What Are the Common Causes of Hip Pain in Women?

According to Ng Teng Fong General Hospital, around 2,500 hip fracture cases are reported annually in Singapore, with numbers projected to triple by 2050 as the population ages. Notably, a nationwide study cited by Today Online found that Chinese women in Singapore face a higher risk of hip fractures compared to their Malay and Indian peers. One reason? A lower average body fat percentage, is associated with reduced bone mineral density, putting them at greater risk of osteoporosis.

Beyond fractures, chronic hip pain itself is more prevalent in women. This comes down to a combination of anatomy, hormones, and life stages. For one, women naturally have a wider pelvis to support childbirth, which changes the alignment of the hip joint and increases the pressure it bears. Hormonal fluctuations throughout life, from puberty to menopause, can also affect the stability and flexibility of ligaments, potentially contributing to wear and strain over time.

Pregnancy further shifts posture and weight distribution, compounding stress on the hips. And for some, the pain they describe as “hip pain” may actually stem from surrounding areas like the lower back or buttocks.

With so many possible causes, how can you tell what’s really behind your symptoms?

Common Causes of Hip Pain in Women

A woman’s age, physical structure, and daily activity level often shape both the type of hip pain she experiences and the likely reasons behind it. For instance, the concerns of a young woman who runs regularly will differ from those of an older adult who leads a more sedentary lifestyle. These differences can point to very different causes.

1. Arthritis

In women, hip pain often stems from osteoarthritis, which is a degenerative condition that wears away the cartilage cushioning the hip joint. As this layer thins, bone rubs against bone, creating stiffness and pain, typically felt in the groin or the front of the thigh.

Daily movement can become challenging, particularly when standing, walking, or getting in and out of chairs. To manage symptoms, non-surgical strategies like physiotherapy, mobility exercises, and walking aids may help ease discomfort and maintain joint function. Anti-inflammatory medication and heat therapy can also provide relief during flare-ups.

For more advanced cases, surgical procedures such as arthroscopy or hip replacement may be explored to restore mobility and reduce persistent pain when conservative options fall short.

2. Hip Fractures

Hip fractures are another major contributor to persistent pain, particularly among older women. This may be associated with the drop in oestrogen levels after menopause that further contributes to a loss of bone strength, raising the likelihood of a fracture even after a minor fall.

Common signs include sharp pain when moving or bearing weight on the affected side and an outward rotation of the toes on the injured side. These symptoms often signal a fracture requiring medical assessment.

Treatment generally focuses on stabilising the joint and preventing complications. Depending on the fracture’s severity, this may involve surgical repair, followed by physiotherapy to restore balance and mobility.

3. Tendinitis and Bursitis

Tendinitis and bursitis are frequent causes of hip discomfort, often linked to repetitive motion or prolonged strain on the joint. Tendinitis develops when the tendons around the hip become irritated or strained from repetitive use or sudden physical stress. This inflammation can make movement painful, particularly when lifting or rotating the leg.

Bursitis affects the bursae, which are small, fluid-filled sacs that cushion and protect the hip joint. When these sacs become inflamed, women may experience pain on the outer side of the hip that worsens with movement or when lying on the affected side. In some cases, mild swelling or tenderness can also appear near the surface.

Management usually includes rest, anti-inflammatory medication, and cold compresses to relieve pain and swelling. Physiotherapy focused on gentle stretching and strengthening can also support recovery and potentially help prevent recurrence.

4. Hernias

Even issues outside the hip joint can contribute to ongoing discomfort. One such example is a hernia. In particular, femoral and inguinal hernias in women can trigger pain in the groin that sometimes radiates to the hip, lower back, or upper thigh.

Symptoms often worsen during movements that increase pressure in the abdomen or pelvis. This can include bending, standing for long periods, or even laughing and coughing. For some, the pain is sharp and sudden. For others, it may feel like a dull ache or heaviness that builds over the day.

While small hernias might not need immediate repair, managing the strain on the body can help reduce symptoms. Avoiding heavy lifting, using supportive garments, and modifying certain movements may ease pressure.

5. Gynaecological and Back Issues

Certain gynaecological or spinal conditions can also produce pain that mimics hip problems. A common example is endometriosis, where uterine-like tissue grows outside the uterus. This can cause cramping and pelvic pain that may feel like discomfort in the hip or groin, especially during menstruation. Ovarian cysts or fibroids can also create pressure in the pelvic area, sometimes radiating outward and downwards.

Spinal causes like sciatica, which occurs when the sciatic nerve is compressed, can trigger a sharp or burning pain that shoots from the lower back through the buttocks and down the leg. Because of how the nerves are connected, this pain may be mistaken for a hip issue, especially if it affects only one side.

Pain from these causes may not worsen with hip movement but instead flare during hormonal changes, prolonged sitting, or even during bowel movements. If the pain feels deep and persistent, and is not eased by typical musculoskeletal remedies, a medical review may help determine if the source lies elsewhere.

Take Charge of Your Health and See a Professional

Concerned about your hip pain? If your hip pain doesn’t resolve or keeps returning, don’t wait it out. What feels like a minor strain could stem from something deeper, especially when pain interferes with daily routines, sleep, or movement. Plus, the range of potential causes, from arthritis and fractures to spinal or gynaecological conditions, means that self-diagnosis can be misleading.

A proper assessment by a healthcare provider helps clarify the source and severity of the issue. From there, targeted plans, whether physiotherapy, medication, or surgery, can begin.

At an orthopaedic clinic in Singapore like OrthofootMD, care is tailored to your needs. Consult an orthopaedic specialist at Mount Alvernia orthopaedic clinic or Mount Elizabeth Novena, and take a proactive step towards better movement and relief.