Hip pain in ankylosing spondylitis

Deep pain in the groin or front of the thigh can arise from the hip joint. Pain over the outer hip or buttock may instead come from tendons, bursae, sacroiliac joints or referred pain from the lower back. Location alone cannot confirm the source, but it gives the examination a useful starting point.

Inflammatory hip symptoms may include stiffness after rest, restricted rotation and discomfort that eases somewhat with gentle movement. Trouble putting on socks, getting into a car, climbing stairs or taking a full stride can signal reduced hip function. Mechanical problems may hurt more with a particular load or position, and both patterns can coexist.

Assessment can include walking, hip range, strength, spinal and sacroiliac movement, and tenderness around the joint. Your clinician will also consider injury, osteoarthritis, tendon problems and other causes. Imaging or blood tests may be requested if they would change the diagnosis or treatment decision.

Break up long periods of sitting and use comfortable, frequent movement rather than forcing the hip at the end of its range. During a flare, temporarily reduce deep squats, steep stairs, running or any task that clearly increases pain. A walking aid may reduce load, but it should be fitted and taught correctly.

Physiotherapy can target hip mobility, trunk and leg strength, balance and walking mechanics. Water-based exercise may allow movement with less weight through the joint. If symptoms suggest active inflammation, the rheumatology team may review medication alongside rehabilitation. Track night pain, stiffness, walking tolerance and daily tasks to show whether the plan is helping.

Book a review if hip pain persists, wakes you repeatedly, steadily restricts movement or causes a limp. Seek urgent care after a fall if you cannot stand or bear weight, or if the hip becomes severely painful with fever or marked swelling. New leg weakness or numbness, loss of bladder or bowel control, or a cold discoloured leg also requires urgent assessment.

Ask whether the pain is coming from the hip joint, surrounding tissues, sacroiliac joint or spine; which movements to maintain; and which loads to reduce temporarily. Discuss how inflammatory activity will be evaluated, when imaging would help and what improvement should look like in walking, sleep and everyday tasks.