Have you ever felt a stubborn ache in your groin, thigh, or knee and chalked it up to a pulled muscle or the result of daily wear and tear? You’re not alone — and you might be missing the real culprit. Pain can be like a faulty GPS, sending you in the wrong direction and making it hard to pinpoint the true source. A sore knee might not indicate a joint issue, and groin discomfort may not stem from overexertion.
Surprisingly, these aches can signal trouble with one of the body’s most important weight-bearing joints — the hip. The hip is a powerful central joint that powers nearly every movement. When it starts to wear down, the pain starts to spread to unexpected areas in the body. And because discomfort doesn’t always start in the hip, the pain often leads to misinterpretation.
Public Misunderstanding of Hip-Related Pain
To understand how common this misunderstanding is, researchers at The Ohio State University Wexner Medical Center recently launched a national survey1 to reveal just how people commonly misread their body’s pain signals.
Their goal is to identify the link between hip health and pain in other areas of the body by assessing the participants’ ability to recognize the signs of hip problems. Their findings suggest that many Americans are misinterpreting symptoms, which could lead to delays in proper diagnosis and treatment.2
• The survey involved a sample size of 1,004 adults aged 18 and above — It revealed that 72% didn’t know knee pain could signal a hip issue, while 69% overlooked groin pain, and 66% missed thigh pain as a possible sign of hip-related problems.
• Signs of hip problem that are often underrecognized — While some participants did recognize indicators such as clicking in the hip, difficulty bending, or tying shoes, others overlooked symptoms such as lower back pain, night pain, and trouble sleeping. The researchers advise consulting a medical expert to correctly diagnose any unexplained pain.
• Many people try to manage their discomfort on their own — Four in 10 people push through the pain, while 52% rely on over-the-counter medications instead of seeking a proper diagnosis. This highlights a cultural tendency to ignore discomfort until it becomes severe.3
“Patients will be referred to me for knee pain. When I examine the patient, I will rotate their hip, and the patient will feel pain. We’ll also do X-rays to determine arthritis in the hip and if a replacement would be beneficial,” says Dr. Matthew Beal, orthopedic surgeon and associate professor at Ohio State.
The survey findings underscore how easily hip issues can masquerade as pain elsewhere in the body. This disconnect is rooted in a medical phenomenon known as “referred pain.”
Demystifying Referred Pain
The Pennsylvania Pain and Spine Institute describes referred pain as a misunderstood condition where pain is felt in one area of the body, even though the source is elsewhere. This can lead to treatments being ineffective by targeting the wrong area, leaving the root cause unresolved and prolonging discomfort.4
• How it happens — Referred pain occurs when the brain misinterprets signals from the body regions that share similar nerve pathways. Because these multiple body regions send signals to the same spinal segment, the brain may “project” pain to a more familiar or superficial area.
• Hip-related referred pain — The hip joint, due to its proximity and shared nerve connections with the lower back, groin, buttock, thigh, and knee, can cause pain in these areas even when the hip doesn’t feel sore. This is common in cases of degenerative osteoarthritis. Common signs of hip-related referred pain include:
◦Groin pain
◦Limping or changes in gait
◦Pain that worsens at night after prolonged sitting
◦Discomfort radiating to the thigh or knee
Other hip conditions that can cause referred pain include:
◦Sacroiliac joint issues
◦Piriformis syndrome
◦Avascular necrosis of the hip
◦Hip impingement syndrome
• Mapping out solutions and treatments — Careful evaluation is essential, especially for those with chronic lower back pain, to ensure the hip is not overlooked. Once the hip is confirmed as the source of referred pain, treatment options may include physical therapy to correct imbalances and advanced therapies like platelet-rich plasma (PRP) injections. Anti-inflammatory drugs are also often prescribed, but they don’t address the root cause and often come with side effects.
Doctors may use X-rays or MRI scans to help confirm a hip diagnosis. In some cases, diagnostic injections are performed — if the injections relieve both hip and referred pain, it confirms the hip as the source. This helps guide treatment so patients can avoid unnecessary procedures that target the wrong area.
Other Causes of Knee and Groin Pain
While hip-related referred pain is the common culprit, an article in Health Central emphasizes that knee and groin pain stem from a variety of overlapping conditions, including:5
• Muscle strain — Overuse or injury to the iliopsoas muscle, the primary hip flexor responsible for bending and rotating the hip, can cause groin-to-knee pain. Activities like weight training, sports, or running often trigger this type of strain. Treatment usually involves rest and physical therapy, with most cases resolving in two to six weeks.6
• Hip arthritis — Especially common in adults over 50, hip osteoarthritis can trigger pain that radiates down the leg. “It can be a surprise to most people when they learn this type of pain most often comes from the hip,” says Dr. Ettore Vulcano, chief of the Columbia University Division of Orthopedics at the Mount Sinai Medical Center.7
Hip arthritis also affects younger adults with preexisting conditions like rheumatoid arthritis, psoriatic arthritis, and lupus.8 While corticosteroid injections are often used for treatment, recent studies show no statistically significant long-term benefit compared to placebo. Repeated injections can worsen joint damage, making physical therapy and PRP therapy safer alternatives.9
• Other hip and joint issues — These include conditions like hip impingement, which occurs when extra bone growth causes abnormal contact between the hip bones, as well as labral tears, which involve damage to the ring of cartilage that cushions and stabilizes the hip socket.
