Pain in your hip when sitting: 7 possible causes and what physical therapy may address

Sitting should be one of the easiest ways to relax — not something that leaves you wondering if it's time to call the doctor. Whether you're settling in to watch a movie or taking a break after a busy day, hip pain can quickly make it difficult to get comfortable. More importantly, it can stem from several issues.

Performance Rehab works with individuals experiencing a wide range of hip conditions and movement-related concerns. In this article, we'll explore possible hip pain causes, explain why sitting may aggravate your symptoms and discuss how physical therapy may help with recovery.

What can cause hip pain?

Hip pain could be related to the structures inside your hip joint, the surrounding muscles and tendons or even other areas like your lower back. Here are seven possible reasons why your hip hurts when you sit down:

Hip flexor tightness or irritation

Hip flexors are a group of muscles at the front of your hips that help lift your legs toward your body. Sitting for long periods can place these muscles in a shortened position, resulting in symptoms like:

• Aching at the front of your hips

• Stiffness when you stand up

• Discomfort after prolonged sitting

PT insight: A physical therapist can assess your mobility, movement patterns and muscle function to determine whether your symptoms may be associated with tight or irritated hip flexors.

2. Gluteal tendinopathy

The tendons that connect the muscles in your buttocks area (gluteal muscles) to your hips can sometimes become irritated. This is called gluteal tendinopathy. It often causes pain along the outside of your hip and sometimes down the outside of your leg. It may feel worse when you:

• Lie on one side

• Climb stairs or walk uphill

• Get out of bed in the morning

• Sit for long periods

PT insight: A physical therapist can help you learn what might be placing extra stress on the outside of your hip. Your treatment may focus on improving your strength, adjusting certain movement habits and finding ways to stay active while minimizing irritation.

3. Hip bursitis

Small, fluid-filled sacs called bursae help reduce joint friction. When one becomes irritated in your hip, it may cause pain. Hip bursitis may cause sharp, intense or aching pain in your hip. You may also notice pain that extends down your thigh or discomfort when lying on the affected side. Also, it may feel worse when you walk, sit, stand or climb stairs.

PT insight: Treatment may focus on reducing irritation around the bursa while improving hip strength and mobility to better support the joint.

4. Hip osteoarthritis

Osteoarthritis is a degenerative joint condition, meaning gradual changes to your cartilage and surrounding structures occur over time. While arthritis is more common with age, it can also affect younger adults. With this condition, you may notice:

• Stiffness after sitting

• Reduced hip flexibility

• Pain with movement or prolonged positions

PT insight: Physical therapy may help improve your strength and mobility, making it easier to stay active at a level that feels manageable for you.

5. Labrum injury

The labrum is a ring of cartilage that helps support your hip joint. Irritation or injury to this tissue may contribute to your pain. Common symptoms of a hip labral tear include:

• Deep pain within your hip or groin area

• Clicking or "catching" sensations in your hip joint

• Discomfort while sitting or twisting

PT insight: A physical therapist can develop a treatment plan designed to help you manage the pain and other symptoms related to a labrum injury and promote long-term hip health.

6. Referred lower back pain

Not all hip pain comes from the hip itself. Parts of your lower back can sometimes refer pain into your hip and buttock areas. Signs of a back-related issue may include:

• Pain that travels into your hip or leg

• Changes in symptoms with spinal movement

• Numbness or tingling sensations

PT insight: A physical therapist can assess your lower back to better understand what might be causing your pain and target those areas in treatment.

7. Muscle weakness and movement dysfunction

Your hips don't work alone. They rely on support from nearby muscles, including your glutes, core and legs. When those muscles aren't providing enough support, your hips may end up doing more work than they were designed to handle.

PT insight: A physical therapist can evaluate how you move and identify key patterns that could be causing your hip pain.

What to expect at your first PT appointment

Because hip pain can stem from multiple conditions, identifying contributing factors is one of the most important steps. A physical therapy evaluation may include:

• Symptom and health history review

• Hip mobility assessment

• Strength testing

• Movement analysis

Based on their findings, your provider can develop a personalized treatment plan that may include a combination of in-office techniques and at-home strategies.

It's important to remember that pain by itself doesn’t tell you exactly what the problem is because different conditions can feel similar. That’s why an evaluation can help, especially if the pain isn’t improving or significantly affects your daily life.

Get help identifying potential hip pain causes

If hip pain is making it harder for you to sit comfortably, Performance Rehab can help you better understand your pain and figure out what to do next. We have offices across the Kansas City area and offer telehealth appointments, making it easier to access the quality care that fits your schedule. 

Contact us or request an appointment today.

FAQs about hip pain

• Why does my hip hurt when I sit for a long time?

Several factors may cause hip pain while sitting, including muscle tightness, tendon irritation, joint changes or referred pain from your lower back. A PT evaluation may help determine the underlying issue(s).

• Can tight hip flexors cause hip pain when sitting?

Yes, tight or irritated hip flexors can sometimes lead to discomfort at the front of your hip, especially after prolonged sitting. However, other conditions can produce similar symptoms.

• Is hip pain when sitting always caused by a hip problem?

No, some people experience hip pain that originates from their lower back, pelvis or surrounding muscles. A PT assessment can help you learn more.

• Can sitting too much make my hip pain worse?

Yes, prolonged sitting may increase hip stiffness or place stress on certain tissues. However, symptoms vary from person to person.

• Can poor posture cause hip pain?

Yes, but your posture alone doesn't always cause hip pain. Your seated positions and movement habits may contribute to this discomfort.

• How can physical therapy help with hip issues?

A physical therapist may be able to identify what's driving your symptoms and recommend evidence-based strategies tailored to your unique needs.

• When should I see a physical therapist for hip pain?

It may be helpful to seek an evaluation if symptoms persist, worsen or interfere with daily activities, exercise, work or sleep.

• What are common hip pain causes in adults?

Common causes of hip pain include muscle strains, tendinitis, osteoarthritis, bursitis, labral irritation and referred pain from your lower back. Only a qualified healthcare professional can offer a diagnosis.

• Is walking good for hip pain?

Walking may be helpful for some individuals, depending on their symptoms and condition. However, activity recommendations typically depend on your individual needs and tolerance.

• Will my hip pain go away on its own?

Some minor soreness or temporary irritation may improve with time. If your pain persists, worsens or limits your mobility, consider consulting your provider.