CONDITIONS • WESTMINSTER, ARVADA, BROOMFIELD, THORTON & DENVER METRO
Hip Pain Treatment in Westminster, CO
The hip is one of the most misdiagnosed pain regions in the body. What feels like a hip problem is often coming from somewhere else entirely.
The hip joint sits at the intersection of the lumbar spine, the pelvis, and the lower extremity. Pain in and around the hip can come from any of these structures independently, or from all of them at once. Understanding which is driving your pain changes everything about how it should be treated.
Same-Day & Same-Week Appointments Available
WE UNDERSTAND WHAT YOU'RE GOING THROUGH
Hip pain changes the way you move through the world — and the losses are more personal than most people realize.
It starts with the things you notice yourself modifying: the way you get out of a car, the side you sleep on, the stairs you take more carefully, the floor you avoid sitting on. Then it becomes the things you stop doing: the morning walk, the round of golf, the grandkids you can no longer pick up, the hike you've been putting off for two years now. Hip pain doesn't announce itself dramatically the way back or knee pain often does. It quietly reduces your world, one small accommodation at a time, until you realize how much ground you've already given up. We hear this from hip pain patients regularly, and we want you to know that recovery is more achievable than you've likely been told.
WHAT YOU MAY BE EXPERIENCING
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Deep groin pain or aching at the front of the hip joint
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Pain on the outside of the hip, especially when walking or lying on that side at night
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Stiffness first thing in the morning that loosens slightly as the day progresses
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A sharp catch or clicking sensation with certain hip movements
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Pain that travels into the groin, buttock, or down the front of the thigh
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Difficulty crossing your legs, getting off the floor, or walking up stairs without pain
IF THIS SOUNDS FAMILIAR
You've likely been told you have arthritis, a labral tear, bursitis, or hip impingement. You may have had an X-ray or MRI, been offered an injection, and either been told to wait it out or been referred to an orthopedic surgeon to discuss hip replacement.
What you probably haven't been told is that the image and the pain often don't match as closely as the diagnosis implies — and that the lumbar spine and pelvis are responsible for a significant proportion of what is labeled as hip pain.
WHAT YOU PROBABLY HAVEN'T BEEN TOLD
Much of what is diagnosed as hip pain is actually referred pain from the lumbar spine or sacroiliac joint. And even when the hip joint itself is involved, the pelvis and spine are almost always contributing.
The hip joint and the lower lumbar spine share overlapping nerve supply. Pain from the L3 and L4 nerve roots refers into the groin and front of the thigh in a pattern that is easily mistaken for intra-articular hip pathology. Many patients who have been told their hip is arthritic and are awaiting joint replacement have significant lumbar and sacroiliac dysfunction that, when treated, resolves or dramatically reduces the pain attributed to the hip. This is not a rare occurrence. It is a known, well-documented clinical pattern that standard orthopedic screening consistently misses.
HIP ARTHRITIS ON IMAGING — AND WHY THE IMAGE IS ONLY PART OF THE STORY
Radiographic hip arthritis — joint space narrowing, osteophyte formation, subchondral sclerosis — is extremely common and increases steadily with age. Studies consistently show that large proportions of adults have significant hip arthritis on imaging and report no pain. Conversely, some patients with severe imaging findings have minimal symptoms, while others with mild findings are severely limited. The imaging describes the structure of the joint. It does not reliably predict the severity of pain or disability, and it does not identify the full set of contributors to that pain.
What this means clinically is that the degree of arthritis on X-ray does not determine how much of your pain is actually coming from the joint itself versus the surrounding muscles, the lumbar spine, the sacroiliac joint, or the soft tissues. All of those contributors need to be systematically assessed and addressed before the hip joint is concluded to be the sole source.
The lumbar spine and SI joint
L3 and L4 nerve root irritation refers pain into the groin and anterior thigh in a pattern indistinguishable from hip joint pain on symptom description alone. The sacroiliac joint, when dysfunctional, produces buttock and posterior hip pain that is commonly labeled as hip pathology. Both of these contributors are upstream of the hip and will continue to drive symptoms regardless of what is done to the hip joint directly.
A positive response to lumbar or SI treatment in a patient with presumed hip pain is one of the most commonly overlooked diagnostic findings in musculoskeletal care.
