Can hip arthritis cause pain down leg?

Hip arthritis, also known as osteoarthritis of the hip, is a common condition that causes deterioration of the hip joint cartilage over time. As the cartilage wears down, inflammation and pain can occur. In many cases, hip arthritis not only causes pain in the hip itself, but can also radiate down the leg.

What is hip arthritis?

Hip arthritis develops when the cartilage that cushions the hip joint wears down over time. This cartilage allows the hip bone to glide smoothly within the socket. When the cartilage breaks down, the bones rub together, causing pain, stiffness, and loss of range of motion in the hip joint.

There are several types of hip arthritis:

  • Osteoarthritis – This is the most common type of hip arthritis, caused by general wear and tear on the hip joint over time. It usually develops gradually.
  • Rheumatoid arthritis – An inflammatory autoimmune disease that can affect the hip joint along with other joints.
  • Post-traumatic arthritis – Develops after an injury like a hip fracture or dislocation damages the hip joint.
  • Avascular necrosis – Loss of blood supply to the femoral head leads to bone cell death and collapse of the hip joint surface.

In this article, we’ll focus specifically on osteoarthritis as the most common cause of hip arthritis.

What are the symptoms of hip arthritis?

The most common symptoms of hip osteoarthritis include:

  • Pain in the hip joint – This may include pain in the groin, outer hip, or buttocks areas. Pain is typically worse with activities like walking or bending at the hip.
  • Stiffness in the hip joint – Stiffness after periods of inactivity is common, especially first thing in the morning or after sitting.
  • Loss of flexibility and range of motion – Over time the hip joint loses its ability to move smoothly through its full range of motion.
  • Affected gait – People with hip arthritis often walk with a limp and have difficulty with tasks like climbing stairs.
  • Joint swelling – Inflammation can cause swelling around the hip joint.
  • Bone spurs – Extra bits of bone, called osteophytes, can grow around damaged joints.

The symptoms tend to develop gradually over years. Many people notice problems with hip pain or stiffness during daily activities at first. Over time symptoms become more constant.

Can hip arthritis cause leg pain?

Yes, it is very common for osteoarthritis of the hip to cause referred pain that radiates down the thigh and leg. This occurs because the nerves that supply the hip joint also branch down into the leg.

Hip arthritis pain can radiate in a few different patterns:

  • Front of the thigh: The femoral nerve runs through the groin and down the front of the thigh. Hip arthritis can irritate this nerve, causing anterior thigh pain.
  • Outer thigh and hip: The iliotibial band runs down the lateral thigh from the hip to the knee. The gluteal nerves also supply this area. Irritation of these tissues can cause lateral hip and thigh pain.
  • Back of the thigh: The sciatic nerve runs from the lower back down the back of each thigh and leg. Hip arthritis can put pressure on the sciatic nerve, leading to sciatica-type pain.
  • Entire leg: In some cases, hip arthritis irritates nerves that run down the entire leg, like the obturator nerve or femoral nerve. This causes diffuse leg pain.

The pattern of pain depends on which nerves are affected. Arthritis in the back of the hip joint is more likely to irritate the sciatic nerve, for example. The pain may radiate down the back of the thigh and into the calf. Front of hip arthritis more commonly causes anterior thigh pain.

Why does hip arthritis cause leg pain?

There are a few reasons why osteoarthritis in the hip joint causes secondary pain that travels down the leg:

  • Nerve irritation – The nerve roots that supply the hip joint also run down into the leg. Inflammation and structural changes from hip arthritis can directly irritate these nerves where they pass through the damaged joint.
  • Referred pain – Nociceptive nerves that transmit pain signals can get crossed and misfired in the spinal cord. This makes pain from the hip get perceived in connected areas like the thigh or knee.
  • Compensatory movements – Changes in gait and weightbearing from hip arthritis put strain on the knee, back, and surrounding muscles. This leads to secondary pain in those areas.
  • Inflammation – Chemicals from the arthritic process like cytokines not only irritate nerves locally but can also cause inflammation to spread down the leg.

The end result is pain that originates in the arthritic hip but gets transmitted down the thigh, knee, or leg due to some combination of the above mechanisms.

Is leg pain serious with hip arthritis?

