Acupuncture for Hip Pain in San Francisco
A pulling ache at the front of the hip, pain on the outside that wakes you when you roll onto it, or a glute that locks up every run? We treat hip pain with acupuncture, dry needling and hands-on work, so you can move, train and sleep without it.
Sound familiar?
- Pain on the outside of the hip that's worse when you lie on that side
- A tight, pulling ache at the front of the hip when you lift your knee or sprint
- A deep ache in the buttock that flares on hills, stairs or longer runs
What our patients say
5.0 on Google from 92 reviews
Gosh, I'm so happy I found Andrew! Thanks to him, I avoided going down a surgery route for my injury! In June 2022, my left knee started acting up (my best guess is overcompensation for gluteal tendonitis I was treating) but I pushed through to backpack 264 miles on the John Muir Trail. When I finished my trek, my left knee was pretty unhappy and I couldn't even get in and out of my car without feeling like a jigsaw puzzle. I tirelessly saw dozens of providers over the next year - chiropractors, physical therapists, orthopedists, massage therapists, etc. All had their own theories - soleus muscle, calf strain, chronic exertional compartment syndrome, etc. The complexity in my case was that my pain was not in my knee itself - it was on the left side in between my knee cap and calf. Despite my knee MRI showing meniscus tears, inflammation, tendonosis, etc. the doctors insisted we treat the symptoms, not the MRIs. So, I got a calf MRI, hip MRI, and an EMG, all of which were negative. Then, one doctor recommended oral Prednisone, and he told me I should see results better than Advil for pain management. It did nothing. It wasn't until I was finally referred to one doctor who noticed something in my knee MRI and caught that there is excess fluid in my proximal tibiofibular joint (PBTJ), and that area tracks with where I feel my pain. To test his suspicion diagnostically, he recommended an ultrasound-guided cortisone injection in my PBTJ to see if that reduced my pain. The pain did decrease (which was good), but it wasn't gone. The doctors informed me issues concerning the PBTJ are rare, and that they needed to refer me to one of the only specialists in the country for this. That specialist happened to be in Minnesota, and when I checked his website, he was only seeing patients for surgery. I did not want surgery. I felt completely defeated, unsure where to go next. In May, I was recommended by someone who also had a challenging journey with injuries (and was able to return to running and hiking) to try acupuncture. I was surprised, since I had not considered Eastern Medicine before for a sports injury. The person specifically recommended I search for an acupuncturist who specializes in athletes, and that led me to find "Acupuncture for Athletics." :) My first appointment with Andrew was May 30, and he patiently listened to my whole ordeal and reviewed all of the documentation I brought (MRIs, doctor's notes, etc). He assured me he treats the root cause, which I appreciated because I did not want to do a band-aid fix only for this to return again, and that he has hope I can feel better. We started off with cupping along my left leg to encourage the inflammation to dissipate, and then we did needles in my leg. Oof, I remember one session when Andrew placed a needle near my PBTJ - I screamed SO loudly lol. But once all of the needles were in, it slowly felt like a meditative experience, and I was able to relax into it. Over my 7 sessions with Andrew, I began to notice the needles felt less painful. In the beginning, I remember feeling the pain just in walking over to Andrew's office. By the 6th session, I realized I wasn't thinking about my pain anymore. I did one more session to be sure, and I was in disbelief that I actually felt pain-free! We decided to go a month testing how the pain fared without regular sessions, and so far so good! The pain flares here and there, but in a MUCH less capacity than before. Throughout this whole process, Andrew was kind, patient, and determined. He was committed to solving the underlying issue, and he was flexible and accommodating to me - whether I wanted to address my left knee or start tackling similar pain that was creeping up on my right knee. Had it not been for Andrew, I would have likely chased surgery because I was running out of ideas. I appreciate you, Andrew! If you're nearing your wits' end with a chronic injury, please go see Andrew and give it a good ~5 sessions if you can. Wishing everyone out there good luck on their chronic pain journeys! You got this!
