Hip osteoarthritis is a long-term condition where the cartilage and bone in the hip joint change, causing pain, stiffness and reduced movement. It usually develops gradually in people over 45. NICE guidance recommends tailored exercise for everyone with osteoarthritis, with weight loss, medicines and joint replacement as further options.
Also known as hip OA, arthritis of the hip, wear and tear of the hip
Symptoms
- Pain in the groin, front of the thigh or buttock, sometimes felt in the knee
- Pain that is worse with walking, standing or activity
- Stiffness after rest, usually easing within 30 minutes
- Difficulty putting on socks and shoes or getting in and out of a car
- Reduced hip movement, especially turning the leg inwards
- A limp on longer walks
Causes and risk factors
- Increasing age
- Previous hip injury or childhood hip problems
- Hip shape differences, such as hip impingement or dysplasia
- Carrying extra body weight
- Family history of osteoarthritis
- Long-term heavy physical work
What the evidence says helps
- NICE recommends offering tailored therapeutic exercise to everyone with osteoarthritis. This can include strengthening and general fitness work, and supervised sessions can help. Pain may increase a little when starting, but regular exercise is still advised.1
- Research suggests exercise improves pain and function in hip osteoarthritis. The benefits are generally small to moderate and tend to be largest straight after a programme.2
- A large review found exercise gave similar pain relief and function gains to commonly used painkillers such as anti-inflammatories and paracetamol, without their side effects.4
- If you are overweight, NICE advises that any weight loss helps, and losing around 10% of body weight is likely to help more than 5%.1
- Manual therapy (hands-on treatment) may be considered for hip osteoarthritis, but only alongside exercise. Evidence suggests any extra benefit is short-term.15
- NICE suggests medicines are used alongside exercise, at the lowest dose for the shortest time. A steroid injection may give short-term relief of 2 to 10 weeks. Referral for hip replacement can be considered when symptoms seriously affect quality of life and other care has not helped.1
Things you can try at home
- Keep moving: walking, cycling, swimming or water exercise are often well tolerated
- Do simple hip and leg strengthening exercises two or three times a week
- Pace activity: break long walks or jobs into shorter chunks with rests
- Use a walking stick in the opposite hand on bad days if it helps
- Wear comfortable, cushioned shoes for longer walks
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A hot, red, swollen hip with fever or feeling unwell – get same-day medical help or call NHS 111
- Sudden severe hip pain and being unable to stand or walk after a fall – go to A&E or call 999
- Hip pain with unexplained weight loss, night sweats or a history of cancer – see your GP urgently
- Severe pain at night that does not ease with rest or change of position – see your GP
- New numbness or weakness in the leg – see your GP urgently
How Apollo can help
We start with a thorough assessment of your hip, back and walking pattern, and explain what we find in plain language. Your osteopath may use hands-on care alongside a tailored exercise plan, and our supervised clinical exercise sessions can help you build strength and confidence over time. If you are waiting for a hip replacement, we offer prehab and post-operative rehabilitation, and we will refer you back to your GP when further investigation or a surgical opinion is needed.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Will exercise make my hip arthritis worse?
Exercise is not thought to damage an arthritic hip, and NICE recommends it for everyone with osteoarthritis. Some aching when you start is normal and usually settles as you get stronger. Building up gradually helps.
Do I need an X-ray to diagnose hip osteoarthritis?
Not usually. NICE advises that osteoarthritis can be diagnosed without imaging in people aged 45 or over who have activity-related joint pain and little or no morning stiffness. Imaging may be used if the symptoms are unusual or another cause is suspected.
When should I think about a hip replacement?
Referral for surgery can be considered when your hip pain and stiffness seriously affect your quality of life and exercise, weight loss and medicines have not helped enough. NICE advises that decisions should be based on your symptoms and needs rather than on age or a score alone.
References
- National Institute for Health and Care Excellence (2022). Osteoarthritis in over 16s: diagnosis and management (NG226). NICE. View source
- Teirlinck C, et al. (2023). Effect of exercise therapy in patients with hip osteoarthritis: a systematic review and cumulative meta-analysis. Osteoarthritis and Cartilage Open. View source
- Fan Z, Yan L, Liu H, et al. (2023). The prevalence of hip osteoarthritis: a systematic review and meta-analysis. Arthritis Research & Therapy, 25, 51. View source
- Weng Q, et al. (2023). Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trials. British Journal of Sports Medicine. View source
- Runge N, et al. (2022). The benefits of adding manual therapy to exercise therapy for improving pain and function in patients with knee or hip osteoarthritis: a systematic review with meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 52(10), 675–684. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
