding or rotational forces through the hip joint, tendons and muscles with every step. The demands increase further on hills, uneven ground and stairs (all familiar features of everyday life in Brighton). Tendons and joints that are mildly irritated may cope reasonably well with low load but become symptomatic once a threshold is crossed.
This is why symptoms are often absent at rest but gradually build over the course of a walk or are worse in the first few minutes before the tissues warm up. Understanding this loading relationship is helpful when thinking about how to manage activity sensibly.
Is It Always Arthritis?
The short answer is no. Arthritis is one possible cause of hip pain in later life, but it is far from the only one and it’s important not to assume the worst before having an assessment.
Side-of-hip pain is more often tendon-related than arthritic. Buttock pain is frequently referred from the lower back. Even when arthritis is present, pain can fluctuate considerably with activity levels, posture habits and general health and is not simply a reflection of the degree of joint change.
Pain is also influenced by factors beyond structural wear alone: irritated or sensitised tissues can produce significant discomfort even when the underlying changes are modest. This is actually encouraging, because it means that sensible management, rather than resignation to decline, is a reasonable and often effective approach.
Signs the Problem May Be Coming from Somewhere Else
When the Lower Back Is More Likely Involved
Back-related hip pain often comes with associated lumbar stiffness, discomfort that changes with bending or prolonged standing or a pattern of aching that spreads into the thigh or varies by posture. Morning stiffness that takes a while to ease can also point towards a spinal or pelvic origin.
When Side-of-Hip Tissues Are More Likely Involved
Outer hip pain that is tender to touch, worse on stairs and inclines, aggravated by lying on that side or made worse by activities that bring the leg across the midline (such as sitting cross-legged) tends to point towards gluteal tendon or outer hip tissue involvement.
When the Hip Joint Itself Is More Likely Involved
Groin-based pain when walking, stiffness first thing in the morning and difficulty with tasks that require rotating the hip (putting on shoes and socks, getting in and out of a low car or swinging the leg) suggest the hip joint is more directly involved.
What Can You Try Yourself?
Keep Moving, But Be Thoughtful About Load
Complete rest is rarely helpful and can in fact allow muscles to weaken and tissues to become more sensitised. The aim is relative rest: that means continuing to move, but reducing the distance, pace or incline temporarily until things settle. Short, regular walks are generally more useful than avoiding movement altogether.
Notice Patterns Rather Than Pushing Through Blindly
Pay attention to what makes your symptoms better or worse. Do you feel worse in the first few minutes and then improve? Does discomfort build up later in the day? Is it worse after certain activities? This information is genuinely useful for any assessment and helps you understand your own pain better.
Gentle Strengthening and Mobility Work
The right exercises depend heavily on the cause, which is why generic advice has its limits. That said, gentle hip and gluteal strengthening exercises (such as clamshells, bridges, and side-lying leg raises) are broadly useful and rarely harmful when done within a comfortable range. Avoiding prolonged static postures and keeping the hips mobile through their range can also help.
Footwear, Pacing and Route Choices
Supportive footwear makes a meaningful difference, particularly on Brighton’s uneven streets and hilly terrain. This includes insoles like the Superfeet ones we sell at Sundial. Breaking longer walks into shorter sections, choosing flatter routes during a flare-up and allowing adequate recovery time between more demanding activities are all practical strategies worth trying.
When Should You Get Hip Pain Checked?
When It Is Not Settling
If hip pain has been present for several weeks without clear improvement or if it keeps recurring after brief periods of relief, it is worth getting a proper assessment. Self-management has its place, but it works best when guided by a clear understanding of what is actually going on.
When Daily Activities Are Becoming Harder
If walking, climbing stairs, getting dressed, or sleeping comfortably has become noticeably more difficult, that is a reasonable prompt to seek help. Early assessment and guidance tends to produce better outcomes than waiting until symptoms are significantly limiting your daily life.
When the Diagnosis Is Unclear
With so many possible sources of hip-area pain, and with so much variable information available online, it is very easy to end up uncertain and confused. A clinical assessment with one of our chiropractors or physiotherapists here in Brighton involving a careful history, physical examination can provide clarity and a rational starting point for management.
