Hip Osteoarthritis: Symptoms, Exercises and Treatment

01Definition

What hip osteoarthritis is

The hip is a ball-and-socket joint: the ball at the top of the thigh bone fits into a socket in the pelvis, and both surfaces are covered with smooth cartilage. Gateshead Health explains that joints go through a normal cycle of wear and repair; when repair changes the shape and structure of a joint, it is called osteoarthritis. NHS inform explains that part of the cartilage thins and the surface becomes rougher, so the joint does not move as smoothly.

Gateshead Health notes that osteoarthritis is the most common form of arthritis and the hip is the second most commonly affected joint. It is different from inflammatory types of arthritis, which have other causes and treatments.

02Symptoms

Symptoms: groin pain, stiffness, limping

NHS inform lists symptoms that vary from person to person:

• pain in or around the hip, groin, buttock or front of the thigh, often worse with movement or activity
• stiffness, often in the morning or after resting
• locking, sticking or grinding of the hip
• weakness in the buttock muscles
• difficulty walking, using stairs, getting up from a chair or getting out of a car

Gateshead Health adds that pain usually comes on gradually over months or years, can come and go and may be felt down to the knee or even the ankle (referred pain). Bending down and putting on shoes can become difficult. See also our guide to hip pain when walking.

03Causes

Risk factors

NHS inform explains that the exact cause is unknown and that a combination of factors probably contributes. The likelihood increases with normal age-related changes, a previous injury to the hip, repetitive activities and physical jobs, inherited genetics and being overweight.

Gateshead Health explains that excess weight increases strain on the hips and knees, making osteoarthritis more likely and more likely to get worse over time.

04Diagnosis

Diagnosis

NHS inform explains that diagnosis needs an assessment by a health professional, who asks about your symptoms and examines the hip, checking range of movement and strength. An X-ray is sometimes used to help, and further examination may be needed to rule out other conditions.

Other conditions can also cause hip pain. Our guides to hip bursitis and hip pain while sleeping explain some of them.

05Expectations

Why X-rays and pain do not always match

NHS inform notes that some people have significant changes on an X-ray with mild symptoms, while others have severe symptoms with little change. In both cases, treatment starts with the same approach: keeping the joint moving.

Gateshead Health adds that many people with osteoarthritis have no symptoms, and that a diagnosis does not mean the condition will get worse, because there are things you can do to manage it. It also notes that osteoarthritis can affect mood, sleep and relationships, and that it is worth talking to your doctor about this.

06Exercise

Exercise and physiotherapy

Gateshead Health explains that exercise should be a core part of treatment whatever your fitness level. It recommends a combination of:

• aerobic exercise, such as walking, cycling, seated pedalling or swimming, aiming for 2 hours 30 minutes a week spread over several days
• strengthening exercise for the muscles that control and protect the hip, at least two days a week
• range-of-movement exercise, such as gentle stretching

Start slowly, build up gradually and keep going even when you feel better, because stopping may bring symptoms back. Low-impact exercise such as swimming, cycling and water-based exercise reduces strain on the hip. NHS inform adds that strengthening the hip muscles helps manage symptoms. Our guide to hip mobility exercises has more ideas to discuss with your physiotherapist.

07Daily life

Weight, walking aids and daily adaptations

Gateshead Health notes that losing weight if you are overweight can really help reduce pain; there is no special diet for osteoarthritis, but a balanced, reduced-calorie diet with regular exercise is advised. Both sources recommend supportive footwear with cushioned soles, avoiding high heels, avoiding low seating and long periods in one position, and pacing activities through the day.

A walking stick may help; hold it on the opposite side to the painful hip. Use a handrail on stairs, going up with the good leg first and down with the affected leg first. Gateshead Health suggests chairs high enough for the hip to be slightly above the knee, and an occupational therapist can advise on aids such as sock aids.

08Medicines

Medicines and pain relief

NHS inform explains that pain medication can help you move more comfortably. Gateshead Health notes that simple over-the-counter pain relief may help, that your doctor may prescribe stronger pain relief if needed, and that a short course of anti-inflammatories can reduce pain and swelling but is not suitable for everyone: ask a pharmacist or GP first.

The sources reviewed do not cover joint injections. Medicines work best combined with staying active and reducing strain on the hip; they do not replace exercise.

09Sources

Where the sources differ

NHS inform (July 2026) is a brief self-management guide: it says surgery may be needed in some cases when all other treatments have been tried, and that maintaining movement while waiting for surgery helps recovery. It advises seeing a professional if symptoms do not improve within 6 weeks. Gateshead Health (May 2024, review date April 2026, now overdue) goes into more detail on exercise, weight, pacing, mood and sleep, but does not describe surgery.

Neither source gives a fixed duration for flare-ups or a list of forbidden activities. For more on recovery after surgery, see our guide to hip replacement recovery. For adults, our physiotherapy practice in Bilbao can design an exercise and load-management plan (consultations are in Spanish).

10Summary

In summary

Hip osteoarthritis causes groin, buttock or thigh pain and stiffness, and makes walking, stairs and chairs harder. There is no cure, but exercise, weight management, pacing, footwear, walking aids and pain relief often control symptoms. Surgery is considered when other treatments have been tried.

A pain-activity diary helps adjust exercise with your physiotherapist. Each day, note the activity or exercise, how long you did it, your pain from 0 to 10 before, straight after and the next morning, and your stiffness. Gateshead Health warns against the “boom and bust” pattern of doing too much on good days; the diary helps find a steady level you can build on.