Hip Pain
Integrated Evaluation of Hip and Related Musculoskeletal Pain
Evaluation for patients seeking a clear understanding of the likely source of hip-region pain and the most appropriate next step.
Hip pain may arise from the joint itself, but often involves surrounding structures including tendons, muscles, the sacroiliac joint, or the lumbar spine. Symptoms may be localized or reflect referred or overlapping pain patterns.
At Network Spine, evaluation focuses on identifying the most clinically relevant pain generator(s) rather than treating the hip in isolation.
Who This Is For
This page is intended for patients with hip-region pain that affects sitting, walking, stairs, training, sleep, commuting, or daily activity.
It may be appropriate for active adults, professionals, and athletes who want a focused evaluation, a clearer diagnosis, and an organized non-surgical treatment plan when clinically appropriate.
Common Hip Pain Locations and Patterns
Hip-region pain is often described by location. The location of pain does not always identify the diagnosis, but it helps guide the examination.
Anterior Hip Pain
May involve the hip osteoarthritis, hip flexors, psoas/iliopsoas, rectus femoris, or selected hip-joint contributors.
Groin / Adductor Pain
May involve the adductor muscles or tendons, directional loading, sport-related strain, or selected hip-joint contributors.
Lateral Hip Pain
May involve the gluteus medius or minimus tendons, greater trochanteric pain syndrome, or bursal-region irritation.
Posterior Hip / Gluteal Pain
May involve gluteal soft tissue, deep gluteal structures, sacroiliac contribution, referred lumbar facet pain, or nerve-related symptoms.
When Hip Pain May Be Influenced by the Back, Sacroiliac Region, Knee, or Foot
Hip pain does not always begin in the hip joint itself. Pain felt in the groin, outer hip, buttock, thigh, or posterior hip region may sometimes be influenced by the lumbar spine, sacroiliac joint, pelvic mechanics, nerve irritation, knee mechanics, foot and ankle mechanics, or related soft-tissue patterns.
This is one reason hip evaluation should not focus only on the hip joint. Examination may include assessment of lumbar motion, neurologic findings, hip mobility, pelvic mechanics, gait, tendon loading, knee alignment, foot and ankle motion, and review of imaging when available.
When symptoms suggest a referred, spinal, sacroiliac, nerve-related, or movement-related source, treatment may emphasize rehabilitation strategy, osteopathic evaluation and treatment, medication strategy, diagnostic clarification, or selective image-guided treatment when appropriate.
Osteopathic, Physiatric, and Biomechanical Approach
Hip pain is often influenced by more than the hip joint alone. Symptoms may come from the joint, surrounding tendons, pelvic mechanics, the sacroiliac region, the lumbar spine, nerve irritation, gait changes, or lower-extremity movement patterns.
At Network Spine, hip pain is evaluated from an orthopedic, neurologic, osteopathic, and functional perspective. The goal is to identify the most likely pain source, understand relevant contributing factors, and determine the most appropriate next step — which may include rehabilitation planning, osteopathic manipulative treatment, diagnostic ultrasound, image-guided injection, further imaging, or referral when appropriate.
Osteopathic evaluation may include assessment of hip mobility, pelvic and lumbar mechanics, sacroiliac contribution, muscular imbalance, tendon loading, gait pattern, and compensatory movement. Osteopathic manipulative treatment may be considered when restricted motion, soft-tissue tension, joint mechanics, or compensatory patterns appear to be contributing to symptoms.
This approach is not based on treating an imaging finding alone. Care is guided by the clinical pattern, physical examination, functional limitations, demand level, imaging when relevant, and the patient’s goals.
Treatment Approach
Treatment is individualized and based on clinical findings.
Depending on the presentation, options may include:
Activity and Load Modification
Adjustments to sitting, training, or daily activity
Return-to-activity planning based on symptoms
Exercise and Movement Strategy
Targeted strengthening or mobility work
Addressing contributing mechanics
Osteopathic Manipulative Treatment (OMT)
Osteopathic manipulative treatment may be used selectively to address joint mechanics, tissue restriction, and relevant movement patterns.
Ultrasound-Guided Injections
Ultrasound-guided injections may be considered when:
Symptoms persist despite appropriate conservative treatment
Pain limits function or meaningful rehabilitation progress
Diagnostic clarification may affect the treatment plan
Selected targets may include:
Peritendinous regions or bursae
The hip joint when clinically appropriate
Trigger Point Injections
Trigger point injections may be considered for myofascial pain involving the gluteal or surrounding musculature.
Advanced Injection Options
Advanced injection options using a patient’s own blood or bone marrow-derived material may be considered for selected joint, tendon, or soft-tissue conditions. Appropriateness depends on the diagnosis, examination and imaging findings, prior treatment, and individual goals.
Selected gluteal or other accessible tendon conditions may also be evaluated for percutaneous tendon and soft-tissue procedures when appropriate.
What a Visit Typically Involves
Focused evaluation of hip, pelvis, and spine
Identification of likely pain source(s)
Discussion of treatment options
When appropriate, treatment may be performed during the same visit.
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Clinical Perspective
Hip-region pain is evaluated in context rather than by imaging alone.
Findings such as labral changes, tendon irritation, bursitis, arthritis, or degenerative changes may be relevant, but they do not always explain a patient’s symptoms. The clinical examination helps determine which findings are meaningful and which may be incidental.
Care focuses on identifying the most likely pain source, understanding contributing mechanics, and selecting the most reasonable next step based on the patient’s symptoms, function, examination, and goals.
Precise diagnosis. Thoughtful care. Individualized treatment.