I’ve always wanted to be able to demonstrate clearly to professional dancers when giving them corrections or setting ballets. However, without the level of daily physical preparation that my body was used to when I danced, my body now has moments of rebellion that, however careful I am, need the assistance of experts to ensure I can do my job fully. Andrew’s combination of acupuncture and soft tissue work always made a significant difference to my mobility, helping me undertake my role in the studio at a level of physicality such that I’m not confined to the minimum level of demonstration. With his level of experience with dancers it was always easy to discuss problematic muscles and joints, and reassuring that he ‘got’ what was going on and what was required to improve the situation efficiently and effectively.
I could not recommend Andrew enough! He has so much knowledge on the human body and can figure out quickly what areas need work. I went in with major back pain that kept me from lifting weights or running, and after a few sessions I am pain free.
Andrew applies his knowledge of the body and expert techniques to address affected muscles both for maintenance during training and related to injury. His combination of acupuncture and massage helps to open up areas and find the place to target. I have seen Andrew in the past for recovery post concussion and most recently for routine maintenance while training at a high level for my next marathon. I highly recommend Andrew and am lucky to have him as a part of my support team to stay healthy! - Katie Hynes, competitive runner -
As an avid runner who is always training for an endurance race my body has a tendency to break down. Andrew is a legit magician. He’s able to get to the root off the problem quickly and I often don’t miss a beat with regards to my training. Marathon prep would not be possible otherwise.
Andrew is the best. I’m a professional ballerina and his treatments helped me come back from a broken foot. When you see Andrew - you’re comforted by his knowledge, expertise, & strategy based treatment. Plus the clinic is so relaxing and warm. I have complete trust that he will help my aches and pains and keep me dancing for a long time.
Andrew treated me over a period of about two years for hip and shoulder problems, and he was tremendously helpful. I was impressed with his knowledge and skill, not to mention wonderful “bedside manner” and especially his enthusiasm for staying current in his field.
Andrew introduced me to a form of healing which, after years of competitive long distance running and many injuries, I am more than thankful to have discovered! My latest injury, a small tear in my left hamstring, sidelined me for a number of months. After trying rest, physical therapy and anti-inflammatories with little results, I finally met Andrew. His approach from the very beginning was completely methodical, precise and extremely professional. Right away the pain eased, and I felt my body finally respond to treatment. Andrew was instrumental in healing my hamstring, and I trust that his acupuncture/massage techniques will keep me healthy and, importantly, keep me running for many decades and miles.
I came to Andrew after nearly six excruciating months of not being able to run. I had a seemingly minor Achilles tendon injury that simply refused to heal, defying every modality I tried. I hoped Andrew, a specialist in sports injuries, could break the deadlock. The simple answer is that in three visits, I was running again, hardly able to believe my good fortune. The more complicated answer runs deeper. Andrew’s work doesn’t just address physical injury; he works on spiritual and emotional injury and stress too. I didn’t realize that my physical injury was bound up with emotional trauma, but he did, and he figured out how to disentangle them so the healing process could start. The process can be painful; emotional injuries that have lodged in your body have to work their way out through muscle and bone, like a physical illness. But it’s also both profound and unexpected. As another of Andrew’s clients said, he is a true healer.
Andrew’s massage and acupuncture techniques have seen me successfully through back-to-back marathons seven weeks apart, plus two active pregnancies and a record-breaking racing season in between. He is a veritable genius in his field — a true healer.
Andrew Castellanos has helped my Achilles tendinosis and tendinitis with acupuncture, not only getting the swelling down, but also massaging the area after. His therapeutic work has enabled me to continue dancing at a high level without having to take a break, so I’m able to dance with injury due to the therapeutic work that Andrew does.
As a professional dancer, I rely heavily on Andrew throughout the performance season to literally fix me in order to get me back onstage. I have chronic problems with my knee and my shoulder, and the combination of acupuncture with electric stimulation and heat has been tremendously helpful. Andrew only needs five minutes to find exactly where he needs to work, and the results are fantastic. His acupuncture work is also gentle, and doesn’t leave me sore the next day — in fact, it’s one of the only therapies I feel comfortable receiving right before a show. Andrew does great deep tissue work as well, and he is very responsive and attentive as a therapist. I’d highly recommend him to dancers, athletes and non-dancers alike.
