Ache buried deep in the hip
Hard to touch or point to, and usually worse after sitting, driving or standing up from a low chair.
Deep hip pain is a symptom with several possible sources, and that is part of why it’s confusing. People describe an ache buried in the joint or deep in the buttock. It may pinch on a deep squat, flare after a long drive, or seem to move around from day to day.
Some of the usual sources sit behind the joint. The piriformis, obturator internus and the other deep rotators control the hip as it turns. They can stay tight long after a strain or heavy training. The gluteus medius and minimus tendons on the side of the hip are another common source. The low back and the sacroiliac joint, where the spine meets the pelvis, can also refer pain here. Where it hurts isn’t always where it starts.
My treatment is dry needling, a form of acupuncture, aimed at the muscles that reproduce your pain. The sciatic nerve passes right beside the piriformis and obturator internus, so easing those muscles takes pressure off it. Sometimes the sciatic nerve has become irritable in its own right. Then electroacupuncture helps: fine needles near the nerve carry a gentle current to help change how it’s signaling.
Anti inflammatory medication, a cortisone injection and hip strengthening are the usual first steps. Some people also see a chiropractor for the low back. Those can calm pain for a while. They don’t always reach a deep rotator that has stayed tight or a sciatic nerve that has become irritated. Scans add another layer, since labral changes and joint wear also show up in people without pain. Dry needling is not within a New York PT’s or chiropractor’s scope. Those deep muscles may never have been treated directly.
I ask how long you can sit, which positions bring on the deep ache, and whether it ever travels to your back or leg. Then the exam:
Orthopedists, pain medicine doctors and physical therapists are the people I most often coordinate with. Should anything point back toward one of them, I’ll let you know and pass along my findings.
Deep hip pain often comes from muscles and nerves under several layers of tissue, so you can’t easily press on them yourself. It can also be referred from the low back or sacroiliac joint. That’s why my exam focuses on reproducing the exact ache rather than on where it seems to be.
It can contribute. Long hours with the hip bent keep pressure on the deep rotators and can leave the hip flexors tight. Usually it’s sitting combined with how you then load the hip on stairs, at the gym or on runs.
Yes. The needles reach deep rotators and gluteal tendons that are hard to get at with hands or a foam roller. Relaxing those muscles also gives the sciatic nerve more space. If the nerve is sensitive as well, I add electroacupuncture, and deep hip pain often calls for a mix of both.
It may be part of it. Labral changes are also common in people with no hip pain. I look at whether the muscles and nerves around the joint reproduce your pain, and your orthopedist handles decisions about the labrum itself.
Usually not entirely. I’ll help you find which ranges, speeds or distances bring the ache on and trim those for a while. Keeping the rest of your training going generally helps more than full rest.
Seek urgent care after a fall or injury, if you can’t put weight on the leg, or if you suspect a fracture. Rapidly worsening weakness or numbness, fever, unexplained weight loss, or night pain that doesn’t change with position also need prompt medical attention.
Adults with pelvic floor, nerve and orthopedic pain, along with neurological conditions. Most of my patients come to me after other care hasn't fully settled things. If you're looking for general wellness acupuncture, I'm not the right fit.
We review your history and what you've already tried. I assess the muscles and nerves involved, and you're treated the same day.
It depends on the condition. Pelvic and orthopedic plans usually run 4 to 6 weeks. Neurological plans are usually 2 visits a week for 6 weeks or 3 a week for 4. After that, visits space out so the changes hold. These are typical timelines, not promises.
Yes. I work alongside doctors, physical therapists and specialists. If something I find needs a closer look from one of them, I'll tell you.
I'm an out-of-network provider. You pay at the time of your visit, and my office submits the claim so any reimbursement comes to you. Free benefit checks are available before your first visit through the verification form, and HSA and FSA cards work. I don't take Medicare or Medicaid, though some Medicare Advantage plans reimburse out-of-network care. Full insurance details
Yes. I treat adults, teens and children, though I don't specialize in infants or toddlers.
Yes. Book a free discovery call to ask your questions and see whether we're a good fit.
Dry needling is a form of acupuncture. Fine needles go into tight bands of muscle and trigger points to lower muscle tension and change how the area is signaling.
You may feel a brief twitch or a deep ache as the needle reaches tight muscle. It passes quickly, and any soreness afterward usually fades within a day or two.
It's generally safe with a properly trained practitioner. Needles are sterile and single-use, and I check your health history first, including blood thinners. In New York, dry needling can only be performed by licensed acupuncturists, MDs and DOs. Physical therapists and chiropractors aren't permitted to perform it.
Eat something light beforehand and wear loose clothing that lets me reach the area being treated.
Usually not. Ultrasound helps in a few specific cases, but it hasn't been shown to improve results for common trigger points. A careful hands-on exam is what guides the needle. More on ultrasound-guided dry needling
Dry needling aimed at the pelvic floor and the hip and abdominal muscles around it, for pain, tension and urinary symptoms driven by those muscles and their nerves. More on pelvic floor dry needling
Sometimes, depending on the muscles involved, and you'll be draped throughout. Treatment always follows your consent and comfort. I don't do internal exams or internal treatment.
No, though it helps if you've already seen a doctor or pelvic floor physical therapist. Bring any notes or imaging you have.
Completely. I've heard it all, and there's no judgment here, just a straightforward conversation so we can treat what's going on.
Yes, I treat adults of every gender and identity. After gender-affirming surgery involving the pelvis, bring your surgical notes and we'll decide together what fits.
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118 W. 72nd St, Rear Lobby, New York, NY 10023
Evidence-based acupuncture and dry needling on the Upper West Side. From chronic pain and headaches to pelvic floor dysfunction, Dr. Jordan Barber pairs the highest level of training with care that actually listens.
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