Hip pain can show up in the groin, on the outside of the hip, or in the buttock, and it often makes walking, sitting and sleeping harder. Here's what causes it and how we treat hip pain in Palo Alto.
What the Research Says
When researchers in the Netherlands put manual therapy and exercise therapy head to head for hip osteoarthritis, the results weren't close. In a randomized trial of 109 patients, a hands-on program combining targeted stretching with manipulation of the hip joint, the same kind of chiropractic care for hip arthritis we provide, produced a success rate of 81% versus 50% for exercise alone after five weeks. The manual therapy group also showed greater gains in pain, hip function, and range of motion. The same source notes that UK national guidelines recommend manual therapy as an add-on to exercise and education, particularly for the hip.
A larger trial from New Zealand tested whether those benefits last. Researchers randomly assigned 206 adults with hip or knee osteoarthritis to usual medical care alone or usual care plus manual therapy, exercise therapy, or both. Manual therapy produced the biggest drop in symptom scores, and the hip pain rehab results held up a full year later, well beyond the end of treatment. Exercise, meanwhile, did the most for physical performance tests like walking and stair climbing.
Taken together, the research points to a clear approach. Hands-on treatment restores motion to a stiff joint and eases pain; exercise builds the strength and control to make that improvement hold up in daily life. We use both, in the order that fits where you are.
Why Your Hip Hurts
The hip is a deep ball-and-socket joint built for both stability and range. It carries your body weight with every step and is surrounded by some of the strongest muscles in the body. When the joint stiffens, from arthritis, long hours of sitting, or an old injury, those muscles tighten around it and movement narrows. You might first notice it putting on socks, getting out of the car, or rolling over in bed.
Where you feel it tells you a lot. Pain deep in the groin often points to the joint itself. Pain on the outside of the hip, especially when lying on that side, frequently comes from irritated tendons and the muscles that stabilize the pelvis. Pain in the buttock can come from the hip, the lower back, or the sacroiliac joint, which is why a careful exam matters before anyone decides what to treat.
Sitting deserves a special mention. Spend most of the day with your hips bent at 90 degrees, and the muscles at the front of the hip adapt to that shortened position while the glutes gradually stop pulling their weight. That imbalance alone can be enough to make a hip ache.
Who Gets Hip Pain in Palo Alto
- The desk worker — Eight-plus hours of sitting, then stiffness and a pinching feeling at the front of the hip when standing up or walking to the car.
- The runner or cyclist — High mileage in one plane of motion, with tight hip flexors and underused glutes. Pain on the outside of the hip creeps in on longer efforts.
- The active adult over 50 — Early hip arthritis showing up as groin pain on walks, morning stiffness, and trouble with shoes and socks.
- The parent — Carrying a child on one hip for months on end, loading one side of the pelvis far more than the other.
Why Waiting Makes It Worse
Hip problems tend to narrow your life gradually. As range of motion shrinks, you start avoiding the movements that hurt, which means less walking, fewer workouts, and more sitting. The muscles that protect the hip lose strength, the joint stiffens further, and other areas pick up the slack. It's common for people with long-standing hip stiffness to develop low back or knee pain from the compensation.
Range of motion is much easier to maintain than to win back. The trials above treated people who were still active enough to take part in a program, and the gains held for a year. Addressing stiffness while you're still moving gives treatment more to work with.
What You Can Do Today
Break up sitting. Stand and walk for a minute or two every 30 to 45 minutes. Even a short walk takes the hip out of the bent position and gets the joint moving.
Adjust your seat. Sit with your hips slightly higher than your knees rather than sinking into a low couch or car seat. It's easier on a stiff hip and easier to stand up from.
Mind your sleep position. If the outside of your hip hurts at night, avoid sleeping on that side. Sleeping on the other side with a pillow between your knees keeps the sore hip from dropping into a stretched position.
If hip pain follows a fall, or you can't bear weight on the leg, get it checked right away.
Your First Visit: What to Expect
Your initial appointment is a comprehensive 3-step process designed to move you from pain to performance. It is a paid visit, separate from the free consultation.
Medical history review, orthopedic and neurological testing, and biomechanical analysis to understand not just where it hurts, but why it hurts.
We sit down with you to explain what is causing your pain, our recommended recovery plan, and how long we expect your recovery to take.
When it is possible and safe to do so, we begin your first phase of therapy during your first visit: gentle spinal adjustments, manual soft-tissue therapy, or initial corrective exercises.