Does this sound like you?
Hip pain shows up in different places depending on what's irritated. These are the patterns we see most often.
If a few of these sound familiar, an assessment will tell us whether it's coming from a muscle, a tendon, the joint or your low back.
- Pain on the outside of the hip that's worse when you lie on that side
- A tight, pulling ache at the front of the hip when you lift your knee or sprint
- A deep ache in the buttock that flares on hills, stairs or longer runs
- Stiffness getting out of the car or pulling on socks and shoes
- Pain when you first stand up after sitting for a while
- Groin or thigh pain that builds the longer you walk
What's behind hip pain
The hip is a deep ball-and-socket joint wrapped in some of the strongest muscles in your body. Pain can come from the joint itself, the tendons and muscles around it, or a nerve passing nearby, and where you feel it is a useful first clue.
In active people, strained hip flexors and glutes top the list, often after a block of speed work, hill repeats or a new sport. Pain on the outside of the hip, long blamed on bursitis, is now usually traced to the gluteal tendons. Cleveland Clinic notes this gluteal tendinopathy is most common in women over 40, but runners, skiers and dancers get it too.
Hip osteoarthritis tends to arrive later in life as groin or thigh pain and stiffness that make stairs, shoes and socks harder. And sometimes the hip isn't the source at all: buttock pain that travels down the leg often starts in the low back.
Common contributors
- Long days of sitting, then hard weekend training
- Sprinting, kicking, hill repeats and quick changes of direction
- Weak or tired glutes and core
- Standing with your weight on one hip, or crossing your legs
- Sleeping on the sore side
- A stiff low back
- Age and old injuries (for arthritis)
Where does your hip hurt?
Location narrows things down fast. Here's how the common causes tend to sort, and where we put our attention for each.
| Where it hurts | Common causes | What it feels like | Where we focus |
|---|---|---|---|
| Front of the hip or groin | Hip flexor strain, hip osteoarthritis, sometimes a labral tear | A pulling ache when you lift the knee, stiffness after sitting, a deep groin ache with walking | Hip flexors, quads and the deep hip muscles. Clicking or locking gets a medical check first. |
| Outside of the hip | Gluteal tendinopathy (greater trochanteric pain syndrome), bursitis | Tender over the bony point of the hip, worse lying on it, on stairs or standing on one leg | The glute medius and minimus and the outer thigh, plus a plan to load the tendons gradually |
| Buttock and back of the hip | Glute strain, piriformis syndrome, pain referred from the low back | A deep ache in the glute, sometimes with pain or tingling down the leg | The glutes and deep hip rotators, and the low back if it's involved |
If the pain runs down your leg
Buttock pain that shoots or burns down the back of the leg is often sciatica, either from the spine or from a tight piriformis muscle crowding the nerve. Our page on acupuncture for sciatica and piriformis syndrome covers that in detail, and low back pain has its own page too.
Who gets hip pain
We treat hips in sprinters and in people who sit at a desk all day, and often in people who do both.
People we see most
Related problems we treat
- Knee and IT band pain
- Running injuries
- Arthritis and long-term pain
- Hamstring strains
- Groin tightness
How we treat hip pain
We calm the painful area and work on the muscles that control the hip. Most visits combine several of these.
- Sports acupuncturePoints around the hip, buttock and thigh to ease pain and muscle guarding.
- Dry needlingInto glute, piriformis and hip flexor trigger points that won't let go with stretching.
- CuppingOver the glutes, outer hip and low back to loosen stuck tissue.
- Cold laserLow-level laser over irritated gluteal tendons, used alongside needling.
- Sports massageDeep work for the glutes, hip flexors and hamstrings.
Who performs dry needling in California?
In California, dry needling is performed by licensed acupuncturists. Physical therapists in California are not currently authorized to perform dry needling. Andrew, Suzanne and Ali are all California-licensed acupuncturists.
