Hip osteoarthritis

HIP OSTEOARTHRITIS

Hip osteoarthritis is a degenerative joint condition in which the smooth articular cartilage gradually breaks down and the underlying bone remodels, leading to pain, stiffness and reduced movement. People commonly feel pain in the groin, buttock or lateral hip, sometimes radiating down the thigh, along with morning stiffness or stiffness after rest and difficulty with tasks such as putting on shoes and socks, getting out of a chair or walking longer distances.

The condition becomes more frequent with age but can also occur earlier in life, especially in the presence of previous hip injury, hip dysplasia, heavy manual work, high joint demands, increased body weight or a family history of osteoarthritis. Although there is no single cure that fully reverses joint changes, a combination of education, tailored exercise, weight management where appropriate and practical adaptations can significantly help reduce symptoms and support day-to-day function.

Cartilage and bone changes in hip osteoarthritis

In hip osteoarthritis, the articular cartilage covering the femoral head and acetabulum becomes thinner, fissured and less able to provide smooth, low-friction movement. The underlying bone responds by forming osteophytes around the joint margins and areas of subchondral sclerosis, altering joint shape and mechanics. These changes can lead to pain, stiffness, reduced range of motion (especially flexion, internal rotation and extension) and difficulty with activities such as low sitting, twisting, walking on uneven ground or climbing stairs. People often report deep groin pain, lateral hip discomfort or aching into the thigh, which may worsen with prolonged weight-bearing during the day and, in some cases, disturb sleep.

Diagnosis relies on a combination of symptoms, physical examination findings and imaging, usually plain radiographs demonstrating joint-space narrowing, osteophyte formation and bony changes consistent with osteoarthritis. However, radiographic severity does not always match symptom intensity: some individuals with modest changes can have significant pain, while others with more advanced changes remain relatively functional. Overall management is guided by the person’s functional goals, daily limitations and co-existing health conditions, with non-pharmacological strategies – education, exercise and lifestyle adaptations – forming the core of care before any consideration of more invasive options.

Exercise and physiotherapy

For hip osteoarthritis, core non-surgical management is built around education, exercise and practical adaptations to how the joint is used in daily life. Current international guidelines for hip and knee OA emphasise structured exercise (aerobic, strengthening and balance work) and patient education as key components to reduce pain and improve function. A physiotherapy-led programme typically includes targeted strengthening of the gluteal and hip muscles, comfortable range-of-motion exercises and low-impact aerobic activities such as walking, cycling or pool-based exercise, tailored to the person’s symptom level and confidence.

At the same time, everyday strategies are reviewed: optimising chair height to make sit-to-stand easier, using aids where appropriate (for example, a stick on the opposite side, grab rails, long-handled shoehorns), planning rest breaks and pacing more demanding tasks across the day. For those living with overweight or obesity, gradual and safe weight reduction combined with exercise can help decrease stress on the hip joint and support mobility. Physiotherapists can guide you in setting up a home-exercise routine, distinguishing between acceptable exercise-related discomfort and a meaningful flare-up, and progressing towards higher-level activities in a way that builds strength and confidence without overwhelming the joint.

Frequently Asked Questions

Where is hip osteoarthritis pain usually felt?
Pain is often felt deep in the groin, but it can also be felt on the outer hip or radiate towards the thigh or knee.
How does body weight affect hip osteoarthritis?
Extra body weight can place more demand on the joint and worsen symptoms; gradual weight loss, where appropriate, can help ease everyday movement.
Is hip osteoarthritis just “wear and tear” from ageing?
Age is one factor, but previous injuries, hip shape, body weight and occupational or sporting demands also contribute to who develops symptoms.
Can exercise make hip osteoarthritis worse?
Appropriately tailored exercise is regarded as safe and beneficial; the aim is to strengthen and move the joint without sudden, excessive overload.
What types of exercise are usually recommended?
A mix of low-impact aerobic activity (like walking or cycling), strengthening for the hip and gluteal muscles and balance exercises, individually tailored.
How can physiotherapy help in hip OA?
By assessing your needs, providing education, designing personalised exercise, advising on daily activities and, when appropriate, using manual techniques to improve movement and comfort.
Are there simple changes I can make at home?
Yes – for example, using slightly higher chairs, grab rails, planning rests and breaking up more demanding tasks into shorter, manageable blocks.
Is it normal to have good days and bad days?
Yes, symptoms often fluctuate with activity, sleep, stress and other factors a flare does not always mean the joint has suddenly worsened structurally.
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