Greater trochanteric pain syndrome
Pain on the outside of the hip is extremely common and is almost always diagnosed as trochanteric bursitis. However, current research has established that the primary pathology in most cases is gluteal tendinopathy, not bursitis. The gluteal tendons degenerate under compressive load when the hip is held in adduction. This occurs during prolonged sitting with the legs crossed, during walking with a wide gait, and in people with weak gluteus medius muscles. Injecting the bursa without addressing the tendon and the loading pattern that is compressing it rarely produces lasting results.
This distinction matters because the treatment for gluteal tendinopathy is fundamentally different from bursitis treatment.
Femoroacetabular impingement
FAI — bony morphological changes to the ball or socket of the hip joint — is widely diagnosed on MRI and has become a common reason for arthroscopic hip surgery. Studies have found, however, that FAI morphology is present in a substantial percentage of asymptomatic individuals, including elite athletes. The presence of bony CAM or pincer changes on imaging does not confirm that those changes are causing the pain. Labral tears associated with FAI can frequently be managed conservatively when the surrounding muscular and movement contributors are corrected.
Surgery for FAI has a significant rate of symptom recurrence when the functional contributors are not corrected alongside it.
What this means before considering surgery
If you have been given a diagnosis of hip arthritis, bursitis, FAI, or a labral tear and are considering surgery, a thorough assessment of lumbar and SI joint contribution, gluteal tendon loading patterns, and systemic inflammation should happen first. For many patients, comprehensive conservative care that addresses all of these contributors produces outcomes that make surgery unnecessary. For those who do ultimately need surgery, optimizing these factors first leads to significantly better surgical outcomes and faster recovery.
UNDERSTANDING YOUR PAIN
Why hip pain presents so differently from person to person
Where your pain is located, what movements provoke it, whether it is worse at rest or with activity, and how long it has been present all point to different underlying drivers. Two people with the same MRI findings can have entirely different pain generators and require completely different treatment approaches.
Intra-articular hip pain
WHAT HAPPENING
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True pathology within the joint: arthritis, labral tear, or FAI morphology with impingement
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Local synovial inflammation producing pain and stiffness
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Often compounded by surrounding muscle weakness and altered movement patterns
WHAT IT FEELS LIKE
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Deep groin pain or a "C-sign" — pain cupped at the front and side of the hip
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Stiffness with internal rotation and flexion, especially getting in and out of low seats
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A catching or locking sensation at end-range hip flexion
Periarticular hip pain
WHAT'S HAPPENING
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Gluteal tendinopathy from compressive loading on the greater trochanter
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Hip flexor tendinopathy or snapping hip from anterior structures
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Piriformis tightness compressing local structures including the sciatic nerve
WHAT IT FEELS LIKE
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Pain specifically on the outside of the hip, worse with walking and at night
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Significant pain when lying on the affected side
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A snapping or popping sensation at the front of the hip with movement
Referred and chronic hip pain
WHAT'S HAPPENING
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Lumbar nerve root or SI joint referral mimicking hip joint pathology
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Central sensitization maintaining pain beyond the structural findings
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Systemic inflammation keeping joint and tendon tissues chronically reactive
WHAT IT FEELS LIKE
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Pain that travels from the lower back through the buttock and into the groin or thigh
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Pain worse during stressful periods or after poor sleep
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Incomplete recovery between flare-ups that is getting gradually shorter
Why accurate identification matters so much
Intra-articular hip pain responds to joint mobilization, biomechanical correction, and anti-inflammatory treatment. Periarticular pain requires addressing the tendon loading patterns and the muscle imbalances driving them. Referred pain requires treating the spine and sacroiliac joint directly. Chronic hip pain requires all of the above plus nervous system regulation and systemic biochemical support. Applying the same treatment to all three patterns is why hip pain so commonly persists through multiple rounds of care without full resolution.
THE BIGGER PICTURE
What you've probably already tried
Most hip pain patients have a similar experience: imaging, a diagnosis, a treatment that provided partial relief, and a gradual return of pain. The treatment addressed what was visible on the scan while the structural, neurological, and biochemical contributors went unaddressed.
TREATMENTS PEOPLE TYPICALLY TRY
✓ Activity modification and rest
✓ Anti-inflammatory medication
✓ Cortisone injection into the hip joint or bursa
✓ Physical therapy targeting hip strengthening
✓ Hip arthroscopy for FAI or labral repair
✓ Total hip replacement for advanced arthritis
Each of these addresses a single contributor. None of them systematically assess and treat the lumbar spine, SI joint, pelvic mechanics, and biochemical environment that together determine whether recovery is complete.
