Hip and groin pain assessment (Clinical assessment of hip and groin pain)
A clinic appointment to work out why your hip or groin hurts, what is likely causing it, and what to do about it — from muscle and tendon strains to joint problems.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Hip and groin pain has many possible causes, so the assessment is about narrowing them down, not running one test.
- Most of the answer comes from your history and a hands-on examination; scans are used selectively, not routinely.
- A clear diagnosis is not always possible at first, and more than one thing can be going on at once.
- Most causes improve with guided activity changes and physiotherapy; surgery is the exception, not the rule.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Identifies the most likely cause (or causes) of your pain so treatment can be targeted.
This routine assessment is not appropriate when there are signs of a serious or urgent problem (such as a possible fracture, a hot swollen joint with...
You receive an explanation of the likely cause and an initial plan. You can usually return to normal activities straight away, with any advised changes to...
A clear written explanation of the likely diagnosis and the plan.
You receive an explanation of the likely cause and an initial plan. You can usually return to normal activities...
If physiotherapy and activity changes are advised, you start these. Any imaging arranged at the appointment is...
Many muscle, tendon and impingement-related problems improve with a guided, progressive exercise programme over...
A review reconsiders the diagnosis, arranges further tests if needed, or refers you on — for example to a hip...
What is a hip and groin pain assessment?
Hip and groin pain is common in active people, and it can come from many different places — the muscles and tendons of the groin, the pubic bones, the hip joint itself, the lower back, hernias, or sometimes problems that have nothing to do with sport. The job of an assessment is to work out which of these is most likely, so the right treatment can start.
The assessment is mainly a conversation and a physical examination. The clinician asks how and when the pain started, where exactly it is, what makes it better or worse, and how it affects your sport and daily life. They then watch you move, test the strength and flexibility of your hip and groin, and press over specific areas to find the source.
Scans are not always needed. When they are, they help confirm the cause or rule out other problems rather than acting as the first step. An assessment cannot always give a single, certain diagnosis straight away — hip and groin pain often has more than one cause at once, and the picture can become clearer with time and treatment.
This guide explains what the assessment involves and what it can and cannot tell you. It is general information and not a diagnosis of your own pain.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
History and pain mapping
A detailed conversation about how the pain started, where it is, what aggravates and eases it, and how it affects training. Pinpointing the exact location and pattern is one...
Physical examination
Watching you stand, walk and move, then testing hip range of movement, muscle strength (especially the adductors), and pressing over the groin, pubic bone, hip and tendon...
Specific clinical tests
Movements that load particular structures — for example combined hip flexion and rotation, which can reproduce pain from hip impingement (FAI) or a labral problem — to...
Imaging, when indicated
An X-ray can show the shape of the hip joint and signs of arthritis or impingement; MRI or ultrasound can show muscle, tendon or labral problems. These confirm or exclude...
Preparing for your test
- Wear or bring loose shorts, as the clinician will need to see and examine your hip and groin.
- Note exactly where the pain is, when it started, whether there was a specific injury, and what activities trigger it.
- Keep a short record of your training — what you do, how often, and any recent change in load or technique.
- Bring any previous scan reports or images, and a list of treatments you have already tried.
- List your medicines and any past hip, groin, back or hernia problems or operations.
- Think about your goals — for example which sport or activity you most want to get back to.
What happens
The appointment usually starts with questions about your pain and your sport. The clinician is building a picture of where the pain is coming from before laying a hand on you.
They then examine you. This typically means watching you walk and move, checking how far and how comfortably your hip moves, testing the strength of the muscles around the hip and groin, and pressing over specific areas to find what is tender. Some movements are designed to load particular structures and reproduce your pain, which helps point to the cause.
Depending on what they find, the clinician may arrange imaging — an X-ray for the hip joint, or MRI or ultrasound for soft tissues — or may start treatment straight away if the cause is clear. You should leave with an explanation of the likely diagnosis, a plan (often physiotherapy and activity changes), and an idea of what to do if things do not improve.
Is this test right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- This routine assessment is not appropriate when there are signs of a serious or urgent problem (such as a possible fracture, a hot swollen joint with fever, or a trapped hernia), which need urgent care.
- An assessment will not give a useful answer if a scan is treated as the diagnosis without examining the person.
- It is not the right first step for pain that is clearly coming from another system (for example testicular or abdominal pain), which needs the appropriate specialty.
- Imaging is not helpful as a 'screen' in someone with no symptoms, as it commonly shows changes that are not the cause of pain.
Delay or rearrange if…
- There are red-flag features (fever, severe pain after injury, inability to bear weight, bladder or bowel changes), which need urgent assessment first.
