Navigating Hip Pain In Ankylosing Spondylitis: Causes & Treatments

ankylosing spondylitis hip pain

Living with Ankylosing Spondylitis (AS) is more than just about managing back pain—it can manifest in places you least expect, like the hips. The recurring pain, the stiffness after a night’s sleep, the limited range of motion; it all feels like a cruel cycle that never seems to end. However, you’re not alone. Countless individuals face the challenges of Ankylosing Spondylitis (AS) related hip pain daily. But here’s the silver lining: With understanding and proactive measures, you can regain control, manage symptoms, and lead a life less governed by pain.

Dive into this guide to discover how to effectively manage hip pain associated with Ankylosing Spondylitis, explore the causes, and uncover expert-recommended treatments.

Understanding Ankylosing Spondylitis and Hip Pain

Ankylosing Spondylitis (AS) is a chronic inflammatory condition primarily targeting the spine. It belongs to a family of disorders known as spondyloarthropathies. While the vertebrae of the spine are the most common areas affected, AS doesn’t limit itself there. Over time, inflammation can spread to other joints, and the hip joint is one of its frequent targets.

The hip joint, comprising the ball (femoral head) and its socket (acetabulum), is one of the body’s largest weight-bearing joints. When AS targets this joint, it can lead to pain, stiffness, and a restricted range of motion. Inflammation in the hip joint can cause the protective cartilage to wear down over time, leading to increased friction and further pain. The discomfort can range from a mild ache to sharp, radiating pain, often worsening after periods of inactivity or prolonged sitting.

But why the hip? AS has a tendency to affect the places where ligaments or tendons attach to bones, known as entheses. The hip, with its intricate web of ligaments and tendons, becomes a susceptible target.

Understanding the link between AS and hip pain is the first step in proactive management and seeking effective treatments.

Symptoms to Watch Out For

Recognizing the signs of hip involvement in Ankylosing Spondylitis is crucial for timely intervention. While each patient’s experience might vary, there are common symptoms that frequently signal AS’s impact on the hip joint. Here’s what you should be alert to:

  • Persistent Pain: Often starting as a mild ache, the pain associated with AS in the hip can gradually intensify, becoming sharper and more localized around the groin area or the front of the thigh.
  • Morning Stiffness: A hallmark of inflammatory arthritis, patients might find their hip feeling particularly stiff upon waking up in the morning. This stiffness typically eases as the day progresses, especially with movement.
  • Pain after Prolonged Inactivity: Extended periods of sitting or lying down can trigger or intensify discomfort. Patients might find it challenging to move their hip joint after such durations.
  • Reduced Range of Motion: Over time, inflammation can lead to the hip becoming less flexible. Simple actions, like bending over to tie a shoe or crossing legs, can become painful or challenging.
  • Radiating Pain: In some cases, the pain can radiate down the leg or towards the buttocks, making it difficult to pinpoint its origin at the hip.
  • Swelling and Warmth: While less common, some patients might notice their hip area becoming swollen and feeling warm to the touch, indicative of inflammation.
  • Associated Spinal Symptoms: Given that AS primarily targets the spine, patients may concurrently experience lower back pain, spinal stiffness, or other related symptoms.

Understanding these symptoms is pivotal, as early detection often leads to more effective management strategies. If you experience any of these signs consistently, it’s essential to consult a healthcare professional for a comprehensive evaluation.

The Role of Early Diagnosis

Catching Ankylosing Spondylitis in its early stages can significantly influence the trajectory of the condition, especially when it impacts the hip. An early diagnosis not only paves the way for effective pain management but can also slow down the progression of joint damage.

To diagnose AS-related hip pain, medical professionals typically

  • rely on a combination of patient history,
  • physical examinations, and imaging tests
  • X-rays can offer insights into any structural changes or inflammation in the hip joints,
  • MRI scans can detect early inflammation even before it’s evident on X-rays.
  • Blood tests, checking for markers of inflammation and specific genetic markers associated with AS, can also be instrumental.

By recognizing the signs early and seeking prompt medical attention, patients can greatly enhance their quality of life and mobility prospects.

Exercise Regimen for Ankylosing Spondylitis Induced Hip Pain

Exercise plays a pivotal role in managing the symptoms of Ankylosing Spondylitis, especially when the hip joint is involved. By adopting a regular exercise routine tailored to the needs of AS patients, one can not only ease pain but also improve joint mobility and overall health. Here are some exercises specifically designed for those with AS-induced hip pain:

Hip Flexor Stretch

  • Begin by kneeling on the floor.
  • Move one foot forward so that you’re in a lunge position.
  • Gently push your pelvis forward until you feel a stretch in the front of your hip.
  • Hold for 20-30 seconds, then switch sides.
  • Safety Tip: Use a soft mat or cushion to protect your knees.

Glute Bridges

  • Lie on your back with knees bent and feet flat on the floor.
  • Pressing through your heels, lift your hips off the ground, squeezing your glutes.
  • Hold at the top for a few seconds, then lower back down.
  • Safety Tip: Ensure your feet are hip-width apart and avoid overarching your back.

