Hip Pain in Women: Common Causes by Location

Hip pain in women usually comes from one of three areas. Front or groin pain often points to the hip joint or hip flexors, outer hip pain often points to the gluteal tendons, and buttock pain often points to the glutes, SI joint or low back. Where it hurts is your best first clue.

As a NASM certified trainer and corrective exercise specialist, I have spent more than 20 years helping women move better, and hip pain is one of the questions I hear most. The good news is that most of it is common, understandable and very workable.

This guide walks you through each hip pain location, what it often means, simple first steps you can take this week, and the signs that mean you should skip the home plan and see a doctor.

Why Hip Pain in Women Is so Common

Many women notice hip aches show up in their late 30s, 40s and beyond. That is not bad luck. A few things about how women are built and how life changes over time play a part.

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Women tend to have a wider pelvis, which changes the angle the thigh bone meets the hip. That can put a little more load on the tendons on the outer hip, especially when the side glute muscles are not strong enough to steady the pelvis.

Hormones matter too. Estrogen helps tendons and joints handle load, so as it shifts around perimenopause and menopause, many women find their hips get sore with activities that never bothered them before.

Then there is daily life. Long hours sitting, standing with your weight hanging on one hip, crossing your legs, or a sudden jump in walking or exercise can all tip a hip from fine to sore. Most hip pain causes in females come back to load: too much, too soon, or too little strength to handle it.

Hip Pain Location Chart

Use this chart as a starting point, not a diagnosis. Pain can overlap, and some hips have more than one thing going on.

Front of the Hip and Groin Pain

A deep ache in the groin or the front of the hip often comes from the hip joint itself. Women frequently point to the groin when the joint is the problem, not to the side of the hip where they expect it.

One common cause is hip osteoarthritis, which means wear and change in the joint cartilage over time. It usually feels stiff first thing in the morning, eases once you get moving, then aches again after a long day on your feet.

My guide to the best exercises for hip osteoarthritis shows how gentle strength and movement often help the joint feel better.

Another is a tight or strained hip flexor, the muscle group that lifts your knee. This often feels like a pull or pinch in the front crease after long sitting or a burst of running or kicking. A few gentle hip flexor stretches once or twice a day can ease that front tightness.

Less often, front hip pain can come from the labrum, a ring of cartilage around the hip socket, especially if you feel catching, clicking with pain, or locking. Groin pain can also come from places that are not the hip at all, such as a hernia or pelvic organs. That is why groin pain that does not settle deserves a proper exam.

Outer Hip Pain on the Side

Pain on the side of the hip, right over the bony point you can feel through your clothes, is one of the most common hip complaints in women over 40. The usual cause is gluteal tendinopathy, which means the tendons of the side glute muscles are irritated and not handling load well.

It often hurts to lie on that side at night, to stand on one leg to put on pants, or to climb stairs. Hip bursitis, swelling of a small fluid sac near those tendons, can sit alongside it and feels very similar.

Here is the important part. Current evidence favors strengthening and load management over stretching for outer hip pain. Deep IT band stretches, figure four stretches and crossing your legs all press the tendon against the bone, which can keep it sore.

Instead, try to stand with your weight even on both feet rather than hanging on one hip, avoid crossing your legs, and sleep with a pillow between your knees. My full guide to outer hip pain covers the strength moves that help most.

Back of the Hip and Buttock Pain

Pain at the back of the hip usually lives in the buttock. Common sources include the glute muscles themselves, the piriformis (a small muscle deep in the buttock that turns your leg outward), and the hamstring tendon where it attaches to your sit bone.

It often shows up after long sitting, a jump in walking or running, or weeks of crossing the same leg. My guide to glute pain breaks down the usual causes by spot, from the upper buttock to the sit bone.

Pain just beside the dimple at the base of your spine is often the sacroiliac joint, or SI joint, where your spine meets your pelvis. It can feel like hip pain but usually behaves differently. If you are not sure which one you have, read my guide on hip pain vs SI joint pain.

When Hip Pain Travels Down the Leg

Sometimes hip or buttock pain does not stay put. If it travels down the back of the thigh, past the knee or into the calf, the cause is often an irritated nerve, and the source is frequently the low back rather than the hip.

