Hip Pain Relief
in Bethesda, MD

Hip pain that appears or worsens with walking usually points to one of three sources. Hip bursitis inflames the fluid-filled sac on the outer hip, causing pain that intensifies with each step. Hip flexor tightness creates a pulling or aching sensation at the front of the hip as the leg swings forward. Hip joint arthritis causes a deep grind or ache in the groin that worsens under load. Less commonly, the pain comes from the lower back or sciatic nerve referring into the hip. A physical assessment is the fastest way to identify which one is causing your pain, since each requires a different approach.

Hip flexor pain is typically felt at the front of the hip and into the upper thigh, sometimes extending toward the groin. It often flares when lifting the knee, rising from a seated position, walking uphill, or during the first few steps after sitting for a long time. In some cases it also causes a deep aching sensation at the front of the hip socket. Runners, cyclists, and people who work at a desk for long hours are most likely to experience hip flexor tightness because the iliopsoas muscle shortens when the hip stays in a bent position.

Women experience hip pain for many of the same reasons men do, including bursitis, hip flexor tightness, arthritis, labral tears, and lower back referral. However, there are a few patterns that appear more often in women. Hip bursitis (greater trochanteric bursitis) is more common in women, particularly in those who are active or who have recently increased their activity level. Wider pelvic anatomy can also affect how load is distributed through the hip joint, making certain movement patterns more likely to cause irritation. Hormonal changes, including pregnancy and postpartum recovery, can also affect hip and pelvic stability. If you have hip pain that is not resolving, an assessment with Dr. Helms will clarify exactly what is going on.

Yes, and this is one of the most common sources of confusion we see. Sciatica refers to irritation of the sciatic nerve, which travels from the lower back through the hip area and down the leg. When the nerve is compressed, whether by a lumbar disc, tight piriformis muscle, or SI joint dysfunction, the pain can settle into the hip and buttock and feel very much like a hip joint problem. The key difference is that sciatica pain often radiates down the leg and may include numbness, tingling, or a burning sensation. Hip joint pain, by contrast, tends to stay local to the groin and front of the hip. Treating the nerve compression, rather than the hip, is what provides lasting relief.

Hip pain that radiates down the leg, especially at night or when lying in certain positions, is usually a sign of nerve involvement rather than a hip joint or muscle problem alone. The most common cause is sciatic nerve irritation from a tight piriformis muscle or lumbar disc putting pressure on the nerve root. Lying down changes the position of the lumbar spine and hip, which can increase or decrease nerve tension. If you are experiencing this pattern, it is worth having it evaluated, since treating the nerve source rather than just the hip symptoms produces much better outcomes.

The fastest way depends on the source. For hip flexor tightness, gentle stretching of the iliopsoas and a temporary reduction in activities that aggravate it (prolonged sitting, running, stair climbing) can provide quick relief. For bursitis, reducing friction through activity modification and targeted soft tissue work tends to help quickly. For nerve-related hip pain, addressing the lumbar spine or tight piriformis is typically faster than treating the hip itself. At Helms Performance, most patients notice meaningful improvement within two to four visits once the correct source has been identified. Guessing at the cause and self-treating extends recovery time, so an accurate assessment is worth doing early.

Hip joint pain is felt deep in the groin (sometimes radiating to the front of the thigh) and typically worsens with weight-bearing activities, rotation, or climbing stairs. It often presents as a deep ache or stiffness and is associated with conditions like osteoarthritis or labral tears. Hip flexor pain, by contrast, is felt at the front of the hip and upper thigh, worsens when lifting the knee or rising from a chair, and is most common in runners, cyclists, and desk workers. The distinction matters because hip joint pain and hip flexor pain require completely different treatment approaches. Treating one when the problem is actually the other delays recovery and often makes things worse.