Medically reviewed guide · Last updated: 23 July 2026 · Reading time: approx. 9 min.

Hip pain:
true hip or back?

At a glance

What is it?Pain around the hip joint — it can come from the joint itself, from tendons and bursae, or radiate from the back
Usually harmless?Often yes — much hip pain comes from tendons, muscles or wear and improves with movement and patience
Common triggersOsteoarthritis, bursitis, tendon-insertion irritation, overload, poor posture, back problems
Warning signsPain after a fall with malalignment, redness and fever, or sudden numbness and paralysis — seek clarification at once
Key distinctionTrue hip (groin, deep on the side) versus pain radiating from the back/sciatica (buttock, back of the leg)
Self-testWhere exactly does the pain sit? Groin, side of the hip bone or buttock — the location is the key

Understand and document hip pain

Record where the pain sits, when it occurs and what makes it worse — a clear overview that is worth its weight in gold at your doctor's appointment. Free.

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Contents

  1. What is hip pain?
  2. True hip or back?
  3. Causes & triggers
  4. Pinpointing the location
  5. When to see a doctor?
  6. Diagnosis
  7. What you can do yourself
  8. How brite helps you
  9. FAQ
  10. Related topics

1. What is hip pain?

Hip pain means discomfort around the hip joint — but the term is tricky, because what many people call the "hip" often has nothing to do with the joint at all. The actual hip joint lies deep inside, where the head of the thigh bone fits into the socket of the pelvis. Pain from there is typically felt in the groin, sometimes pulling down into the front of the thigh.

Alongside this there are two quite different sources of pain that are easily mistaken for the hip: the soft tissues on the side of the hip bone (tendon insertions and bursae) and the lower back, from which pain can radiate into the buttock and the back of the leg. This very mix-up is the most common misattribution — and the reason why location matters so much.

The most important thing first Where the pain sits usually already reveals the cause: the groin points to the joint, the side of the hip bone to tendons or bursae, and the buttock with radiation into the leg often points to the back. This simple classification is the first step.

2. True hip or back?

The key question is not "does the hip hurt?" but "where does the pain really come from?". Because discomfort from the lower back or an irritated sciatic nerve often radiates into the buttock and leg and feels like a hip problem. This distinction determines where treatment needs to happen.

  • Points to the true hip: pain in the groin, start-up pain after sitting, trouble putting on shoes or reaching for socks, restricted rotation in the joint. The pain tends to stay local and does not radiate down to the foot.
  • Points to the back/sciatica: pain in the buttock that pulls down the back of the leg as a dragging or "electric" sensation, often to below the knee or into the foot, sometimes with tingling or numbness. Worsening when coughing or straining also points to the back.
Quick self-test to tell them apart Point with one finger at the most painful spot. If it is at the front in the groin, the joint is the most likely culprit. If you can press directly on the side of the hip bone and it hurts exactly there, it is usually tendons or a bursa. If the pain pulls from the buttock into the leg, it is worth looking at the back.

3. Causes & triggers

Hip pain often has no dangerous cause, but arises from wear, irritation or overload. Depending on where the pain sits, different triggers come into question.

  • Hip osteoarthritis (coxarthrosis): wear of the joint cartilage — the most common cause of true hip pain from middle age onwards, typically with groin and start-up pain. More on this under osteoarthritis.
  • Bursitis: irritation of the bursa on the side of the hip bone — hurts when lying on the side and under pressure from outside.
  • Tendon-insertion irritation: overloaded tendons of the buttock and hip muscles, often after unaccustomed strain or long walks.
  • Muscle tension and poor posture: muscular imbalances, one-sided strain or a protective posture.
  • Back and sciatica: a herniated disc or a nerve irritation in the lower back that radiates into the buttock and leg.
  • Overload and sport: increasing training too quickly, running on hard surfaces, standing for long periods.
  • Rarer, but important: inflammation, bone fractures after a fall or rheumatic diseases.

The link with particular movements, long periods of sitting or physical strain is something you can observe well yourself. A simple log helps to spot patterns.

4. Pinpointing the location

The most important self-check for hip pain is to pinpoint the painful spot precisely. The location often already reveals which structure is affected — and whether it is the hip at all.

  • Point to the spot: use one finger to indicate the most painful place — groin, side of the hip bone or buttock?
  • Test with pressure: can the pain be triggered by pressing on the side of the bone from outside? That points to a bursa or tendon.
  • Check movement: does putting on socks or rotating the leg hurt in the groin? That points to the joint.
  • Note the radiation: does the pain pull from the buttock down the back of the leg, possibly with tingling? Then it is more likely the back/sciatica.
  • Write it down: record location, trigger, time of day and duration — ideal for the doctor's consultation.

Pain accompanied by tingling, numbness or weakness in the leg should always be clarified by a doctor. Local discomfort without radiation, on the other hand, is often muscular or due to irritation and frequently improves on its own.

Your pain log always with you

With brite you record the location, triggers and course of your hip pain — the best basis for the practice to quickly get to the bottom of the cause.

Document the course

5. When to see a doctor?

Hip pain is usually harmless, but there are clear situations in which you should have it clarified or act at once.

You should have it clarified by a doctor promptly if the pain persists for several weeks, gets worse, noticeably limits your walking or disturbs you strongly at night. Recurring discomfort and restricted movement in the joint should also be examined — if only to start the right treatment early.

