How to tell if your dog’s pain is in the hips or knees

When a dog begins to show signs of discomfort or altered movement, one of the most common questions pet owners ask is whether the pain is coming from the hips or the knees.

Determining the exact location of pain can be challenging, especially because dogs cannot communicate their discomfort directly. Instead, they rely on subtle shifts in behavior, posture, and movement patterns, which can offer valuable clues for observant owners and veterinarians.

Hip pain in dogs is often associated with conditions like hip dysplasia, osteoarthritis, or even trauma. Dogs with hip pain may show a reluctance to jump, difficulty rising from a sitting or lying position, or a swaying gait, especially in the hind end.

You may also notice muscle atrophy in the gluteal region or a “bunny hopping” gait when running, where both hind legs move simultaneously. These signs suggest that the dog is compensating for discomfort in the hip joints by altering the way it walks or runs.

On the other hand, knee pain—often linked to cranial cruciate ligament (CCL) injuries or patellar luxation—can manifest a bit differently. A dog with a painful knee may exhibit sudden limping, toe-touching lameness, or avoid bearing full weight on the affected leg. In cases of CCL rupture, it's common for the dog to initially cry out and then start limping severely, often holding the leg completely off the ground.

Unlike hip problems, which tend to progress more gradually, knee issues can have an acute onset, especially after activity.

A careful physical examination by a veterinarian is essential in distinguishing between these possibilities. By performing specific manipulations of the hip and stifle (knee) joints, veterinarians can assess the range of motion, feel for instability, and identify areas that provoke pain. Radiographs are often required to confirm the diagnosis and to assess the severity of joint damage or underlying structural abnormalities.

It’s important to remember that some dogs may have concurrent issues in both the hips and knees, especially as they age or in large-breed dogs that are genetically predisposed to orthopedic problems.

Because of this, a thorough and comprehensive evaluation is always recommended. Prompt recognition of the problem and early intervention can significantly improve your dog’s quality of life, whether through medication, physical therapy, weight management, or surgery.

Understanding where your dog’s pain is coming from is not just about managing symptoms—it's about giving them the best chance at a happy, active life, free from chronic discomfort.

References:

1. Johnston, S. A., & Budsberg, S. C. (1997). Nonsteroidal anti-inflammatory drugs and corticosteroids for the management of canine osteoarthritis: Current status. Journal of the American Veterinary Medical Association, 210(11), 1621–1624.

   
   

2. Vasseur, P. B., et al. (1985). Diagnosis of cranial cruciate ligament rupture in dogs: Comparison of clinical methods. Veterinary Surgery, 14(3), 169–172.

About the autor

Felipe Garofallo is a veterinarian in Brazil, specialized in orthopedic and neurosurgical care for dogs and cats.

He is also the founder of Ortho for Pets – Veterinary Orthopedics and Specialties.