Hip Arthritis (Osteoarthritis)


Article by J. MillerS.Armfield

What is Hip Arthritis?

hip arthritis

Hip Arthritis

Hip arthritis commonly describes the most common for of hip arthritis, which is known medically as hip osteoarthritis.

Hip osteoarthritis is a joint disease that mostly affects your hip joint cartilage. Articular cartilage is the hard slippery surface that covers the sections of bones that move against each other in your hip joint. 

Healthy articular cartilage allows your hip joint bones to smoothly and painlessly glide over each other and also helps to absorb any shock forces not dispersed by your hip muscles.

What Causes Hip Arthritis?

In hip osteoarthritis, your top layer of articular cartilage breaks down and wears away. Eventually, your cortical bone that lies under the cartilage rubs together to cause pain, swelling, grating and loss of hip joint motion.

Muscle weakness and the resultant hip joint instability associated is thought to contribute towards the deterioration of your hip joint cartilage. Weaker hip muscles also provide less shock absorption capabilities than their strong counterparts, which increases your hip joint compression forces. Hip osteoarthritis usually happens gradually over time.

Some risk factors that might increase your likelihood of deterioration include:

  • Being overweight.
  • Age.
  • Previous joint injury.
  • Muscle weakness.
  • Stresses on the joints from certain jobs and playing sports.
  • Poor biomechanics.
  • Malformed joints or a genetic defect in your joint cartilage.

Hip osteoarthritis is the most common form of arthritis affecting your hip. Unlike some other forms of arthritis, osteoarthritis affects only joints and not internal organs. It is becoming more common with an ageing population. However, it can also occur in younger people, especially where there is a history of hip injury or heavy work.

Some research suggests that early intervention can delay the onset of the hip arthritis and may reduce the number of cases of hip osteoarthritis. There is not currently a cure for hip osteoarthritis.

What are the Symptoms of Hip Arthritis?

Hip arthritis results in hip pain, joint weakness, joint instability, and restrictions of movement that interfere with your most basic daily tasks such as walking, climbing stairs or driving. 

Your symptoms can develop suddenly or slowly and may include:

  • Hip joint pain or tenderness that comes and goes. Typically there will be sharper pains in the groin, and sometimes an ache in the front of the thigh. Many people present with hip arthritis thinking that it is a knee problem.
  • Hip stiffness, particularly early morning stiffness.
  • Hip joint movement is difficult, especially inward rotation, movement of the leg across the body and hip extension.
  • Weak hip muscles, especially during sit to stand, squatting and stair climbing.
  • Hip joint swelling or deformity can be hard to detect because of the location of the hip joint.

How is Hip Arthritis Diagnosed?

Your initial diagnosis of hip osteoarthritis is usually clinically formed by taking a detailed history of your symptoms and a physical examination looking at the range of movement of your hip joint and any associated pain.

If hip osteoarthritis is suspected, a hip X-ray will assess your hip joint wear and tear, and sometimes a blood test to check for other factors.

hip arthritis

In a small number of cases, a CT scan or MRI may be performed.

For advice specific to your hip, please consult your doctor or physiotherapist.

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Hip Physiotherapy Effectiveness

Does Physiotherapy Help Hip Arthritis?

The short answer is Yes!

Short-Term Benefits

Poulsen et al 2013 compared patient education only, patient education plus manual therapy, and minimal (control) intervention (continue medication usage, minimal education on stretching) groups. At 6 weeks, significant differences were found, favouring patient education plus manual therapy versus the minimal (control) intervention group. At 6 weeks, 76.5% of patients in the education-plus-manual therapy group improved, versus 22.2% in the patient-education group and 12.5% in the control group. 1

Medium-Term Benefits

Fernandes et al 2010 enrolled 109 patients with mild to moderate hip OA and compared patient education versus patient education plus exercise at 16 months. The WOMAC physical function scores had improved significantly for the education-plus-exercise group. Their findings in this study show that participating in a 12-week exercise therapy programme in addition to patient education can reduce the need for THR or postpone surgery in patients with hip OA. This supports the recommendations stating that exercise therapy should be offered to patients with hip OA as first-line treatment. 2 

Long-Term Benefits

Svege et al 2015 conducted a 6-year follow-up study of a previous study of 109 patients in which participants were randomized to 2 groups: exercise plus patient education and patient education only (control group). 