Seek immediate medical clarification or call 112 Call the emergency number or go to the emergency department with hip or leg pain after a fall with malalignment of the leg or an inability to stand (suspected fracture), with redness, warmth and swelling with fever (suspected infection) or with sudden pain with numbness or paralysis in the leg. These signs are an emergency.

6. Diagnosis

To find the cause, the practice has simple and informative examinations at its disposal. It is important to describe the site of the pain and the triggers as precisely as possible.

ExaminationWhat it shows
History & palpationLocation, triggers, radiation, tenderness on pressure, restricted movement
Movement testsMobility and pain on rotation, flexion and abduction
X-rayJoint space and wear (osteoarthritis), bone, malalignments
UltrasoundBursae, tendons, effusions and soft tissues
MRI if neededCartilage, tendons, nerves and possible back causes
Table scrollable to the right

Because hip and back pain can overlap in everyday life, an accurate description and targeted movement tests are especially valuable. A well-kept pain log makes the attribution easier still.

7. What you can do yourself

  • Stay active: gentle movement such as walking, cycling or swimming keeps the joint mobile — strict rest tends to make many things worse.
  • Adjust the triggers: dose the strain, break up long periods of sitting and increase sport slowly instead of overloading.
  • Strengthen and stretch in a targeted way: exercises for the hip, buttock and core muscles stabilise the joint and relieve the back.
  • Relieve the pain: warmth for tension, cooling for acute irritation; in the short term a painkiller such as Ibuprofen can help — follow the instructions on the package leaflet.
  • Keep a log: where does the pain sit, when does it occur, what makes it worse? That helps you and the practice.

Recognise triggers, understand patterns

brite helps you document hip pain and possible triggers over time — free and ad-free.

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How brite helps you with hip pain

Hip pain changes with movement, strain and time of day — which is exactly what makes it hard to pin down. Anyone who records the site of pain, triggers and course over time gives the practice the decisive clues. brite makes that easy.

  • Health history — document the site of pain, intensity and possible triggers (sitting, sport, strain) over time and bring it as an overview to your appointment. Track your history
  • Intake reminder — if painkillers or anti-inflammatory medication are prescribed, brite reliably reminds you to take them. Set up a reminder
  • Interaction check — checks whether painkillers such as Ibuprofen combine unfavourably with other medicines. Check now
  • Digital medication plan — all medicines clearly in one place for your GP and orthopaedics. To the medication plan
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FAQ: Common questions about hip pain

A good clue is the location: true hip pain usually sits in the groin or deep on the side and hurts when rotating the leg or putting on socks. If the pain comes from the back or from the sciatic nerve, it often pulls from the buttock down the back of the leg, sometimes with tingling or numbness reaching into the foot.
Pain in the groin most likely points to the hip joint itself, for example to hip osteoarthritis. Typical signs are start-up pain after sitting and restricted rotation in the joint. If such discomfort persists, it should be clarified by an orthopaedic specialist.
Pain at the side of the hip bone, especially when lying on the side and under pressure from outside, often points to bursitis or an irritated tendon. This is usually not dangerous but can be persistent and improves with relief, targeted exercises and patience.
No. Osteoarthritis is a common cause of true hip pain from middle age onwards, but much discomfort comes from tendons, bursae, muscles or the back. In younger people in particular, overload or muscular causes are often behind it. The precise attribution is achieved through location and examination.
In most cases gentle movement is better than strict rest. Walking, cycling or swimming keep the joint mobile and the muscles strong. Only avoid what clearly increases the pain, and increase the strain slowly. With acute severe irritation, brief relief makes sense.
The first point of contact is the GP practice, which classifies the problem and refers you on if needed. Orthopaedics is responsible for the joint, tendons and bones. If the back is behind it, a neurological or physiotherapy assessment may additionally make sense.
In the short term, relieving the irritated structure, warmth for tension or cooling for acute irritation and, if needed, an anti-inflammatory painkiller such as Ibuprofen according to the package leaflet help. In the long run, targeted exercises for the hip and core muscles are more effective than rest alone.
You should seek immediate medical clarification or call the emergency number 112 with hip or leg pain after a fall with malalignment or an inability to stand (suspected fracture), with redness, warmth and fever (suspected infection) or with sudden pain with numbness or paralysis in the leg.
Yes. A herniated disc or a nerve irritation in the lower back can radiate pain into the buttock and leg that feels like a hip problem. Clues are radiation down the back of the leg, tingling, numbness and worsening when coughing or straining. Such discomfort should be clarified by a doctor.

10. Related topics

Osteoarthritis Back pain Herniated disc Joint pain Ibuprofen

Sources

  1. gesundheitsinformation.de (IQWiG): Hip osteoarthritis and back pain. gesundheitsinformation.de
  2. German Society for Orthopaedics and Orthopaedic Surgery (DGOOC): Coxarthrosis guideline. dgooc.de
  3. Institute for Quality and Efficiency in Health Care (IQWiG): Herniated disc. gesundheitsinformation.de

This article is for general information and does not replace medical advice, diagnosis or treatment. With hip or leg pain after a fall with malalignment, with redness and warmth with fever, or with sudden numbness or paralysis, please call the emergency number 112 immediately.