Red Flags: When to Seek Urgent Medical Advice
The following symptoms warrant prompt medical attention rather than a routine physiotherapy or chiropractic appointment:
- Sudden severe pain following a fall or injury, particularly if you are unable to bear weight
- Significant swelling, redness, warmth or heat around the hip
- Unexplained weight loss
- Severe night pain that is constant and unrelated to movement
- New bladder or bowel symptoms alongside back or hip pain
- General feeling of being unwell alongside joint symptoms
These presentations are uncommon, but it is important to be aware of them. If any of these apply, please contact your GP or, if necessary, seek urgent care.
How Sundial Clinics May Help
Assessment First
The starting point is always understanding where your symptoms are most likely coming from and what is most important to you, whether that is getting back to regular walks, sleeping more comfortably or managing a specific activity. There is no value in jumping straight to treatment without first building a clear picture of the problem.
Clear Explanation in Plain Language
Being given a clear explanation of what is going on, why it is happening, and what is realistic to expect makes a significant difference to how people feel about their condition and how well they engage with management. At Sundial, explaining things in straightforward terms is a core part of what we do.
Conservative Care Tailored to You
We offer chiropractic, physiotherapy and massage therapy, used thoughtfully and in combination where appropriate. Depending on the cause of your hip pain, this might involve hands-on treatment to address stiffness or muscle tension, a guided exercise programme to build strength and control or practical advice on activity modification and pacing. The aim is always to help you do more of what matters to you.
Onward Referral When Appropriate
If your assessment suggests that imaging, a specialist opinion or GP review would be useful, we will tell you clearly and help facilitate that. Our role is to ensure you receive the right care, not simply to keep you coming back.
Hip Pain When Walking Is Common, But Worth Understanding Properly
Hip pain when walking in midlife and older age is genuinely common and in most cases it is very manageable. The key points to take away are:
- Hip pain is not always arthritis and arthritis does not always mean serious damage or inevitable decline.
- The location and behaviour of your pain can provide important clues to its origin.
- Walking pain may come from the hip joint, surrounding tendons and muscles or from the lower back and pelvis.
- Sensible self-help, such as keeping active, managing load and building strength, can make a real difference.
- Persistent or limiting symptoms deserve a proper assessment rather than ongoing uncertainty.
If hip pain is affecting your walking or you are unsure what is driving it, booking an assessment at Sundial Clinics in Brighton is a straightforward next step. The aim is simply to give you clarity, a sensible plan and the confidence to stay active.
Frequently Asked Questions: Hip Pain When Walking
Q. Is hip pain when walking always a sign of arthritis?
A. No. Whilst hip osteoarthritis is one possible cause, pain felt around the hip when walking can originate from several structures, including the gluteal tendons, the outer hip bursa, the deep hip muscles or the lumbar spine. The location and behaviour of the pain offer important clues, and a clinical assessment is the most reliable way to identify the source.
Q. Where is hip joint pain usually felt?
A. Pain originating from the hip joint itself is most commonly felt in the groin, and sometimes into the front of the thigh. It tends to be worse after periods of inactivity and builds over longer walks. Pain felt at the outer hip, buttock, or further down the thigh is more likely to involve tendons, muscles or referred pain from the lower back rather than the joint itself.
Q. What is gluteal tendinopathy and how common is it?
A. Gluteal tendinopathy involves irritation or overload of the tendons connecting the gluteal muscles to the outer part of the hip bone (the greater trochanter). It is one of the most prevalent causes of outer hip pain, particularly in women over 40, and is often misdiagnosed as bursitis. It typically responds well to a structured programme of load management and progressive strengthening exercises.
Q. Can lower back problems cause hip pain when walking?
A. Yes. The lumbar spine and sacroiliac joint can refer pain into the buttock, outer hip and upper thigh in patterns that closely mimic hip joint pain. If your symptoms are accompanied by lower back stiffness, vary with posture or spread into the thigh, the spine may be contributing even if it does not feel like a back problem.