Results showed that people who had exercise therapy were less likely to have a hip replacement. People who had exercise therapy were also able to wait longer before a hip replacement. The average time before having a hip replacement for people in the exercise group was five and a half years, compared with three and a half years for people who had not had exercise therapy. After six years, 22 of the 55 people who’d had exercise therapy had a hip replacement (40%) compared with 31 of the 54 people not in the exercise group (57%).

The people who had exercise therapy also rated their hip function as better.

This means that there is very good scientific support for the use of patient education, manual therapy and exercises prescribed by your physiotherapist assisting your hip osteoarthritis and delaying the need for hip replacement surgery. Please consult your physiotherapist to determine if you are a candidate for hip physiotherapy.

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What’s the Treatment of Hip Arthritis?

PHASE I - Pain Relief & Protection

  • Managing your hip pain. Hip pain is the main reason that you seek treatment for hip arthritis. 
  • Regular application of ice packs is highly recommended to reduce your hip pain.
  • NSAIDs or anti-inflammatory drugs (i.e. ibuprofen). Use of these medications should be discussed with your doctor.
  • Your physiotherapist will use an array of treatment tools to reduce your hip pain and inflammation. These may include ice, electrotherapy, acupuncture, unloading taping techniques, soft tissue massage and temporary use of a mobility aid (eg cane or crutch) to off-load the affected side. 

PHASE II - Restoring Normal Hip ROM, Strength

As your hip pain and inflammation settles, your physiotherapist will turn their attention to restoring your normal hip joint range of motion, muscle length and resting tension, muscle strength and endurance, proprioception, balance and gait (walking pattern).

Hip researchers have discovered the importance of your hip muscle recruitment patterns with a normal order of deep, then intermediate and finally superficial muscle firing patterns in normal pain-free hips. Your physiotherapist will assess your muscle recruitment pattern and prescribe the best exercises for you specific to your needs. 

PhysioWorks has developed a “Hip Core Stabilisation Program” to assist their patients to regain normal hip muscle control. 

Please ask your physio for their advice.

PHASE III - Restoring Full Hip Function

The final stage of your hip arthritis rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their hips that will determine what specific treatment goals you need to achieve. For some people, it may be simply to walk around the block. 

Your physiotherapist will tailor your hip rehabilitation to help you achieve your own functional goals.

PHASE IV - Delaying Hip Surgery

Hip osteoarthritis is a condition that gradually deteriorates even though your pain may come and go in the initial stages.

In addition to your hip muscle control, your physiotherapist will assess your hip biomechanics and start correcting any defects. It may be as simple as providing your will core abdominal exercises or some foot orthotics to address any biomechanical faults in the legs or feet. Your physiotherapist will guide you.

Fine-tuning your hip stability and function by addressing any deficits in core strength and balance, learning self-management techniques and achieving the ultimate goal of safely returning to your previous daily or leisure activities! 

Your aim for any exercise or physiotherapy program is to delay the deterioration of your hip arthritis. Your best chance is to have strong hip muscles and bones performing activities that don’t traumatise your hip joint surfaces.

PHASE V - Hip Surgery

Hip surgery is usually required as your hip joint arthritis deteriorates and your hip joint becomes permanently deformed. The most common surgical procedure for an arthritic hip is a total hip replacement. Your hip surgeon may also recommend arthroscopic surgery or joint resurfacing.

Your prognosis following a total hip replacement is very good. In most cases, you will have no or considerably less pain plus improved hip function.

You will require a post-operative hip strengthening and rehabilitation program to prolong the life of your new hip and resume your most active lifestyle.

For more information about hip surgery, please your physiotherapist or doctor.

What Else Can You Do For Your Hip?

Lose Weight

Lose weight. You won’t just look better, you’ll feel better, too. Why? Every extra kilogram you carry around translates to added stress to your hip joints. Excess weight can mean more hip pain, no matter which form of arthritis you have. 

Ice it!

When your hip joint is hot and inflamed, applying something cold can decrease pain and swelling by constricting blood vessels and preventing fluids from leaking into surrounding tissues. 


Follow your doctor’s advice. Some medications will be designed for pain relief and others to reduce inflammation. Since most hip osteoarthritis sufferers normally have other medications, it is always wise to check with your doctor before changing.

Exercise - Keep Moving

Exercise helps to lessen your hip pain, increase your hip joint range of movement, reduce fatigue and help you feel better overall. 

A well-rounded workout routine for people with hip osteoarthritis includes flexibility exercises to increase your hip joint and muscle range of motion, aerobic exercises to improve your endurance and decrease fatigue, and strengthening exercises to improve your muscle endurance and power.