- You cannot attend in suitable clothing for an examination, which limits how useful the visit is.
- Key previous scans or reports are missing and would change the plan.
- An acute, very painful injury would be better assessed once the initial swelling has settled, unless a serious injury is suspected.
Alternatives to discuss
- Starting with your NHS GP, who can assess and refer for physiotherapy or imaging.
- Direct physiotherapy assessment, which is often the right first step for muscle and tendon problems.
- A period of guided activity modification and watchful waiting for mild, recent symptoms.
- Specialist hip, hernia or other referral where a specific cause is suspected.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Identifies the most likely cause (or causes) of your pain so treatment can be targeted.
- Distinguishes problems that settle with rehabilitation from those that may need imaging or a specialist.
- Reassures when the cause is a manageable muscle or tendon problem rather than something serious.
- Guides sensible changes to training so you can stay as active as possible while you recover.
- Flags the small number of cases where pain in this area signals a different, sometimes urgent, problem.
Risks & complications
- Some discomfort during the examination, as certain movements are meant to reproduce your pain.
- The cause may not be clear on the first visit, and a period of treatment or further tests may be needed.
- More than one cause may be present, which can make the picture less tidy than expected.
- A scan may show a finding (such as mild impingement or a small tear) that is also common in people without pain, which can cause unnecessary worry.
- Over-investigation or over-treatment if minor scan findings are assumed to be the cause without fitting the clinical picture.
- Delay in starting helpful treatment while waiting for scans that may not change the plan.
- A serious cause behind groin pain (such as a hip fracture, infection, or referred pain from elsewhere) being missed if warning signs are not considered.
- A scan picking up an unrelated, incidental finding that leads to further tests.
The main pitfall in this area is treating a scan finding rather than the person: mild hip impingement and small labral changes are common even in people with no pain, so a finding only matters if it fits your symptoms and examination. Ask your clinician how confident they are in the diagnosis, whether a scan would actually change the plan, and what should prompt a rethink if you do not improve.
Published figures to discuss
There are no single reliable accuracy figures for a hip and groin assessment, because it is a combination of history, examination and selective imaging rather than one test. The most important caution is that imaging findings such as hip impingement and labral changes are common in people without any pain, so their presence does not prove they are the cause. The platform therefore avoids quoting precise percentages here.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Serious hip cause missed | Uncommon but important | Fracture, infection, tumour, avascular necrosis or inflammatory disease need escalation when red flags are present. | FASHIoN trial — hip arthroscopy vs personalised hip therapy for FAI (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
| Pain source mislabelled | Common | Hip joint, adductor, pubic, abdominal wall, lumbar spine and nerve causes can overlap. | FASHIoN trial — hip arthroscopy vs personalised hip therapy for FAI (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
| Imaging abnormality not actually causing symptoms | Common in athletes | Labral changes and cam morphology may be incidental; treatment should match symptoms and examination. | Guide sourcesClinical context |
| Return to sport before load capacity returns | Common reinjury risk | Good plans use strength, range, pain response and sport-specific progression rather than time alone. | FASHIoN trial — hip arthroscopy vs personalised hip therapy for FAI (PMC)pmc.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from the assessment itself — you can usually carry on as normal afterwards. What follows is a treatment plan, and most hip and groin problems improve over weeks to months with the right approach.
- Some tenderness for a short time after the examination, which settles.
- Waiting a little while for any scan results before the picture is complete.
- A gradual, not instant, improvement once treatment begins.
- Needing to adjust training load rather than stopping all activity.
Aftercare
- Follow the activity advice you are given, which usually means modifying rather than completely stopping exercise.
- Start and stick with any physiotherapy or exercise programme, as these often take weeks to work.
- Use simple pain relief only as advised, and do not rely on painkillers to push through significant pain.
- Attend any arranged scans and book the follow-up to discuss results.
- Keep a simple note of what helps and what aggravates the pain, to guide the next review.
- Go back sooner if the pain changes character, worsens, or new symptoms appear.
- Loose shorts for the examination
- A written note of where and when the pain occurs
- A summary of your training and any recent changes
- Previous scan reports or images to hand
- A list of treatments already tried
- Your main activity goal written down
- The clinic's contact details for follow-up
⚠ Get urgent help if…
- Severe groin or hip pain after a fall or injury, or being unable to put weight on the leg — seek urgent assessment.
- Hip or groin pain with fever, feeling generally unwell, or a hot, swollen joint — seek urgent assessment.
- Pain with unexplained weight loss, night pain that wakes you, or a history of cancer — see a doctor promptly.