What the research says
A 2023 review of 12 trials with 806 people found that adding acupuncture to standard care eased hip pain more than standard care alone.
Looking at long-term pain more broadly, a 2018 analysis of 39 trials and more than 20,000 patients, including people with osteoarthritis, found acupuncture eased pain more than both sham and no treatment, and most of the benefit was still there a year later.
Pain on the outside of the hip has an encouraging trial too. In a 2017 study of 43 people with greater trochanteric pain syndrome, dry needling relieved pain and improved function as well as a cortisone injection over six weeks, with no side effects reported.
We use needling to ease pain and release guarded muscles so strengthening can do its job. New to needles? Here's how an acupuncture session works.
The short version
- Studies suggest it may ease hip and arthritis pain
- Dry needling looks promising for outer hip pain
- It works best alongside strengthening
- It won't repair a structural problem like a labral tear
Your first visit and your plan
Plan on about an hour for your first visit. How many sessions you'll need varies, and we'll give you an honest estimate after your assessment.
Assess
We watch you walk, squat and stand on one leg, test hip strength and range of motion, and check the tendons, glutes and low back to pin down where the pain is coming from.
Treat
You'll usually lie on your side with a pillow between your knees, or face down, while we needle the glutes, outer hip or hip flexors and follow with cupping or massage.
Afterwards
The hip often feels looser right away. Deeply needled glutes can ache for 24-48 hours, a bit like the day after a hard leg session. A gentle walk helps.
Build it back
We give you a few targeted glute and hip exercises, plus tips on sleeping and sitting positions, then space visits out as the hip settles.
When to see a doctor instead
Hip pain after a fall needs a medical check before anything else, especially if you're over 65 or have osteoporosis. A broken hip usually causes sharp groin and upper thigh pain, and the AAOS notes the injured leg often looks shorter and turned. Go to the ER or call 911.
Some problems aren't emergencies but still need a physician first. Deep groin pain with clicking, locking or catching can mean a labral tear or hip impingement. In runners, groin pain that keeps getting worse with every run can be a stress fracture. The NHS also flags a hot, swollen hip, or hip pain with a fever, as urgent.
Once you've been checked, we're happy to work alongside your doctor.
Get medical care first if you have
- Severe hip pain after a fall or accident
- A leg you can't stand on, or that looks shorter or turned outward
- Groin pain with clicking, locking or the hip giving way
- A hot, swollen hip, or hip pain with a fever
- Groin pain that worsens with every run or aches at rest
Who'll treat you
All three of our practitioners are California-licensed acupuncturists with Traditional Chinese Medicine training, and they treat hips every week. Andrew Castellanos has more than 25 years of experience, including the San Francisco Ballet and Alonzo King LINES Ballet, where hips take a lot of strain.
Andrew Castellanos
L.Ac, CST · Clinic owner
Glute, hip flexor and outer hip pain in dancers and runners.
- On call for San Francisco Ballet and LINES Ballet
- Neuromuscular re-education and soft tissue mobilization
- Treats hip and joint pain, sprains and strains
Ali Hakimi
L.Ac
Acupuncture and cupping for hip pain and injury recovery.
- Local acupuncture aimed at pain reduction
- Cupping and moxibustion when they suit
- Diet and lifestyle advice, with movement as medicine
Suzanne Lange
DACM, L.Ac, CMT
Hip pain care that blends acupuncture with myofascial bodywork.
- Advanced study in orthopedics and sports medicine
- Advanced training in pregnancy and postpartum care
- More than 20 years of clinical experience
Pricing and booking
Hip treatment happens within a standard session, with no package to buy.
We don't bill insurance, but we provide a superbill for possible out-of-network reimbursement, and we accept HSA and FSA cards and all credit cards. You'll find us on Webster Street, an easy walk from Union Street if you're searching for acupuncture in Cow Hollow.