In general, having pain from hip arthritis that radiates down the leg is not dangerous or a medical emergency on its own. However, severe or worsening nerve pain should be evaluated by a doctor.

See your physician promptly if you have symptoms like:

  • Numbness, tingling, or weakness in the leg
  • Severe leg pain at night or pain that wakes you from sleep
  • Loss of bladder or bowel control
  • Difficulty walking due to leg weakness

Rarely, hip arthritis can press severely on nerves in a way that damages them. Seeking prompt treatment for nerve compression symptoms can help prevent permanent damage.

Also see your doctor if you have new onset of leg swelling, redness, or warmth, which could indicate a blood clot.

How is hip arthritis diagnosed?

Doctors use a combination of methods to diagnose hip arthritis:

  • Medical history – Looking for risk factors like age, prior hip injury, and osteoarthritis in other joints.
  • Physical exam – Checking for joint tenderness, reduced range of motion, stiffness, muscle weakness, or numbness in the leg.
  • Imaging – X-rays, MRI, and sometimes CT scans or ultrasound to evaluate joint damage, bone spurs, cartilage loss, and other structural issues.
  • Lab tests – To rule out other types of inflammatory arthritis.

Diagnosing the underlying hip arthritis can help explain why you may be experiencing secondary pain down the leg.

How can you find the source of leg pain?

It’s important to pinpoint where your leg pain is actually originating from – be it the hip, back, or knee. Here are some tips to find the source:

  • Note exactly where your pain is located and where it radiates.
  • Think about when the pain occurs – during certain activities or times of day?
  • Consider other associated symptoms like hip stiffness.
  • Try applying heat or ice to different areas to test which makes the pain better or worse.
  • See which movements or positions provoke the pain – like flexing your hip or extending your knee.
  • Discuss the pattern and qualities of your pain with your doctor.
  • Have a doctor examine your spine, hips, pelvis, and legs.
  • Undergo imaging tests like x-rays or MRI scans to look for issues.

Finding the true origin point of leg pain allows proper treatment. Knee or back problems can sometimes masquerade as hip arthritis, for example.

How is hip arthritis with leg pain treated?

Doctors aim to both treat the underlying hip arthritis and provide pain relief for symptoms. Common treatment approaches include:

  • Medications – Such as NSAIDs, analgesics, corticosteroid joint injections, duloxetine, or pregabalin.
  • Physical therapy – Stretching, strengthening exercises, gait training, and modalities like heat/ice therapy.
  • Assistive devices – Canes, walkers, raised toilet seats, grab bars, and other equipment to aid mobility and daily tasks.
  • Weight loss – For overweight patients to reduce joint stress.
  • Surgery – Such as hip arthroscopy, resurfacing, or total hip replacement for severe arthritis.
  • Alternative medicine – Methods like massage, acupuncture, or supplements are sometimes tried.

A combination approach with both conventional and complementary techniques tailored to your needs provides the most effective relief in most cases.

What is the outlook for hip arthritis with leg pain?

The prognosis for hip arthritis depends on factors like:

  • How much cartilage damage is present
  • How quickly symptoms progress
  • Your age and activity levels
  • Presence of other health conditions
  • Whether therapies like weight loss or physical therapy help

Mild to moderate hip arthritis can often be managed with conservative treatment for many years before surgery is needed. However, severe osteoarthritis may advance more quickly to hip replacement.

While hip arthritis itself doesn’t shorten life expectancy, poor mobility from severe joint damage can increase risks for heart disease, diabetes, obesity and depression.

Focusing on healthy lifestyle habits along with medical management helps preserve quality of life and avoid complications.

When to see a doctor

See your doctor promptly if you have new onset of leg pain, especially if it:

  • Is severe, worse at night, or interferes with sleep
  • Is accompanied by numbness, tingling or leg weakness
  • Causes loss of bladder/bowel control
  • Is due to injury or sudden trauma

Seeking prompt medical attention for nerve compression symptoms or unexplained leg pain can help guide proper treatment.

Also let your doctor know if you experience symptoms like:

  • Unexplained weight loss
  • Fever, chills, or night sweats
  • Swelling, redness, warmth in the leg

These may indicate an infection, injury or other condition requiring further evaluation.

