Hip pain at night?Outside, groin or buttock.Find the source.

Pain on the outside of the hip that is worse lying on that side is most often gluteal tendinopathy, also called greater trochanteric pain syndrome: the tendons of the buttock muscles are sore where they attach to the bony point on the outside of the hip, and the bursa over it is irritated. It is far more common in women, most often in their 40s to 60s. Lying on it, crossing the legs, sitting low and standing on one leg squeeze the tendon and flare it.

Usually both, and the tendon is the main driver. The bursa over the bony point is irritated by the tendon beneath it and by being squeezed, so the older name "trochanteric bursitis" is misleading. Treating the tendon, with the right load and strengthening, is what settles it; treating the bursa alone rarely does.

Deep groin pain, often with stiffness and a catch or click when you bend the hip or turn the leg, points to the hip joint itself: wear (osteoarthritis), a pinch between the ball and the rim of the socket (impingement), or the rim cartilage (labrum). Groin pain can also come from the tendons at the front of the hip, the adductors, or the back. An examination separates them.

Walking is usually good, within your comfort. Complete rest weakens the muscles that support the hip. Walk at a pace and distance that your hip tolerates, ease off hills and stairs when it flares, and build up gradually. For tendon pain on the outside, avoid standing hung on one hip and crossing your legs; for arthritis, regular walking and strengthening help.

Not the compressive stretches. For tendon pain on the outside of the hip, stretches that pull the leg across the middle, such as pulling the knee across the body or crossing the legs, press the tendon against the bone and often make it worse. Strengthening the gluteal muscles, starting with gentle holds, is what helps. Your physiotherapist will show you the exceptions.

No, the opposite. For hip osteoarthritis, exercise, education and keeping a healthy weight are the first-line treatment, and strengthening reduces pain and improves walking. Aches that settle within a day are fine; sharp or lingering pain means the dose was too high. Your physiotherapist sets it to your joint.

Femoroacetabular impingement is a mismatch in shape between the ball and the socket so that a bump on the neck pinches the rim when the hip bends deeply, causing groin pain and sometimes clicking, mostly in active people in their 20s to 40s. A programme of strengthening and movement control helps many people. Trials show hip arthroscopy gives a modest extra benefit to some who do not improve with good rehabilitation, so surgery is a decision after a proper trial.

Not usually at the start. The diagnosis comes from your story and examination. An X-ray shows the shape of the joint and arthritis; an MRI shows the labrum and tendons. Scans often show changes, such as labral tears, in people who have no hip pain at all, so they are used when the result will change the plan, after a fall, or when progress stalls.

They can ease pain for a few weeks, but in a major trial education with an exercise programme gave better results than an injection at one year. An injection can make exercises easier to start, but it is not a cure and repeated injections are not advised. It is a decision to make with your doctor.

Deep pain in the buttock that is worse sitting, especially on hard surfaces, and when walking uphill, running or stretching the hamstring, is often the hamstring tendon where it attaches to the sitting bone (proximal hamstring tendinopathy). It responds to graded loading and to avoiding long hard sitting and deep hamstring stretches, which pull on the sore tendon.

Yes. The lower back and sacroiliac joint refer pain to the buttock, hip and groin, often with back stiffness or leg tingling. A back cause is more likely if the pain does not change with hip movement. An assessment checks the back, pelvis and hip together so you are not treated for the wrong place.

In some ways. Gluteal tendinopathy is far more common in women, with a peak around menopause. Hip dysplasia, a shallow socket, is more common in women and can cause groin or outer hip pain in early adult life. Pregnancy changes the pelvis and can cause hip and pelvic girdle pain, and after menopause the risk of arthritis and bone thinning rises. These shape the plan.

There is no single timetable. Tendon pain on the outside of the hip usually needs a progressive loading programme of 8 to 12 weeks or more, with the pain settling over the first weeks. Groin pain and arthritis depend on the cause. Steady progress in what you can walk, climb and sleep through matters more than a date.

Yes. Munaza Physio Studio in Allama Iqbal Town, Lahore, is a women-only practice. Your assessment and treatment are one-to-one with a female physiotherapist in a private room, at the studio or at home across Lahore.