Does hip pain mean I should stop walking? Not usually. Complete rest is rarely the right approach and can allow muscles to weaken and symptoms to become more persistent. The aim is to manage load sensibly by reducing distance, pace or gradient temporarily during a flare-up whilst staying as active as is comfortable. Short, regular walks are generally more useful than stopping altogether.
Q. Will hip pain get worse if I keep walking?
A. It depends on the cause and how you manage your activity. Tendons and joints respond to load and pushing through significant pain is not advisable. However, gradual progressive activity guided by your symptoms is generally beneficial. Noticing what aggravates and eases your pain helps you find the right balance while things settle.
When should hip pain when walking be assessed by a professional? It is worth seeking an assessment if pain has persisted for several weeks without clear improvement, if it keeps recurring, if daily activities such as dressing or using stairs are becoming harder or if you are simply unsure what is causing it. Earlier assessment tends to produce better outcomes than waiting until symptoms are significantly limiting your life.
Q. Are exercises helpful for hip pain when walking?
A. Yes, in most cases. The right exercises depend on the cause, but gluteal and hip strengthening work (such as bridges, clamshells, and side-lying leg raises) is broadly beneficial and rarely harmful when performed within a comfortable range. A Sundial physiotherapist or chiropractor can tailor an exercise programme to your specific presentation.
Q. What are the red flag symptoms that need urgent medical attention?
A. Seek prompt medical advice if you experience sudden severe pain after a fall, are unable to bear weight, notice unexplained swelling, redness or heat around the hip, have a fever alongside joint pain, are experiencing unexplained weight loss or have persistent night pain that is unrelated to movement. These presentations are uncommon but require medical review rather than a routine clinic appointment.
Q. Can hip pain in midlife improve without surgery?
A. For the majority of people, yes. Conservative management, including exercise rehabilitation, load modification, manual therapy and activity guidance, is effective for most common causes of hip pain when walking, including mild to moderate osteoarthritis and gluteal tendinopathy. Surgery is typically considered only after conservative approaches have been thoroughly explored.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.
Supporting Evidence and Peer-Reviewed Sources
The information in this article draws on current clinical evidence. The following peer-reviewed sources support the key findings and recommendations:
Hip Osteoarthritis
Osteoarthritis Research Society International (OARSI) guidelines recommend exercise therapy as a core treatment for hip osteoarthritis, with evidence supporting improvements in pain and function independent of structural joint changes. Quickenden et al. (2023) in Osteoarthritis and Cartilage confirm that pain experience does not correlate simply with radiographic severity.
Bannuru RR, et al. (2019). OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis.
Quickenden MJ, et al. (2023). Pain sensitisation in hip osteoarthritis: a systematic review.
Gluteal Tendinopathy
Seminal work by Mellor and colleagues established that a targeted exercise programme outperforms both corticosteroid injection and a wait-and-see approach for gluteal tendinopathy at 52 weeks.
Mellor R, et al. (2018). Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: a randomised clinical trial.
Plinsinga ML, et al. (2018). Gluteal tendinopathy is characterised by features of central sensitisation: a cross-sectional case-control study.
Referred Pain from the Lumbar Spine
Research consistently demonstrates that lumbar spine and sacroiliac joint pathology can produce pain patterns closely resembling hip joint involvement, highlighting the importance of differential assessment.
Lesher JM, et al. (2008). Hip joint pain referral patterns: a descriptive study.
Sembrano JN & Polly DW (2009). How often is low back pain not coming from the back?
Hip Pain Prevalence and Load Management
Segal NA, et al. (2022). Prevalence and risk factors for hip pain in adults: findings from the Johnston County Osteoarthritis Project.
Rio E, et al. (2019). Tendon neuroplastic training: changing the way we think about tendon rehabilitation.
Exercise Rehabilitation and Conservative Care
Fransen M, et al. (2016). Exercise for osteoarthritis of the hip.
Kemp JL, et al. (2020). Is exercise therapy effective for hip pain? A systematic review with meta-analysis.