Appointments
- 60-min initial acupuncture & assessment
- $225
- 45-min acupuncture follow-up
- $195
- 60-min acupuncture/massage combo
- $225
- 75-min acupuncture/massage combo
- $265
- 90-min acupuncture/massage combo
- $300
Hip pain FAQ
Can acupuncture help hip pain?
It can help many people, especially when the pain comes from tight, overworked muscles or irritated tendons around the hip. A 2023 review found that adding acupuncture to standard care eased hip pain more than standard care alone. Results vary from person to person, so we combine needling with strengthening and practical changes, and we'll estimate how many sessions you may need after your assessment.
Can acupuncture help hip bursitis?
Most pain on the outside of the hip that used to be called bursitis is now traced to the gluteal tendons. A 2017 trial found dry needling worked as well as a cortisone injection for this kind of pain over six weeks. We pair needling with gradual tendon loading, since rest alone rarely fixes it.
What about a strained hip flexor?
Hip flexor strains are common in runners, soccer players and anyone who sprints or kicks. We use acupuncture, dry needling and massage to ease pain and guarding in the hip flexors and quads, then help you rebuild strength before you return to full speed.
Does acupuncture help hip arthritis?
It may help. A 2018 analysis of 39 trials, which included people with osteoarthritis, found acupuncture eased long-term pain more than sham or no treatment, with most of the benefit lasting a year. Arthritic hips often come with tight muscles around the joint, and that's where we can often help most. Results vary from person to person.
Can you help with a labral tear?
Acupuncture can't repair a torn labrum. Once a physician has diagnosed it, we can help ease the muscle pain and guarding that often build up around the joint, alongside the rehab plan from your doctor or physical therapist.
How many sessions will I need?
It varies. A recent strain often settles faster than outer hip pain you've had for months, since tendons adapt slowly. We'll estimate after your first assessment.
Does needling the hip hurt?
Most people find it very tolerable. Dry needling a deep glute or piriformis can bring a strong ache or a quick muscle twitch that fades in seconds, often followed by a sense of release. Some soreness for a day or two is normal.
Should I stop training?
Usually not completely. We'll help you scale back what flares it, such as hills, sprints or deep squats, and keep what doesn't. Staying active generally helps more than total rest.
Do I need a referral or an X-ray?
No referral is needed to book with us, and most muscle and tendon hip pain doesn't need imaging to start treatment. If we suspect arthritis, a labral tear or a stress fracture, we'll refer you to a physician for an exam and imaging.
Where can I find acupuncture for hip pain in Cow Hollow?
Right here at 2920 Webster Street, between Union and Filbert. Andrew Castellanos treats hip flexor strains, gluteal pain, bursitis and stiff, arthritic hips with acupuncture, dry needling and hands-on work. His years with the San Francisco Ballet and Alonzo King LINES Ballet mean he's used to hips under a lot of strain.
Can I walk to the clinic from the Presidio or Fillmore Street?
You can. We're a short walk from the Presidio and from Fillmore Street, one block north of Union Street. If walking aggravates your hip right now, the 22 Fillmore runs one block west and the 45 Union/Stockton stops on Union Street, one block away.
References
- Park HS, et al. Acupuncture Treatment for Hip Pain: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2023.
- Vickers AJ, et al. Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The Journal of Pain. 2018.
- Brennan KL, et al. Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial. Journal of Orthopaedic & Sports Physical Therapy. 2017.
- Cleveland Clinic. Gluteal Tendinopathy: Symptoms, Causes and Treatment.
- Cleveland Clinic. Hip Labral Tear.
- American Academy of Orthopaedic Surgeons, OrthoInfo. Hip Fractures.
- NHS. Hip Pain in Adults.
Ready to move freely again?
Book an assessment at our Cow Hollow clinic, or call us to talk it through first.
Visit us in Cow Hollow
2920 Webster Street, between Union and Filbert. A short walk from the Marina, Pacific Heights and the Presidio.
Address
Acupuncture for Athletics2920 Webster Street
San Francisco, CA 94123 Gate code: in your booking confirmation email
Hours
- Every day
- 7:30am – 9:00pm