Your physiotherapist is an expert in the assessment and prescription of hip arthritis exercises. Please ask them what is best for you.

General exercise such as swimming, hydrotherapy, Tai Chi, yoga, pilates, balance and walking programs are excellent if pain-free.

The key is to have a regular daily exercise program. The goal is to keep moving.

Strengthen Your Bones

Ask your doctor to check your bone density. If they are concerned they’ll arrange for a test to check if you have osteoporosis (bone thinning).

Follow their advice or the advice of your dietitian on your Calcium and Vitamin D intake. You need normal levels of both plus some form of weight-bearing exercise to strengthen your bones.

Treat Your Muscles with a Massage!

A quality remedial massage may be just the relief your hip muscles need. Treat yourself to a good rub down with someone you trust. The benefits vary from person to person but may include decreased pain and muscle stiffness associated with your arthritis, increased circulation, and an improvement in your sleep and immune functions. Mentally, massage can also decrease stress and depression. 

Besides all it that, massage just feels good!

For more advice, please ask your physiotherapist, massage therapist or doctor.

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Related Hip Arthritis Conditions

General Information

Hip Joint Pain

Lateral Hip Pain

Adductor-related Groin Pain

Pubic-related Groin Pain

Inguinal-related Groin Pain

  • Inguinal hernia
  • Sportsman's hernia

Iliopsoas-related Groin Pain

  • Hip Flexor Strain

Other Muscle-related Pain

Systemic Diseases

Referred Sources

Hip Surgery

Hip Arthritis Products Available

Arthritis - Hip

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Common Hip Arthritis Treatment Options

  • Early Injury Treatment
  • How to Ease Arthritic Pain
  • Acupuncture and Dry Needling
  • Core Exercises
  • Gait Analysis
  • Biomechanical Analysis
  • Balance Enhancement Exercises
  • Proprioception & Balance Exercises
  • Medications?
  • Orthotics
  • Soft Tissue Massage
  • Brace or Support
  • Dry Needling
  • Electrotherapy & Local Modalities
  • Heat Packs
  • Joint Mobilisation Techniques
  • Kinesiology Tape
  • Neurodynamics
  • Prehabilitation
  • Strength Exercises
  • Stretching Exercises
  • Supportive Taping & Strapping
  • TENS Machine
  • Video Analysis
  • Yoga
  • FAQs about Hip Arthritis

  • Common Physiotherapy Treatment Techniques
  • What is Pain?
  • Physiotherapy & Exercise
  • When Should Diagnostic Tests Be Performed?
  • Massage Styles and their Benefits
  • What Causes Post-Exercise Muscular Pain?
  • Can Kinesiology Taping Reduce Your Swelling and Bruising?
  • Heat Packs. Why Does Heat Feel So Good?
  • How Can You Prevent a Future Leg Injury?
  • How Do You Improve Your Balance?
  • How Much Treatment Will You Need?
  • What are the Common Massage Therapy Techniques?
  • What are the Early Warning Signs of an Injury?
  • What Can You Do To Help Arthritis?
  • What is a TENS Machine?
  • What is Chronic Pain?
  • What is Nerve Pain?
  • What is Osteoarthritis?
  • What's the Benefit of Stretching Exercises?
  • When Can You Return to Sport?
  • Why Kinesiology Tape Helps Reduce Swelling and Bruising Quicker
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    1. Poulsen, E., Hartvigsen, J., Roos, H.W., Poulsen, E.M., Hartvigsen, W., Christensen, S., . . . Overgaard, S. (2013). Patient education with or without manual therapy compared to a control group in patients with osteoarthritis of the hip. A proof-of-principle three-arm parallel group randomized clinical trial. Osteoarthritis and Cartilage, Osteoarthritis and Cartilage, 2013.

    2. Fernandes, Storheim, Sandvik, Nordsletten, & Risberg. (2010). Efficacy of patient education and supervised exercise vs patient education alone in patients with hip osteoarthritis: A single blind randomized clinical trial. Osteoarthritis and Cartilage,18(10), 1237-43.

    3.Svege, I., Nordsletten, L., Fernandes, L., & Risberg, M. (2015). Exercise therapy may postpone total hip replacement surgery in patients with hip osteoarthritis: A long-term follow-up of a randomised trial. Annals of the Rheumatic Diseases, 74(1), 164.

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    Last updated 14-Feb-2019 10:42 AM

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