Why Your Hips Ache When Sitting: Causes, Relief, and Prevention

If you spend hours at a desk, in a car, or on the couch, you might be uncomfortably familiar with a persistent ache in your hips. This common complaint is more than just a minor annoyance; it's your body signaling that something is wrong. In our increasingly sedentary world, hip pain from sitting is a growing problem, but understanding its roots is the first step toward finding lasting relief.

This comprehensive guide will explore the complex causes of hip pain when sitting, differentiate it from related issues like back pain, and provide actionable strategies for both immediate relief and long-term prevention, all grounded in expert advice and medical insights.

Why Your Hips Hurt When You Sit: Unpacking the Causes

Sitting for long periods puts your hips in a constant state of flexion, leading to muscle imbalances and placing stress on the joint. This can either cause pain directly or worsen underlying conditions.

Musculoskeletal Imbalances from Prolonged Sitting

According to Dr. Lisa Covey, a chiropractor at FitWell Chiropractic Sports Medicine, prolonged sitting causes several changes in your hip and core muscles. The main culprits are:

• Tight Hip Flexors: The muscles at the front of your hip, including the psoas, become short and tight. This constant tension can pull on your lower back and pelvis, causing misalignment and pain.
• Weak Glutes and Core: When you sit, your gluteal (buttock) and core muscles become inactive and weaken over time. These muscles are crucial for stabilizing your pelvis and supporting your hip joint. Without their support, more stress is placed directly on the joint and surrounding tissues.
• Poor Posture: Slouching, leaning to one side, or crossing your legs puts uneven pressure on your hips and spine. Over time, this poor posture strains muscles, ligaments, and the hip joint itself.

!Anatomical illustration of the hip joint showing the psoas and gluteus muscles. An illustration of the deep muscles of the lower back and hip, including the psoas. Image Source: National Geographic

Common Medical Conditions Exacerbated by Sitting

Often, sitting doesn't create the problem but reveals it. Several medical conditions can cause a noticeable ache in the hips, especially after being seated.

• Hip Bursitis: This is an inflammation of the bursae, small fluid-filled sacs that cushion the bones and tendons around your hip. The pain is typically felt on the outer point of the hip and can feel sharp initially before turning into a dull ache.
• Tendinitis: Overuse or muscle imbalances can lead to inflammation of the tendons connecting your gluteal muscles to the hip bone. Dr. Lauren Elson, a physiatrist with Harvard-affiliated Massachusetts General Hospital, notes that pain on the side of the hip is often misdiagnosed as bursitis when it's actually tendinitis.
• Osteoarthritis (OA): This "wear-and-tear" condition involves the breakdown of cartilage in the hip joint. Pain is often felt deep in the groin or thigh and is characterized by stiffness that's worse after periods of rest, like sitting.
• Piriformis Syndrome: The piriformis muscle, located deep in the buttock, can spasm and irritate the nearby sciatic nerve. This causes pain in the buttocks and can radiate down the leg, a condition often worsened by sitting.
• Hip Impingement (Femoroacetabular Impingement - FAI): This occurs when abnormally shaped hip bones rub against each other, damaging the joint. The pain is often a sharp sensation in the groin, especially when flexing the hip.
• Hip Labral Tear: A tear in the labrum (the ring of cartilage that rims the hip socket) can cause a clicking, catching, or locking sensation, along with pain when sitting or bending.

Is It Your Hip or Your Back? A Crucial Distinction

One of the most confusing aspects of hip pain is determining its true source. The hip and lower spine are closely connected, and pain signals can get crossed. Differentiating between true hip pain and referred pain from the lower back is essential for effective treatment.

Here’s how to tell the difference:

Feature	True Hip Joint Pain	Referred Pain from Lower Back
Pain Location	Primarily in the groin, front of the thigh, or outer hip. Rarely goes below the knee. A good cue is the "front pocket" area.	Typically in the buttocks, back of the hip, or radiating down the leg (sciatica). A good cue is the "back pocket" area.
Pain Character	Often a dull, deep ache. Can be sharp with certain movements.	Can be sharp, shooting, burning, or accompanied by numbness, tingling, or weakness in the leg.
Movement Triggers	Pain worsens with activities like putting on socks, getting out of a car, or standing after prolonged sitting.	Pain is often triggered by bending forward, twisting the spine, or prolonged standing. It may feel better when sitting or leaning forward.

If you are unsure about the source of your pain, a consultation with a doctor or physical therapist is the best course of action for an accurate diagnosis.

Strategies for Relief and Prevention

Managing hip pain involves a two-pronged approach: relieving current discomfort and making long-term changes to prevent it from returning.

Immediate Relief for Aching Hips

When you're in pain, you need strategies that work now.