Burning, electric or tingling pain, or pain that changes when you bend or sit, are clues it may be nerve related. My guide to hip pain radiating down the leg explains what that pattern can mean and what to do next. Numbness or leg weakness is a reason to get checked rather than wait.

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Hip Pain on Both Sides

Hip pain on both sides at once is a slightly different picture. When both outer hips ache, it is often tendon irritation on both sides from the same habits, such as long standing, a new walking plan, or weak side glutes.

When both hips are stiff in the morning and ease with movement, the joints may be involved. And when pain on both sides comes with widespread joint aches, morning stiffness that lasts longer than an hour, swelling in other joints, or general fatigue, it is worth asking your doctor about inflammatory causes.

Both-sided pain is not automatically more serious. It simply makes the bigger picture, your habits, your activity and your general health, more important to look at.

Hip Pain That Comes and Goes

Hip pain that comes and goes is very common, and it often follows a pattern. Many women I coach tell me their hip is fine for a week, then flares after a long walk, a day of yard work or a new class.

That on and off pattern usually points to load. Tendons and joints have a comfortable limit, and pain shows up when you go past it. The fix is rarely total rest. It is finding the amount of activity your hip tolerates now, then building it up slowly.

A simple rule many people find useful: mild discomfort during activity that settles within 24 hours is usually OK. Pain that is clearly worse the next morning means you did a bit too much, so dial it back next time.

Simple First Steps for Most Hip Pain

These steps are gentle and safe for most women while you figure out what is going on. Stop any move that causes sharp pain.

1. Walk a little most days. Aim for 10 to 20 minutes at an easy pace on flat ground. Movement keeps joints and tendons healthy.
2. Do glute bridges. Lie on your back, knees bent, and lift your hips until your body forms a line from knees to shoulders. Do 2 sets of 10, holding each for 2 seconds at the top.
3. Add a side glute hold. Stand tall beside a wall with the sore hip away from it. Press the outer knee of the leg nearest the wall gently into the wall and hold 30 seconds. Do 3 to 5 holds.
4. Try sit to stands. Sit on a sturdy chair, then stand up without using your hands. Do 2 sets of 8 to 10, keeping your knees in line with your toes.
5. Ease the daily strain. Break up sitting every 45 to 60 minutes, stand evenly on both feet and keep a pillow between your knees at night.

When to See a Doctor or Physical Therapist

Most hip pain is a nuisance rather than an emergency. But some signs point to something a home plan cannot fix. See a doctor or physical therapist if you notice:

• Numbness or tingling in your leg or foot
• Leg weakness, or your leg giving way
• Hip pain after a fall, especially if you cannot put weight on the leg
• Fever with joint pain, or a hip that is hot, red and swollen
• Pain that wakes you at night, no matter how you lie
• Loss of bladder or bowel control, which needs emergency care
• Groin pain with a bulge, or pain that is no better after 2 to 3 weeks of gentle care

A physical therapist can test your strength, movement and sore spots to tell whether the problem is the joint, the tendons, your SI joint or your back, then build a plan around what they find.

Your This-Week Plan

1. Day 1: Use the chart above to note where your pain is and what makes it worse.
2. Days 1 to 3: Walk 10 minutes a day and do glute bridges once a day.
3. Days 4 to 7: Add the side glute hold and sit to stands, 3 or 4 days this week.
4. Every day: Avoid crossing your legs, break up sitting and sleep with a pillow between your knees if the side of your hip hurts.

Quick Questions

This guide is part of my hip and lower body pain guide, where you’ll find help for outer hip pain, glute pain, SI joint pain and piriformis problems, plus clear advice on when to see a doctor.

The Bottom Line

Hip pain in women is common, and where it hurts is your best first clue. Front and groin pain often involves the joint, side pain often involves the tendons, and buttock pain often involves the glutes, piriformis or SI joint.

For most women, steady walking, simple glute strength work and fewer aggravating positions are the right first steps. Give it 2 to 3 weeks, and see a doctor sooner if any red flags show up.

This article is for general education and isn’t medical advice, and it can’t diagnose the cause of your hip pain. Talk to your doctor or a physical therapist if you have ongoing hip, groin or leg pain, or a recent injury or surgery. Get medical help promptly for numbness or tingling, leg weakness, pain after a fall, fever with joint pain or a hot swollen hip, pain that wakes you at night, or any loss of bladder or bowel control.