Pain Symptom
Deep Hip Pain
By Dr. Anthony J. Gordon, Doctor of Acupuncture | Last reviewed September 2026
The pain feels like it is inside your hip, too deep to reach. You cannot quite put a finger on it. It aches when you sit, walk, climb stairs or cross your legs, and your hip X-ray may look fine. Some of the most important hip muscles sit deep under the gluteals and even inside the pelvis, and they are a common, overlooked source of this pain.
Prefer to talk it through? Call (516) 597-5400. Most new patients are seen within one to two weeks.
Overview
Understanding Deep Hip Pain
Deep hip pain is a vague, deep ache in the back or side of the hip or buttock. The hip joint itself can be a source, through arthritis, labral tears or impingement, and your physician may order imaging.
Often, though, the pain comes from the deep hip rotators: the piriformis, gemelli, quadratus femoris and the obturator internus. The obturator internus is unusual because it lines the inside of the pelvis before wrapping out to the hip, so it connects the pelvic floor and the hip. Trigger points in these muscles cause deep, diffuse pain that is easy to confuse with joint pain. The gluteus minimus can also refer deep pain down the side of the leg.
Because these muscles are deep, massage and stretching often cannot reach them. Dry needling can, and Dr. Gordon combines it with nerve care for any irritated nerves nearby.
Deep Hip Pain at a Glance
Also called
Deep buttock pain, posterior hip pain, deep gluteal pain
Where it is felt
Deep in the back or side of the hip and buttock
Common muscle sources
Piriformis, gemelli, quadratus femoris, obturator internus, gluteus minimus
Possible joint sources
Arthritis, labral tears, impingement
Common aggravators
Sitting, walking, stairs, crossing the legs, running
The Gap in Care
What Tests Check, and What They Can Miss
Deep hip pain is often attributed to the joint. When imaging does not explain the pain, the deep muscles are rarely examined.
What routine testing is looking for
- Hip arthritis
- Labral tears
- Hip impingement
- Stress fractures
What often keeps symptoms going
- Deep rotator trigger points
- Obturator internus tension linking the pelvis and hip
- Gluteus minimus referral
- Sciatic nerve irritation in the buttock
- Weak gluteals that overload the deep muscles
These are found with targeted palpation and hip testing, which is how Dr. Gordon approaches deep hip pain.
Signs & Symptoms
Does This Sound Like You?
Symptoms vary from person to person. These are the patterns Dr. Gordon sees most often.
A deep, vague ache
Pain that feels inside the hip and is hard to pinpoint.
Pain with sitting
Aching that builds in a chair.
Pain crossing the legs
Pain when bringing one leg across the other.
Pain with walking or stairs
Aching that increases with activity.
Clicking or catching
Sometimes with joint involvement.
Pain spreading down the leg
Aching down the side or back of the thigh.
Root Causes
The Four Drivers Dr. Gordon Looks For
Most people have more than one of these in play. Finding which one leads makes treatment more efficient.
Deep rotator trigger points
The piriformis, gemelli and quadratus femoris refer deep hip pain.
Obturator internus
This muscle connects the pelvic floor to the hip and is a major source of deep pain.
Gluteus minimus
Trigger points refer deep pain down the side of the leg.
Joint involvement
Arthritis, labral tears or impingement can add pain, which your physician evaluates.
Your First Visit
How Dr. Gordon Evaluates Deep Hip Pain
The initial evaluation runs 60 to 75 minutes. You leave with a clear picture of what is driving your symptoms, a written plan, a realistic timeline, and in most cases your first treatment.
Records and history review
Dr. Gordon reviews your imaging, physician or physical therapy notes, medications and past treatments so he knows what has been ruled out and what has already been tried.
Hip joint screen
Tests to separate joint pain from muscle pain.
Deep muscle palpation
Targeted assessment of the deep rotators, obturator internus and gluteals.
Movement and gait
Dr. Gordon watches walking, stairs and squatting.
Plan and coordination
A clear plan, plus communication with your physician, orthopedist or physical therapist when that helps your care.
When to see a physician first
- Hip or groin pain with inability to bear weight
- Pain after a fall, especially if you are older or have osteoporosis
- A hot, red, swollen joint or fever
- Groin pain with nausea, vomiting or a painful bulge
- Severe pain at night that does not change with position
- Calf pain and swelling, which can signal a blood clot
If you have any of these, contact your doctor or go to the nearest emergency department.
Bring to your first visit
Records
Recent lab results, imaging reports and specialist notes. These can also be faxed ahead.
Treatment history
A short list of what you have tried and what did or did not help.
Clothing
Something comfortable and loose fitting.
Treatment
How Dr. Gordon Treats It
These are the tools Dr. Gordon uses most often for deep hip pain, chosen from your exam findings.
