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Hip Pain Radiating Down the Leg to Knee

By Last updated on January 9th, 2023January 9th, 2023No Comments

Hip pain sometimes travels down to the knee or lower leg, causing difficulty performing daily activities. The pain usually occurs in the front, back, or side of the hip. The nerves running through the hip to the legs carry this pain to the thigh, knee, and lower limb. 

This hip pain can also cause stiffness in your joints and muscles. As a result, you’ll struggle standing up, driving, sitting, walking, and even putting on shoes. 

There are many causes of hip pain radiating down the leg to the knees, such as hip osteoarthritis, labral tear, sciatica, and iliopsoas bursitis. It’s recommended to visit a professional health care provider in the early stages to get on-time treatment.  

The Anatomy of Hip Joint

The hip joint consists of a ball and socket joint. The thigh bone is the ball that fits into the hip socket. The hip socket is known as the acetabulum. It is covered with a soft tissue or fibrocartilage called the labrum. 

The labrum maintains stability and enhances the surface area of the hip joint by 22%. However, it is susceptible to wear and tear and several injuries, like impingement, congenital malformation (dysplasia), and joint laxity.

Causes of Hip Pain that Radiates Down the Leg 

Causes of Hip Pain that Radiates Down the Leg 

Hip pain can occur due to several conditions of the hip joint. The most common ones include:

Hip Osteoarthritis

Hip osteoarthritis is the wear and tear of the hip joint, resulting in severe pain in the hip and the groin area. This pain can travel to the front region of your thighs and knees and sometimes to the lower knee area. 

You may feel an aching pain in the morning or after sitting or resting for a long time. It can also occur after performing a physically-demanding activity. In severe cases, your hip joint may make a loud locking or grinding sound during the movement. 

Hip Labral Tear

Any injury or tear in the labrum can cause severe hip pain radiating down the leg to knee. Hip labral tears commonly cause pain in the groin region and side area of the hip. You’re likely to feel labral tear pain during or after a workout. 

If not treated in the early stages, you may start feeling labral tear pain during less demanding activities like sitting and walking.

Hip Impingement

Hip osteoarthritis and labral tears can occur due to abnormal contact between the hip joint bones. Both of these conditions may result in hip impingement. It causes pain in the front and side regions of your hip that travels to the front area of your knee and thigh. 

This pain can worsen when sitting, squatting, or doing activities that make the hip move.

Iliopsoas Bursitis

The iliopsoas bursa is a small, thin sac filled with fluid in the front part of the hip. Inflammation in this part can cause hip pain that spreads down the leg to knee. You may feel this pain in the groin region, particularly when bending the knee close to the chest. 

Iliopsoas bursitis inflammation can also lead to snapping hip syndrome. This condition refers to when the joint makes a snapping or clicking sound during the movement. The snaps are usually felt when you straighten your hips from a flexed position, like standing up. 


Hip pain radiating down the leg to knee can also cause when the lumbar and sacral nerve roots become irritated. This condition is called sciatica. Other musculoskeletal conditions can cause sciatica pain, such as piriformis syndrome and sacroiliac joint dysfunction.

Treatment Options for Hip Pain Radiating Down the Leg to Knee

Severe hip pain that does not go away with preventive methods requires immediate medical attention. Your healthcare provider may suggest conservative care or orthobiologic methods for your condition. 

Conservative Care

Conservative care for hip pain comprises:

  • Anti-inflammatory Medications. The doctor may recommend over-the-counter anti-inflammatory medications for pain management, such as naproxen and ibuprofen. You can better tolerate the pain with these drugs. If the pain aggravates, the doctor may prescribe you more potent medicines. 
  • Physical Therapy. It is the best non-invasive method to treat mild hip pains. Your physiotherapist will help you practice exercises that strengthen your hip joint and relieve pain.
  • Corticosteroid Injections. Your doctor may opt for an anti-inflammatory or corticosteroid injection as an instant pain reliever. It is mostly used for patients with arthritis as a short-term treatment. Long-term use of corticosteroid injections may damage the soft tissues of your hip joint.
  • Surgery. When nothing works, your doctor will go for an arthroscopy surgical procedure on the hip joint. In this surgery, the surgeon inserts a narrow gauge camera and multiple operating tools into the hip joint. This gives them a clear view of the inside structures, especially the labrum. 

Orthobiologic Treatment

If you’re experiencing unbearable hip pain radiating down the leg to knee, you can go for a less painful method: orthobiologic treatment. This option involves cell-based therapy and plasma-rich platelet (PRP) therapy. 

These orthobiologic treatments replace inflamed or damaged tissues and cells with newer, healthy ones. 

Also known as stem-cell therapy, cell-based therapy primarily consists of two types of transplant, Minimally Manipulated Adipose Tissue Transplant (MMAT) and Bone Marrow Concentrate (BMAC). MMAT focuses on your adipose tissues and replaces the damaged ones with healthy tissues. On the other hand, BMAC involves transplanting the affected bone marrow cells with new ones. 

If you need an MMAT in several body parts, the doctor will cater to all the affected areas in the same procedure.

Cell-based therapy is usually completed within 1.5-2 hours, and you may go home right after as per the doctors’ suggestion.  

Platelet-Rich Plasma (PRP) therapy is a well-known treatment for spine and orthopedic conditions. It focuses on enhancing the growth of healthy tissues in your body. 

Platelets are present in the blood to promote healing in your body. They produce a sticky web-like structure called fibrin that promotes tissue development in the affected area. An increased number of regenerative cells boost recovery and prevent injuries. PRP usually takes 45 minutes to complete.

Dr. Matthew HC Otten

Director of Regenerative Orthopedic and Sports Medicine
Fellowship-trained & Board Certified in Sports medicine
Director Angiography at Harvard Clinical Research Institute
Michigan State University Alumni


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