December 9, 2025

Hip pain is one of the most common problems experienced by people in their 40s and 50s. While many assume hip pain is a normal part of ageing, the truth is that it often signals underlying joint, muscle, or nerve problems that need medical attention. Middle age brings significant changes to our bones, joints, and soft tissues, and these changes can make the hip joint more vulnerable to wear-and-tear, inflammation, and injury.

Understanding the causes of hip pain helps you seek timely treatment, prevent long-term damage, and maintain an active lifestyle. Here is a detailed look at the major causes of hip pain in middle age.

1. Osteoarthritis of the Hip

Osteoarthritis (OA) is the most common cause of hip pain after age 40. Over time, the protective cartilage that cushions the hip joint begins to wear down. As the cartilage thins, bones rub against each other, causing pain, stiffness, swelling, and reduced flexibility.

Symptoms of hip osteoarthritis include:

  • Groin pain
  • Stiffness in the morning
  • Pain while walking, sitting, or climbing stairs
  • Clicking or grinding sensations (crepitus)

OA develops gradually but becomes progressively painful if not managed early. Weight gain, genetics, repetitive stress, and previous injuries accelerate the process.

2. Hip Bursitis

Around the hip joint, small fluid-filled sacs called bursae help reduce friction between bones and soft tissues. With age and repetitive motions, these sacs can become inflamed—a condition known as trochanteric bursitis.

You may notice:

  • Sharp, burning pain on the outer side of the hip
  • Pain worse when lying on one side
  • Pain that travels down the thigh
  • Discomfort after walking long distances

Bursitis is especially common in women, runners, and people who stand for long hours.

3. Hip Tendinitis & Tendon Degeneration

Tendons around the hip become less flexible and more prone to irritation with age. Repetitive movements, long sitting hours, sudden heavy physical activity, and weak muscles can cause tendinitis.

In some cases, chronic inflammation leads to tendinopathy, where the tendon begins to degenerate.

Common symptoms include:

  • Aching pain around the hip and groin
  • Pain when moving the leg sideways or lifting the knee
  • Difficulty getting up from a chair
  • Discomfort after exercise

4. Hip Labral Tear

The hip has a cartilage ring called the labrum, which stabilizes the joint. Repeated twisting, sports injuries, abnormal hip bone shape, or age-related degeneration can cause a labral tear.

Signs include:

  • Sharp hip or groin pain
  • Clicking or locking of the hip
  • Feeling that the hip may “give way”
  • Reduced range of motion

Although commonly seen in athletes, labral tears are increasingly noticed in middle-aged adults due to wear-and-tear.

5. Femoroacetabular Impingement (FAI)

FAI is a condition where the hip bones have a slight shape abnormality, causing friction during movements. Over time, this repeated rubbing damages the cartilage and labrum.

Many people develop symptoms of FAI in their 40s
as the hip joint begins to show signs of ageing.

Common symptoms:

  • Groin pain during bending
  • Stiffness
  • Pain after sitting for long
  • Reduced hip rotation

6. Muscle Weakness & Imbalance

Modern lifestyles involve prolonged sitting, limited physical activity, and poor posture. All these lead to weak glute muscles and tight hip flexors.

Weak and imbalanced muscles shift the load to the hip joint, causing:

  • Pain during walking or standing
  • Fatigue in the hip area
  • Poor posture
  • Strain during daily activities

Strengthening the core and glutes is essential to reduce hip pressure.

7. Sciatica and Referred Pain

Not all hip pain originates in the hip. The lumbar spine plays a major role in hip comfort and mobility. Conditions like:

  • Herniated disc
  • Spinal stenosis
  • Nerve compression
    can cause pain that radiates to the hip, thigh, and buttock.

Sciatica typically causes:

  • Sharp, shooting pain
  • Pain that worsens when sitting
  • Numbness or tingling

Middle-aged individuals often develop these spinal issues due to degeneration or poor posture.

8. Obesity and Sedentary Lifestyle

Extra body weight places significant stress on the hip joint, accelerating wear-and-tear. Every extra kilogram adds mechanical load and increases inflammation, worsening conditions like osteoarthritis, bursitis, and tendinopathy.

A sedentary lifestyle weakens supporting muscles, further increasing strain on the joint.

9. Hormonal Changes in Women

Women after the age of 40 often experience hormonal changes that decrease bone density and affect joint health. Reduced estrogen levels weaken cartilage and increase inflammation, making hip pain more noticeable.

This is one reason hip pain is more common in middle-aged women than men.

10. Previous Injuries or Undiagnosed Childhood Conditions

In some adults, childhood hip conditions like hip dysplasia, slipped capital femoral epiphysis (SCFE), or untreated injuries start showing symptoms only in middle age. Old injuries that healed improperly can also lead to early arthritis or chronic pain.

When Should You See a Doctor?

Seek immediate medical assessment if you experience:

  • Persistent hip or groin pain
  • Pain that disturbs sleep
  • Difficulty walking or bending
  • Sudden swelling or redness
  • Clicking, locking, or instability
  • Pain radiating to the thigh or knee

Early diagnosis prevents long-term joint damage and improves mobility.

How Is Hip Pain Treated?

Treatment depends on the cause but often includes:

  • Lifestyle modification
  • Weight management
  • Physiotherapy & strengthening
  • Anti-inflammatory medicines
  • Activity corrections
  • Image-guided injections (if required)
  • Surgery only when necessary

Correct evaluation ensures the right treatment plan.

Conclusion

Hip pain in middle age should not be ignored. Whether it is due to arthritis, bursitis, muscle imbalance, or nerve compression, timely diagnosis is the key to preventing long-term complications. Staying active, maintaining strength, and consulting an orthopaedic specialist helps restore movement and reduce pain effectively.

For personalized evaluation and expert care, always consult a qualified specialist like Dr. Nirmal Patil, Orthopaedic & Spine Surgeon, who can guide you toward the right treatment and long-term joint health.