Standing Hip Abduction

  • Stand upright with a chair or wall for support.
  • Slowly lift one leg out to the side and then bring it back to the starting position.
  • Repeat 10-12 times on each side.
  • Safety Tip: Engage your core for stability and avoid leaning too much to one side.

Pelvic Tilts

  • Lie flat on your back with knees bent.
  • Tighten your abdominal muscles, pushing your lower back into the floor.
  • Hold for a few seconds, then relax.
  • Safety Tip: Breathe steadily throughout and avoid straining your neck.

Piriformis Stretch

  • Lie on your back and bend both knees.
  • Cross one ankle over the opposite knee.
  • Gently pull the uncrossed leg towards your chest until you feel a stretch in the buttock area.
  • Hold for 20-30 seconds, then switch sides.
  • Safety Tip: If you feel any sharp pain, ease out of the stretch.

It’s essential to remember that consistency is key when it comes to exercising for AS. Furthermore, always consult with a physical therapist or healthcare professional before beginning any new exercise routine. They can provide tailored advice and ensure that exercises are performed correctly and safely.

Tips & Natural Remedies for Ankylosing Spondyliti-Induced Hip Pain

While traditional medical treatments are essential in managing Ankylosing Spondylitis (AS), many individuals find relief by incorporating natural remedies and supplements. Here are some holistic options that may be beneficial:

  • Turmeric (Curcumin):
    • Renowned for its anti-inflammatory properties.
    • Can be taken as a supplement or used in cooking.
  • Omega-3 Fatty Acids:
    • Found in fish oil, flaxseeds, and walnuts.
    • May reduce inflammation and joint stiffness.
  • Ginger:
    • Has natural anti-inflammatory and analgesic properties.
    • Can be consumed in teas, as a supplement, or used in meals.
  • Hot/Cold Therapy:
    • Hot Packs: Relax tight muscles and improve blood flow.
    • Cold Packs: Reduce inflammation and numb the affected area.
  • Capsaicin Cream:
    • Derived from chili peppers, it can help reduce pain by desensitizing nerve endings.
    • Apply topically to the painful area.
  • Willow Bark:
    • Contains salicin, which the body converts to salicylic acid, providing pain relief.
    • Available in supplement form or as a tea.
  • Epsom Salt Baths:
    • The magnesium sulfate in Epsom salts can help relax muscles and soothe pain.
    • Soak in a warm bath infused with Epsom salts for about 15-20 minutes.
  • Boswellia:
    • Also known as Indian frankincense, it has anti-inflammatory effects.
    • Available as a resin, pill, or cream.
  • Acupuncture:
    • An ancient Chinese therapy that involves inserting thin needles into specific points on the body.
    • May help in reducing pain and improving mobility.

Always consult with a healthcare professional before starting any new remedy or supplement, especially if you’re currently on medication.

Medications and Conservative Treatments for Ankylosing Spondylitis Hip Pain

For those battling Ankylosing Spondylitis-induced hip pain, medications and conservative treatments play an indispensable role in managing symptoms, reducing inflammation, and improving quality of life. Below is a comprehensive look at these intervention strategies:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs):
    • These are the most commonly prescribed medications for AS hip pain.
    • Help reduce inflammation, pain, and stiffness.
    • Examples include ibuprofen (Advil, Motrin), naproxen (Aleve), and celecoxib (Celebrex).
  • Disease-Modifying Antirheumatic Drugs (DMARDs):
    • Designed to slow the progression of AS.
    • Methotrexate and sulfasalazine are among the commonly used DMARDs.
  • Biologics:
    • Target specific parts of the immune system that trigger inflammation.
    • Administered via injection or intravenously. Examples are etanercept (Enbrel) and infliximab (Remicade).
  • Corticosteroid Injections:
    • Deliver relief directly to the inflamed hip joint.
    • Provide temporary relief from pain and reduce inflammation.
  • Physical Therapy:
    • Tailored exercise regimens improve flexibility, strength, and posture.
    • Techniques to relieve pain and improve movement.
  • Pain-Relief Patches, Ointments, and Creams:
    • Topical pain relievers like capsaicin or salicylates can be applied directly to the hip area for localized relief.
  • TENS (Transcutaneous Electrical Nerve Stimulation):
    • Delivers low-voltage electrical current through electrodes on the skin, which can offer pain relief.
  • Orthotic Devices:
    • Shoe inserts or braces can help manage posture issues and provide better joint support.

Always ensure that medications and treatments are tailored to your specific needs. It’s essential to collaborate closely with healthcare professionals, rheumatologists, or physical therapists to devise the best therapeutic approach for AS-induced hip pain.


Ankylosing Spondylitis-induced hip pain can be both mentally and physically taxing. Understanding the condition, keeping an eye on symptoms, and adopting tailored therapeutic strategies are crucial for managing the pain and leading a fulfilling life. Remember, the journey with AS is unique to every individual, and while challenges might seem daunting, there’s a wealth of resources and treatments available to assist you.

If you’re experiencing Hip pain, physical therapy for hip pain at PhysioMantra can help: Book an online physical therapy session.