Ankylosing spondylitis of the hip

Symptoms may restrict putting on shoes, climbing stairs, rising from a low seat, or taking a comfortable stride. Management combines control of the underlying inflammation with exercises and activity adjustments that protect mobility and leg strength.

The hip is a ball-and-socket joint where the thigh bone meets the pelvis. In ankylosing spondylitis, inflammation may involve the joint lining and nearby attachment points. Pain can be felt in the groin, outer hip, buttock, or thigh, and reduced extension may shorten the stride.

Pain around the buttock can also arise from the sacroiliac joints or the lower spine. Examination therefore compares hip rotation and flexion, walking pattern, tenderness, muscle function, and spinal movement. The location of pain by itself cannot identify which structure is responsible.

Choose regular low-impact movement that the joint tolerates, such as level walking, pool exercise, or cycling with a suitable seat position. A physiotherapist may prescribe hip extension, rotation, and strengthening work while checking that the pelvis and lower back are not compensating excessively.

During a flare, reduce the load that clearly aggravates symptoms but avoid prolonged bed rest. A walking aid may temporarily improve balance and unload a painful side when fitted correctly. Discuss anti-inflammatory medicines with a prescriber who can account for other health conditions and current medicines. Persistent limitation merits reassessment of disease control and joint damage.

Get urgent help if you cannot bear weight after a fall, the leg looks shortened or turned, or the hip becomes suddenly severe and painful. A hot swollen joint with fever or feeling acutely unwell also needs same-day assessment because infection must be excluded.

Book an earlier review if the hip repeatedly gives way, pain wakes you despite usual treatment, mobility is steadily shrinking, or a new limp persists. Numbness in the saddle area, leg weakness, or loss of bladder or bowel control points to possible nerve compression and requires emergency evaluation.

Consider asking whether the pain comes from the hip joint, sacroiliac region, or lower back; whether disease activity is controlled; and what examination or imaging would alter treatment. Request clear advice on walking aids, exercise loading, work demands, and signs that warrant an orthopaedic opinion.