THE GAP NO ONE HAS FILLED
The imaging has identified something. A diagnosis has been given. Treatment was applied and something improved, temporarily. You are still in pain and still compromising your life around it. Surgery is being discussed, or has already been done, and the pain persists.
"The injection helped for a few months and now it's back. I've been doing the exercises and they're not working. How long am I supposed to wait before having surgery?"
The answer, in many cases, is not to wait. It is to assess what has not yet been assessed: the lumbar spine referring pain into the hip, the pelvic mechanics loading the joint asymmetrically, the gluteal tendons being compressed rather than inflamed, the systemic inflammation keeping the joint tissue reactive. These are treatable. They are simply not being treated.
OUR FRAMEWORK
What's actually driving your hip pain
Persistent hip pain is almost never caused by the hip joint alone. The lumbar spine and pelvis above it, the nervous system determining how load is distributed through it, and the biochemical environment determining whether its cartilage and tendons can heal all directly contribute. Addressing only one of these while the others continue is the most common reason hip pain outlasts every treatment applied to it.
1
The Physical System
The lumbar spine, sacroiliac joint, pelvis, and hip's own mechanics — all of which must be assessed together
What goes wrong
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Lumbar joints at L3 and L4 become restricted and refer pain into the groin and thigh
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Sacroiliac joint dysfunction creates posterior hip and buttock pain mistaken for joint pathology
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Gluteus medius and minimus weakness allows the hip to drop during single-leg loading
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Tight hip flexors and adductors alter joint mechanics and increase compressive forces in the joint
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Leg length inequality or pelvic asymmetry creates chronically asymmetric joint loading
Why that causes pain
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The hip joint absorbs forces equivalent to several times body weight during single-leg stance. Without proper muscular support, cartilage, labrum, and tendons are overloaded repetitively
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Lumbar and SI referral patterns produce hip region pain that will not respond to any treatment directed at the hip itself
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Pelvic asymmetry from spinal dysfunction is one of the most common and most neglected causes of premature hip joint degeneration
Correcting pelvic and spinal mechanics reduces joint load directly and is among the most protective interventions available for hip arthritis.
What this means
Assessment must extend from the lumbar spine through the pelvis to the hip joint. Restricting the evaluation to the hip in isolation will miss the most common contributors to hip pain. Clearing the lumbar spine and SI joint, correcting pelvic asymmetry, and restoring glute activation reduces the load on the hip joint, relieves referred pain, and creates the mechanical conditions for healing to actually occur.
2
The Nervous System
How altered nerve input changes hip muscle coordination — and why chronic pain outlasts the structural problem
What goes wrong
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Lumbar nerve root irritation alters motor signals to the gluteal muscles, reducing their protective activation
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The hip joint capsule has a rich nerve supply that becomes sensitized after sustained irritation
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Central sensitization causes the nervous system to amplify hip pain signals independently of ongoing joint damage
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Fear-avoidance patterns alter gait and loading, increasing joint stress with every step
Inhibited gluteals cannot protect the hip joint. The joint then overloads. The pain intensifies. This is a cycle, not a diagnosis.
What this feels like
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Hip weakness and instability that does not improve with strengthening exercises alone
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Pain that seems disproportionate to the imaging findings
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Discomfort that worsens with stress, fatigue, or during high-inflammation periods
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A deep aching that is present even at rest and does not fully clear overnight
What this means
The lumbar spine must be assessed and treated as part of every hip pain case, not only because it refers pain to the hip region but because its nerve output directly controls the muscles protecting the hip joint. When those muscles are neurologically inhibited, no exercise program will restore full function. And when the hip has been painful long enough to sensitize the nervous system, structural treatment alone will not be sufficient. The nervous system requires direct regulation.
3
The Biochemical System
The internal environment that determines whether cartilage, tendons, and the joint capsule can repair themselves
What Goes Wrong
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Systemic inflammation accelerates cartilage breakdown and sustains local joint inflammation
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Nutritional deficiencies in collagen co-factors, vitamin D, and omega-3 fatty acids impair connective tissue repair
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Hormonal disruption, especially in the context of inflammatory arthritis or metabolic dysfunction, sustains joint degradation
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Gut dysbiosis drives systemic inflammatory cytokines that directly affect joint tissue biology
What this feels like
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Hip consistently worse during periods of illness, stress, or dietary change
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Morning stiffness that takes longer to resolve than it should
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Slow recovery after activity or a setback
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Imaging findings progressing faster than expected for your age or activity level
What this means
Hip cartilage, tendons, and the joint capsule exist in a biochemical environment. When that environment is chronically inflamed, driven by gut health, nutritional status, hormonal function, or systemic disease, repair is impaired even when mechanical treatment is otherwise appropriate. Addressing the internal biochemistry is not an optional add-on for hip pain. For patients with arthritis or inflammatory joint disease, it is often the most powerful lever available for changing the trajectory of the condition.