Primary approach
Orthopedic Dry Needling
Dr. Gordon has used dry needling for more than 18 years. Dry needling reaches the deep rotators, obturator internus and gluteus minimus that cause deep hip pain.
See all servicesNerve focus
Neuro-Functional Acupuncture
Electro-acupuncture to calm nerve irritation in the buttock and hip.
See all servicesBetween visits
Hip Plan & Team Coordination
Activity and strengthening guidance, coordinated with your physician or physical therapist.
Referring provider? Contact the clinicWhat to Expect
A Typical Recovery Arc
Visits 1 to 3
Find the main driver
Dr. Gordon confirms which muscles and nerves are behind your symptoms and starts calming the most reactive areas. Many people notice early changes between visits.
Visits 4 to 8
Lower the baseline
Day-to-day symptoms ease, flares become shorter and less frequent, and normal routines start to feel more manageable.
Visits 9 to 12 and beyond
Build resilience
Visits are spaced out as improvement holds. You leave with a maintenance and early-flare plan.
Most patients are seen weekly or every other week during active care. Individual results vary with how long symptoms have been present and how reactive they are. Progress is reassessed at every visit.
Not sure how to describe it? Put your pain or discomfort into words before your visit
"As a professional ballet dancer I'm always looking for a knowledgeable doctor with effective treatment methods for my injuries. Within 3 visits my hip injury, which I had been dealing with for months, was gone. I've worked with several physical therapists and tried many alternative treatments and none compared to the dry needling I received here!"
Max Lippman, Google Review
Deep Hip Pain Questions
Answers About Deep Hip Pain
Still unsure whether this is the right fit? Reach out before you book and Dr. Gordon will talk through your history with you.
The exam includes tests for both. Many people have a mix.
Deep muscles are hard to reach with stretching or massage and often need direct treatment.
Yes. It lines the pelvis and attaches to the hip, linking pelvic and hip pain.
Yes. Dr. Gordon treats the muscle guarding around the hip, which often accounts for much of the pain.
Many people improve within six to ten sessions.
Often with modifications.
Before You Book
General Questions
The clinic is an out-of-network practice. The initial evaluation is $300 and follow-up visits are $250. After each visit you receive a detailed superbill to submit to your PPO plan for possible reimbursement. FSA and HSA cards are accepted, and the clinic can run a complimentary benefits check before your first appointment. The check is a courtesy, so please confirm your coverage with your plan. See Insurance & Fees for details.
The first evaluation is 60 to 75 minutes and usually includes treatment. Follow-up visits run 45 to 60 minutes.
Yes. Call (516) 597-5400 or send a message through the contact page. This is especially helpful if your case is complex and you want to understand the approach before committing to a full evaluation.
1508 Union Turnpike, Suite 133, North New Hyde Park, NY 11040, with free parking on site. The clinic is an easy drive from Manhasset, Great Neck, Garden City, Lake Success, Floral Park and Mineola. Early morning, evening and weekend hours are available.
Most people feel a quick muscle twitch or a deep ache that lasts a few seconds. That twitch is a normal sign the trigger point is releasing. Mild soreness for 24 to 48 hours afterward, similar to a hard workout, is common. Depth, angle and stimulation are adjusted to your comfort.
Both use the same fine, sterile, single-use needles. Dry needling targets specific trigger points and tight bands in muscle based on your exam. Neuro-functional acupuncture targets nerve pathways, often with gentle electrical stimulation, to calm nerve sensitivity. For deep hip pain, Dr. Gordon commonly uses both.
When performed by a trained, licensed provider with detailed knowledge of anatomy, it has a strong safety record. Tell Dr. Gordon if you take blood thinners, have a bleeding disorder, are pregnant or have a weakened immune system so he can plan accordingly.
Further Reading
Hip Pain and the Pelvic Floor: How One Can Drive the Other
From the blog: Deep hip pain and pelvic floor symptoms often show up together. How the obturator internus links the two, and why treating only one can leave you stuck.
Hip Arthritis or Muscle Pain? How to Tell the Difference
From the blog: Hip arthritis and hip muscle pain can feel alike. Where each one tends to hurt, why X-rays and pain often disagree, and why many people have both at once.
About Dr. Anthony J. Gordon
Dr. Anthony J. Gordon is a Doctor of Acupuncture licensed in New York and board certified. He holds ASE certification in intrapelvic and extrapelvic dry needling, along with advanced certifications in Functional Dry Needling and Neuro-Functional Acupuncture. With more than 18 years of clinical experience and over 3,000 complex cases treated, he focuses on pelvic, spinal and orthopedic conditions that have not responded to standard care, and works closely with each patient's physicians and physical therapists.
Read Dr. Gordon's full bioBook an Evaluation for Deep Hip Pain
Book a full evaluation with Dr. Gordon and find out which deep hip muscles are behind your pain.
Early morning, evening and weekend appointments available. Free on-site parking.
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