- New numbness around the genitals or back passage, or problems controlling your bladder or bowels — call 999.
- A tender lump in the groin that you cannot push back, with pain, sickness or vomiting (possible trapped hernia) — seek urgent assessment.
- Sudden severe testicular or lower-abdominal pain — seek urgent assessment.
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good outcome from the assessment is a clear, plain-English explanation of what is most likely causing your pain and a plan to address it. Often the diagnosis is confident on clinical grounds alone; sometimes it becomes clearer with time or after a scan.
It is normal not to get a single definitive label on the first visit. Hip and groin pain frequently has more than one contributing cause, and the most useful result is a sensible plan plus clear advice on what would change it. A scan result should always be read alongside your symptoms, because common findings are not always the cause of pain.
The assessment gives a snapshot of your hip and groin at one point in time. If your symptoms change, or you do not respond as expected, the diagnosis should be revisited. For longer-standing problems such as impingement or early arthritis, the plan may evolve over months or years as your activity and symptoms change.
Related tests, treatments or support
A hip and groin assessment is often combined with a look at the lower back and, where relevant, the abdominal wall, because pain in this area can be referred from elsewhere. Where needed, it may lead on to imaging, physiotherapy, a diagnostic or therapeutic injection, or specialist referral.
Follow-up & long-term care
Most people are reviewed after a period of physiotherapy or activity change, or once any scan results are back. If the diagnosis is uncertain or symptoms persist, the clinician should reassess and consider further tests or onward referral rather than simply repeating the same advice.
- Continue strengthening and mobility exercises even after the pain settles, to reduce the chance of recurrence.
- Increase training load gradually rather than in sudden jumps.
- Address technique or equipment factors your clinician or physiotherapist identifies.
- Seek review early if the same pain returns, rather than training through it.
Repeat, follow-on and what comes next
- A first assessment may not give a definite diagnosis; reassessment after a trial of treatment is common and normal.
- Scans may need repeating or adding to if symptoms change or do not fit the first results.
- The plan is often adjusted over time as the response to physiotherapy becomes clear.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear written explanation of the likely diagnosis and the plan.
- A structured, progressive physiotherapy or exercise programme with someone to supervise it.
- A named contact and a defined review point to check progress.
- Clear advice on what to keep doing, what to avoid, and what warning signs mean urgent review.
- A sensible threshold for further imaging or specialist referral if you do not improve.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The seniority and experience of the clinician (for example a sport and exercise medicine consultant or hip specialist).
- The length of the appointment and whether it includes a full physical examination.
- Whether imaging (X-ray, ultrasound or MRI) is arranged, and how soon it is reported.
- Whether physiotherapy is included or arranged separately.
- Whether a diagnostic or therapeutic injection is part of the plan.
- Whether follow-up reviews are included in the fee.
- The clinician's fee and what the appointment covers.
- The cost of any imaging and who reports it.
- Whether follow-up is included or charged separately.
- The cost of physiotherapy if recommended.
- What happens, and what it costs, if the diagnosis is unclear and more tests are needed.
- Any cost for a written report or onward referral.
On the NHS? Hip and groin pain can be assessed on the NHS through your GP, with referral to physiotherapy or a specialist when needed; private clinics may offer faster access to assessment, imaging and physiotherapy.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being given a confident diagnosis based on a scan finding that may be incidental.
- No discussion of non-surgical options before surgery or injections are suggested.
- No clear plan for what happens if the first treatment does not work.
- Not being told that more than one cause may be contributing.
- Being steered straight to imaging or a procedure without a proper examination.
Marketing red flags
- Promising a precise diagnosis from a scan alone, without examination.
- Recommending surgery for hip impingement before non-surgical treatment has been properly tried.
- Routine 'screening' MRIs for active people without symptoms.
- Quick-fix injections marketed as a cure without addressing the underlying cause or rehabilitation.
- Guarantees of a return to sport by a fixed date.
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What do you think is causing my pain, and how confident are you?
- Would a scan change what we do, or can we start treatment now?
- Is my pain coming from the hip joint, the groin muscles, or somewhere else?
- What can I keep doing in training, and what should I avoid for now?
- What would make you reconsider the diagnosis if I don't improve?
- When and how should I be reviewed?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my test, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this test not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Do I need a scan to find out what is wrong?
Could my groin pain be a hernia?
Will I need surgery?
How long will it take to get better?
Should I rest completely until it settles?
Can I get this assessed on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Hip pain in adults Doha agreement meeting on terminology and definitions of groin pain in athletes (BJSM) FASHIoN trial — hip arthroscopy vs personalised hip therapy for FAI (PMC) Versus Arthritis — hip pain
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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