Why Does Only One Hip Hurt? Understanding Hip Pain on One Side
Pain in one hip only is common, and it usually means something in the way your body is aligned or loaded is uneven. A small difference in leg length, a tilted pelvis, or years of favouring one side can put more stress on a single hip. Standing whole-body imaging can reveal asymmetries that lying-down scans often miss.
Key takeaways
- One-sided hip pain usually points to an asymmetry in alignment, loading, or gait.
- The cause is not always at the hip itself. It can start at the pelvis, legs, or spine.
- Lying-down scans relax muscles and can hide the very imbalance causing your pain.
- A standing EOS scan captures both hips and the full skeleton on one image under real weight-bearing load.
- Accurate alignment data helps clinicians target the real source, not just the sore spot.
If you have hip pain when walking on one side, or a dull ache in just your left or right hip, you have probably wondered why the other hip feels fine. It is a fair question. Most people assume the sore hip must be the damaged one. But the body is a connected chain, and one-sided hip pain often tells a bigger story about alignment and compensation.
What does one-sided hip pain feel like?
It can show up in several ways, depending on which structures are under strain. You might notice one or more of the following.
A nagging soreness on one side that worsens after sitting or walking.
One hip feels tight or locked when you first get out of bed, but the other moves freely.
Climbing stairs, stepping off a kerb, or standing on one leg is painful only on one side.
You catch yourself leaning away from the sore hip or shortening your stride on that side.
Important: if you experience sudden severe hip pain with numbness, weakness in your leg, or any loss of bladder or bowel control, seek urgent medical attention. Contact your GP, call 111, or go to A&E straight away.
What causes hip pain on one side only?
Several factors can load one hip more than the other. Often it is a combination rather than a single cause.
Even a small difference means the longer-side hip bears more force with every step. Read more about leg length discrepancy.
A lateral pelvic tilt or a rotated pelvis shifts load unevenly across the two hip joints.
Favouring one leg when standing, carrying bags on the same shoulder, or a repetitive sport can overwork one hip over time.
Osteoarthritis can develop faster in the hip that has been absorbing extra load for years, leaving the other hip relatively healthy.
Why does pain appear in one hip when the problem is elsewhere?
Your skeleton works as a connected chain from your feet up through your pelvis and spine to your head. When one link in that chain is out of position, the body compensates. It shifts weight, tilts the pelvis, or changes your gait pattern to protect one area, and the extra load ends up somewhere else.
This is why treating only the painful hip can bring short-term relief but not a lasting solution. If the root cause is a subtle lateral pelvic tilt or a leg length discrepancy further down the chain, the same hip will keep taking the extra strain.
How does a standing scan show what lying-down imaging misses?
Standard X-rays, CT, and MRI are usually taken while you lie flat. In that position, gravity is removed, muscles relax, and the pelvis settles into a neutral shape. Any tilt, rotation, or uneven loading that happens when you stand and walk disappears from the image.
What it captures: Both hips, the pelvis, your full leg lengths, and your spine, all on one image, taken while you stand and bear weight normally.
This reveals pelvic obliquity, true leg length differences, and how each hip joint is loaded under gravity. The EOS system uses about 90% less radiation than a standard X-ray, around ten times less.
What it captures: A detailed snapshot of bones or soft tissue in one area, with gravity removed.
Excellent for spotting fractures, tumours, or local joint damage. But it cannot show the alignment imbalances that only appear under load, so the reason one hip hurts more than the other may not be visible.
At ScanAlign, full-body standing imaging captures both hips on the same full-body image. Your clinician can see exactly how the pelvis sits, whether one leg is longer, and how your spine compensates, all from a single scan. Learn more about hip pain and alignment on EOS imaging.
When MRI is the better tool: EOS shows bones, joints, and alignment. If your clinician suspects soft-tissue damage, a labral tear, or nerve involvement, MRI is usually the right choice. The two scans answer different questions and often work well together.
What helps with hip pain on one side?
The most effective route depends on finding out why one hip is overloaded. General approaches that clinicians often consider include:
- Accurate diagnosis first. A standing whole-body image gives your physiotherapist, osteopath, or surgeon measurable alignment data. Without it, treatment can end up addressing symptoms rather than causes.
- Targeted strengthening. Once the imbalance is understood, exercises can be prescribed to support the weaker side and reduce the load on the painful hip.
- Gait and footwear review. If a leg length difference is contributing, small corrections at the foot or shoe level can make a meaningful difference to how force travels through your hip.
- Pelvic alignment work. Manual therapy or specific movement programmes focused on restoring symmetry to the pelvis can take pressure off the overloaded hip.
ScanAlign is a diagnostic imaging clinic. We provide the detailed alignment data. Treatment decisions are made by you and your chosen clinician, informed by that data.
Want to find out what is driving your one-sided hip pain? A free video consultation can help you decide whether a standing scan is the right next step.
Book a free video consultationFrequently asked questions about hip pain on one side
Left hip pain on its own usually means the left side is taking more mechanical load. This can be caused by a pelvic tilt, a slight difference in leg length, or a habitual pattern like always standing on the left leg. It does not necessarily mean the left hip joint itself is damaged.
Yes. Even a small discrepancy changes how force is distributed across the pelvis and hip joints. The hip on the longer-leg side often absorbs more shock with each step, which can lead to gradual wear and pain on that side.
It can be. Osteoarthritis often develops unevenly, especially if one hip has been overloaded for years. But many other causes, including alignment issues and muscle imbalance, can produce similar symptoms. Imaging helps tell the difference.
Walking puts your full body weight through each hip alternately. If one hip is receiving more load due to alignment imbalance, the repetitive impact of walking amplifies the strain. A standing scan captures this loading pattern.
Yes. A rotated pelvis changes the angle of both hip sockets. One hip ends up in a different position from the other, which alters how it moves and how much force it absorbs. You can read more about a rotated pelvis and its effects.
No. ScanAlign accepts self-referrals. You can book a full-body standing scan directly. A free video consultation is the first step, where a specialist radiographer reviews your concerns.
An EOS scan uses about 90% less radiation than a standard X-ray, around ten times less. It is one of the lowest-dose skeletal imaging systems available.
Yes. The EOS system captures the full skeleton, from head to foot, in a single standing image. Both hips, the pelvis, legs, and spine are all visible on one scan, making side-to-side comparison straightforward.
Pricing details are available on our FAQs and cost page. The free video consultation is a good place to discuss what your scan would include.
A standing scan provides detailed alignment and joint data that a surgeon uses alongside clinical examination to decide whether a hip replacement is appropriate. It does not diagnose or recommend treatment on its own, but it gives your surgeon information that lying-down imaging cannot.
Find out why one hip hurts
A free video consultation with a specialist radiographer is the first step. No referral needed, no obligation.
Book a free video consultationWritten by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- NHS. "Hip pain in adults." nhs.uk. Accessed 2024.
- Illés T, Somoskeöy S. "The EOS imaging system and its uses in daily orthopaedic practice." International Orthopaedics, 2012;36(7):1405-1411.
- Khamis S, Yizhar Z. "Effect of feet hyperpronation on pelvic alignment in a standing position." Gait & Posture, 2007;25(1):127-134.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.