OUR APPROACH
How we treat hip pain differently
We assess the entire kinetic chain from the lumbar spine through the pelvis to the hip joint, identify every structural, neurological, and biochemical contributor, and treat all of them simultaneously. For most hip pain patients, that means correcting the spinal and pelvic mechanics loading the joint, restoring neuromuscular coordination around it, and optimizing the internal environment for tissue recovery.
1
Correct the mechanical contributors above, beside, and within the hip joint
The lumbar spine, sacroiliac joint, pelvis, and hip mechanics all need to be addressed together, not sequentially.
Restore lumbar and sacroiliac joint mobility to clear referred pain patterns and correct pelvic asymmetry loading the hip
Release piriformis, hip flexor, TFL, and quadratus lumborum trigger points contributing to hip loading and referred pain
Reduce chronic tension in hip flexors, adductors, and external rotators that are altering joint mechanics and increasing compressive load
Restore gluteus medius activation, correct pelvic drop patterns, and rehabilitate hip joint loading mechanics from the ground up
WHAT THIS CORRECTS
Lumbar and SI referral · Pelvic asymmetry · Gluteal inhibition · Joint loading mechanics
2
Restore neuromuscular coordination and break the pain-inhibition cycle
The hip cannot be stabilized by muscles that the nervous system is not properly activating. And sensitized joint tissue requires direct treatment, not only rest.
Lumbar joint restoration normalizes the nerve output to the hip's stabilizing muscles and reduces the referred component of the pain
Directly address the sensitized hip and pelvic musculature that has become hyperreactive and is contributing to abnormal joint loading with every step
Photobiomodulation to stimulate cellular repair in the hip joint capsule, tendons, and surrounding soft tissue
Progressive loading through functional movement patterns, rebuilding the neuromuscular coordination needed to protect the hip joint during real-life activity
WHAT THIS CORRECTS
Neuromuscular inhibition · Joint sensitization · Protective pain-inhibition cycle · Functional movement deficits
3
Optimize the biochemical environment for joint and tendon recovery
The internal conditions that determine whether cartilage, tendon, and capsule tissue repair — or continue to degrade.
Identify and treat systemic inflammation, gut health, hormonal disruption, and nutritional deficiencies sustaining joint degeneration and tendon impairment
Identify the specific internal contributors including inflammatory markers, vitamin D, hormones, gut function, and metabolic factors
Reduce systemic inflammation, support mitochondrial function, and improve circulation to the hip joint and surrounding structures
Targeted collagen support, omega-3s, anti-inflammatory protocols, and cartilage co-factors to directly support joint tissue repair and slow degradation
WHAT THIS CORRECTS
Systemic inflammation · Cartilage degradation rate · Nutritional deficits · Hormonal contributors to joint disease
WHY THIS APPROACH WORKS
We treat what the hip depends on, not just the joint itself
The hip is not self-contained. It is the convergence point of the lumbar spine, the pelvis, and the lower extremity, and its mechanical health depends on all three. When any of those systems fail to do their job correctly, the hip absorbs the consequence. Treating the hip while those systems remain dysfunctional is a temporary solution to a permanent problem.
✓ The lumbar spine and SI joint contributing referred pain and altered nerve output
✓ Pelvic mechanics and gluteal function protecting the joint from overload
✓ The biochemical internal environment driving or suppressing cartilage and tendon repair
The hip is often the victim of what is happening around it. That is where treatment has to begin.
WHO THIS IS FOR
This approach is for people whose hip pain...
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Started recently and they want to address it fully before it becomes chronic
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Has responded partially to injections or physical therapy but keeps returning
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Is accompanied by low back pain, buttock pain, or symptoms that travel into the thigh
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Involves arthritis and they want to slow progression and avoid or delay surgery
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They have been offered hip replacement or arthroscopy and want a thorough, comprehensive conservative evaluation before committing to surgery
TAKE THE NEXT STEP
Hip pain does not have to be permanent. The cause is rarely the hip alone.
We assess the lumbar spine, sacroiliac joint, pelvic mechanics, and internal healing environment alongside the hip itself.
Not sure where to begin? Give us a call and we'll help you choose the best first step.