When to see an orthopedic specialist

Seeing an orthopedist or sports medicine specialist is a good idea if you have:

  • Prolonged hip pain interfering with daily activities
  • Pain severe enough to require regular pain medication use
  • Symptoms like limping, stiffness, or limited mobility
  • Night pain or pain at rest from hip arthritis
  • Hip pain combined with referred thigh, knee or leg pain
  • Locking, popping, or crunching sounds in the joint

An orthopedic evaluation can help to:

  • Confirm if hip arthritis is causing your leg pain
  • Assess the extent of cartilage and joint damage
  • Provide accurate diagnosis if other joint or spine issues are involved
  • Prescribe optimal therapies like injections, physical therapy
  • Determine if surgery like hip replacement may become necessary

Seeing an orthopedist promptly when symptoms arise leads to better outcomes.


While the wear and tear process of hip osteoarthritis can’t be completely stopped, you can take proactive steps to help slow progression:

  • Maintain a healthy weight to limit mechanical stress on the hips.
  • Build hip muscle strength through exercise.
  • Avoid high impact activities that worsen pain.
  • Use proper form with exercises and daily activities.
  • Stop smoking to optimize arthritis management.
  • Use assistive devices like canes or raised seats to protect joints.
  • Adopt anti-inflammatory diet and lifestyle habits.

Early intervention with physical therapy can also teach you how to move in hip-protective ways before arthritis develops.

Exercises for hip arthritis and leg pain

Certain exercises can help strengthen muscles around the hip, improve flexibility, and reduce pain. Try these examples, but check with your physical therapist to design the best program for your needs:

  • Knee to chest stretch – Gently pull knee up to stretch hip flexors.
  • Heel slides – Slide foot out and pull back in to stretch hip adductors.
  • Hip abduction – Lying on side, lift top leg up and lower down.
  • Hip extension stretch – Standing, bring leg behind and lean forward at hips.
  • Mini-squats – Hold onto support and practice gentle partial squatting motion.
  • Bridging – Raise hips up and down while lying on back with knees bent.
  • Hip flexor stretch – In lunge position, push hips forward to feel stretch.

Start gently and stop any exercise that aggravates hip pain. Proper form prevents injury. Water therapy exercises are also excellent low-impact options.

Living with hip arthritis and leg pain

Though challenging, living an active and fulfilling life is possible with hip arthritis:

  • Pace activities with rest periods to avoid overdoing it.
  • Use assistive devices to aid mobility and reduce strain.
  • Ask for help with physically demanding tasks when needed.
  • Arrange your environment to reduce the need to bend or reach.
  • Find new hobbies or social activities you can enjoy.
  • Stay mentally active and engaged to reduce stress and depression.
  • Join a support group to share tips with fellow patients.

With proper self-care, social support, and treatment, it is possible to maintain quality of life despite progressive hip arthritis.

When hip replacement surgery may be needed

For severe hip arthritis causing significant pain and disability, hip replacement surgery is often the best option to restore mobility. Consider surgery when:

  • Hip pain interferes with work, caregiving duties, or daily tasks
  • Pain continues at night or while at rest
  • Pain is not adequately controlled by medications and other conservative treatments
  • Arthritis severely limits walking and function
  • Activities like climbing stairs or putting on shoes become difficult
  • There is significant stiffness, limping, or limited range of hip motion
  • Imaging shows advanced osteoarthritis, cartilage loss, or bone changes

Newer minimally invasive hip replacement techniques allow for quicker recovery. The procedure helps reduce both hip arthritis pain and referred thigh and leg pain in 85-95% of patients.


It is very common for hip arthritis to cause referred pain that radiates down the thigh or leg. This occurs because the nerve pathways that supply the hip joint also branch downward. Hip osteoarthritis can directly irritate these nerves or cause secondary strain on surrounding joints.

Diagnosing the underlying hip arthritis as the source of leg pain is key. Treatment focuses on managing the hip arthritis itself through methods like anti-inflammatory medications, physical therapy, and potentially surgery. Gaining control over the arthritic process helps provide both hip and leg pain relief.

While living with hip arthritis can be challenging, staying active with a proper treatment plan helps many people successfully manage symptoms for years. For severe cases, hip replacement surgery reliably reduces joint destruction and allows return to normal function.

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