According to Harmony Wellness, labral repair surgery has a success rate of 70% to 90%, with most patients reporting improved function and pain relief. Arthroscopic procedures such as these are minimally invasive and often performed on an outpatient basis.10
• Nerve compression — Pinching of the femoral and sciatic nerve can cause pain to radiate from the lower back or pelvis down to the groin and knee. Vulcano says, “A pinched nerve can be a result of factors such as a herniated disk in the lower back, arthritis, or just age-related wear and tear on your spine.”11
If the pain persists for weeks, your doctor may recommend a corticosteroid shot as a temporary fix to reduce inflammation. But in more extreme cases, surgery options such as anterior cervical discectomy and fusion (ACDF) or artificial disc replacement (ADR) can be considered.
• Pregnancy pain — Increased levels of relaxin, a reproductive hormone,12 and added weight during pregnancy can shift the body’s center of gravity and compress the sciatic nerve. A cross-sectional survey found that 22.1% of pregnant women in their third trimester experienced sciatica.13 Gentle stretching, yoga, and exercises targeting the lower back and hamstrings are recommended.
If the pain persists for more than four to six weeks despite rest, consider consulting with an orthopedist (However, if you’re pregnant, you may need to consult with your OB-GYN first).14 In many cases, this prolonged pain is referred pain from an underlying issue that is not related to your thigh muscle.
Declining Bone Health in Young Adults
Strong bones are the foundation of hip health. But today, poor skeletal health has become a concern not just for the elderly — it’s increasingly affecting young adults as well, causing bone density loss, joint degeneration, and early signs of osteoarthritis.15 A combination of lifestyle and environmental factors is fueling the trend:
• Sedentary lifestyle and poor nutrition — Long hours of sitting, minimal physical activity, and deficiencies in nutrients like calcium, magnesium, and vitamins D and K2 make the problem worse.
• Poor sleep and chronic stress — Lack of restorative sleep disrupts the body’s natural bone-building cycle, while chronic stress raises cortisol levels, triggering calcium loss. These factors accelerate degeneration and lead to the earlier onset of hip and joint pain.
• Lack of weight-bearing workouts — Weight-bearing activities, such as walking, running, and resistance training, stimulate bone growth and strength. Without them, bones weaken and become more prone to injury. Modern desk jobs and the popularity of low-impact workouts have led to reduced stimulation, causing bones to become more fragile over time.
• If left unaddressed, declining bone health increases the risk of hip problems, knee pain, and other joint issues later in life — Regularly screening for bone density and joint health helps catch issues before they worsen. To strengthen your bones and protect your long-term hip health, I recommend techniques like blood flow restriction (BFR) training and vibration therapy, alongside weight-bearing movements.
To learn more about how to build bone strength through purposeful movement without overtraining, check out “How Exercise Can Help Promote Stronger Bones.” Later on, we’ll also discuss exercise movements to help ease hip pain.
There Are Safe and Natural Ways to Manage Pain
Pain is complex, and treating it effectively requires more than just masking the symptoms. A natural approach to pain management focuses on identifying and addressing the root causes which often lie deeper.
• The role of physical therapy and posture correction — Targeted movement, stretching, and strengthening exercises can help restore balance, reduce inflammation, and improve joint function.16 Therapists often use diagnostic techniques to pinpoint imbalances and tailor interventions that support long-term healing.
• Herbal options — The following herbal remedies help reduce inflammation, modulate pain signals, and support overall joint health. For a deeper dive into how these herbs work, check out my article “An Herbal Guide to Natural Pain Relief,” where I discuss in detail how these herbs can help ease your symptoms:
◦Willow bark
◦Ginger
◦Turmeric (Curcumin)
◦Rose hips
◦Devil’s claw
◦Boswellia (Frankincense)
◦Feverfew
◦Ashwagandha
◦Black cohosh
◦Corydalis
◦Rosemary
◦Thunder God vine
Just remember that some herbs can interact with prescription drugs, so consult a healthcare provider, naturopathic doctor, or herbalist before adding these to your regimen. The same applies if you’re pregnant, breastfeeding, or considering use in children.
• Nutritional support — Certain nutrients play a key role in reducing inflammation and supporting musculoskeletal health, including:
◦Magnesium — Helps regulate muscle, supports nerve function, and reduces pain sensitivity.
◦Vitamin D — Crucial for bone health and immune regulation; deficiency is linked to increased pain perception.
◦Choline — A precursor to acetylcholine, which plays a role in pain modulation. Many people are deficient, especially vegans, athletes, and post-menopausal women.
• Stress-reducing practices — Chronic stress triggers your fight-or-flight response, which leads to muscle tension, inflammation, and body aches.17 Doing mindfulness meditation, breathing techniques, yoga or tai chi, and visualization or guided imagery can help lower stress and ease pain.