1. Change Your Position Frequently: The most important rule is to avoid staying in one position for too long. Set a timer to get up, walk around, and stretch every 30-60 minutes.
2. Apply Ice or Heat: For acute, sharp pain and inflammation, apply an ice pack for 15-20 minutes. For a dull, muscular ache and stiffness, a heating pad can help relax tight muscles.
3. Perform Gentle Stretches: Targeted stretches can provide immediate relief by lengthening tight muscles.

*Watch this video from SpineCare Decompression and Chiropractic Center for stretches that can instantly relieve a stiff hip after sitting.*

A particularly effective stretch recommended by experts at Harvard Health is the Seated Pretzel Stretch:

• Sit straight in a chair.
• Rest your left ankle on your right thigh, just above the knee.
• Keeping your spine straight, slowly hinge forward from your hips until you feel a stretch in your left hip and buttock.
• Hold for 20-30 seconds, then switch sides.

The Seated Pretzel stretch effectively targets tight gluteal and hip muscles. Image Source: Harvard Health Publishing

Long-Term Prevention: Building a Pain-Free Foundation

Preventing hip pain requires addressing the root causes through ergonomics and lifestyle adjustments.

1. Master Your Ergonomics

Your workstation setup is paramount. An ergonomic environment supports good posture and reduces strain on your joints.

• Invest in a Supportive Chair: Your chair should have adjustable height, backrest, and armrests. Crucially, it must have good lumbar (lower back) support to maintain the natural curve of your spine.
• Adjust Your Position:
  • Your feet should be flat on the floor with your knees at a 90-degree angle, level with or slightly lower than your hips.
  • Your monitor should be at eye level to prevent slouching.
  • Avoid crossing your legs, which tilts your pelvis and strains your hips.
• Consider a Sit-Stand Desk: Alternating between sitting and standing is the gold standard for reducing the load on your hips and spine throughout the day.
• Use a Cushion: As mentioned by users in online forums, a wedge or donut-shaped cushion designed for sciatica can help distribute pressure more evenly and reduce direct compression on the hips and piriformis muscle.

2. Strengthen and Mobilize Your Hips

A targeted exercise routine can correct muscle imbalances.

• Strengthen Your Core and Glutes: Exercises like planks, bridges, and clamshells activate and strengthen the muscles that stabilize your hips.
• Improve Hip Mobility: Regularly perform stretches for your hip flexors, hamstrings, and glutes to maintain flexibility and prevent tightness.

3. Make Lifestyle Adjustments

• Maintain a Healthy Weight: Excess weight adds significant stress to your hip joints, accelerating wear and tear.
• Stay Hydrated: Proper hydration is essential for keeping your joint cartilage healthy and lubricated.
• Adopt an Anti-Inflammatory Diet: Foods rich in omega-3s, fruits, and vegetables can help reduce systemic inflammation that may contribute to joint pain.

When to See a Doctor: Recognizing Red Flags

While many cases of hip pain from sitting can be managed at home, certain symptoms warrant immediate medical attention. These "red flags" can indicate a more serious underlying condition like an infection, fracture, or severe nerve compression.

See a doctor immediately if you experience:

• Inability to put weight on the affected leg.
• Sudden, severe pain, especially without a known injury.
• Signs of infection, such as fever, redness, or warmth around the hip.
• Obvious swelling or deformity of the joint.
• Numbness, tingling, or significant weakness in your leg.
• Loss of bowel or bladder control.

You should also consult a healthcare professional if your hip pain is persistent, worsens over time, or significantly interferes with your daily activities and sleep.

References

1. Covey, L. (2024, July 9). What Causes Hip Pain While Sitting and How to Relieve It. Sports-health. https://www.sports-health.com/blog/what-causes-hip-pain-while-sitting-and-how-relieve-it
2. Elson, L. (2024, April 8). Think that hip pain is bursitis? Think again. Harvard Health Publishing. https://www.health.harvard.edu/pain/think-that-hip-pain-is-bursitis-think-again
3. Franciscan Health. (2025, August 25). Hip Pain From Sitting (And What To Do). https://www.franciscanhealth.org/community/blog/hip-pain-stiffness-after-sitting
4. Cleveland Clinic. (n.d.). Hip Pain: Causes and Treatment. https://my.clevelandclinic.org/health/symptoms/21118-hip-pain
5. Medical News Today. (n.d.). Hip pain when sitting: Causes, treatment, and stretches. https://www.medicalnewstoday.com/articles/hip-pain-when-sitting
6. National Health Service (NHS). (2023, May 23). Hip Pain. Remedy BNSSG ICB. https://remedy.bnssg.icb.nhs.uk/adults/orthopaedics/hip-pain/