Other effective stress-relief tools include biofeedback, which helps you control your body’s reaction to pain by monitoring physiological responses like heart rate and muscle tension,18 and cognitive behavioral therapy (CBT), which teaches strategies for reframing negative thoughts and managing pain more effectively.19 Aromatherapy, particularly with orange essential oil, has been shown to ease pain and anxiety while promoting a sense of calm.
• Patient empowerment works wonders — Understanding your body and actively participating in your care can significantly improve pain outcomes. Research shows that when patients are empowered — through education, self-management strategies, and collaborative decision-making — they experience better symptom control and quality of life.20
Try These Exercises to Relieve Hip-Related Pain
Strengthening the muscles that support your hips helps shift stress away from the joint and onto surrounding tissues. This improves alignment, reduces pain, and retrains your hips to function properly, easing tension and restoring balance throughout your body. Health Central outlines 11 simple exercises that can help restore hip mobility and function — below are six of them. For the rest, see Health Central’s slideshow.21
• Hip extension
1. Stand tall and hold onto a stable surface like a countertop or wall for balance.
2. Keeping your knee straight, slowly lift one leg behind you without leaning forward. Pause briefly, then lower your leg back down.
3. Do 8 to 10 reps on each leg. This activates your glutes and supports upright posture.
• Side-leg snow angel
1. Lie on your back with legs straight and arms relaxed at your sides.
2. Slowly slide one leg out to the side while raising the opposite arm overhead in a wide arc, like making a snow angel. Keep your limbs straight and your movements controlled.
3. Bring your arm and leg back to center, then switch sides. Do 8 to 10 reps on each side.
• Glute bridge
1. Lie on your back with knees bent and feet flat on the floor.
2. Press through your heels to lift your hips, engaging your glutes and hamstrings. Hold for a few seconds, then lower slowly back to the floor.
3. Do 8 to 10 reps. This helps stabilize the pelvis and strengthen the posterior chain.
• Side-lying hip adduction
1. Lie on your right side with your left knee bent and pointing up, left foot flat on the floor slightly behind you.
2. Keeping your right leg straight, lift it a few inches off the floor.
3. Lower your leg back down. Do 8 to 10 reps on each leg. This strengthens your inner thighs and helps stabilize the hips.
• Heel slide
1. Lie on your back with your legs straight and your heel resting on a smooth surface like a mat or blanket.
2. Slowly slide one heel up toward your butt, bending your knee while keeping your heel in contact with the floor.
3. Slide your heel back down to straighten your leg. Do 8 to 10 reps and switch legs. Just a reminder, if you have tight or irritated hip flexors, this move may cause discomfort. A physical therapist can help you decide if it’s right for you.
• Hamstring curl
1. Stand with your feet hip-width apart, hands on your hips or holding onto a chair or wall for balance.
2. Slowly raise one heel toward your buttocks, bending your knee while keeping your upper leg still.
3. Lower your foot back down with control. Do 8 to 10 reps on each leg. This strengthens your hamstrings and supports hip movement.
For more exercises that help support proper hip function, I recommend reading my article, “Tight Hips? Try These Moves to Help.”
To sum up, pain isn’t always what — or where — it seems. It’s a messenger, often pointing to deeper issues beyond the site of discomfort. Understanding this connection shifts how you approach treatment and recovery. Staying proactive means seeking accurate diagnoses and strategies that address the real source, whether through targeted exercises or guidance from medical professionals.
Frequently Asked Questions (FAQs) About Hip-Related Pain
Q: Why does my knee or groin hurt if the problem is in my hip?
A: This is often due to referred pain. The hip shares nerve pathways with areas like the thigh, groin, and knee. When the hip joint is inflamed or damaged, your brain may interpret the pain as coming from a different location, which makes diagnosis tricky.
Q: How common is it for hip issues to be mistaken for knee pain?
A: A recent national survey found that 72% of people didn’t know knee pain could be linked to hip problems, and 69% overlooked groin pain as a possible sign. Many people first seek treatment for knee discomfort, only to later discover that the hip is the root cause.
Q: When should I see a doctor about knee or groin pain?
A: If the pain lasts longer than four to six weeks, worsens with activity, or affects your ability to walk or sleep, it’s time to see a specialist. Persistent pain may indicate conditions like hip arthritis, nerve compression, or labral tears that need proper evaluation.
Q: Are young adults really at risk for hip and bone health problems?
A: Yes. More young adults are experiencing early signs of bone and joint degeneration. This is often caused by sedentary lifestyles, poor nutrition, and lack of weight-bearing exercise. Early intervention with proper diet, supplements, and strength training can prevent long-term issues.
Q: What steps can I take to relieve hip, knee, and groin pain?
A: Natural approaches focus on more than just pain relief. It looks at the whole picture — your movement, nutrition, and lifestyle. This can mean physical therapy to build strength and improve posture, adding anti-inflammatory foods and supplements to support your joints, and even stress-reducing practices like yoga or meditation.
articles.mercola.com (Article Sourced Website)
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