Hip & pelvis
Hip Osteoarthritis
Hip osteoarthritis is age-related wear of the hip joint, causing groin pain and stiffness. Most common over 50 and manageable with exercise and hands-on care.
Common symptoms
- Deep ache in the groin, sometimes spreading to the front of the thigh or knee
- Stiffness after sitting or first thing in the morning, easing within 30 minutes
- Difficulty putting on socks and shoes or getting in and out of a car
- Reduced walking distance, with pain building as you go
- A limp or a feeling that the hip is 'catching'
- Pain at night when lying on the affected side
Overview
The hip is a ball-and-socket joint lined with smooth cartilage that lets the thigh bone glide within the pelvis. In osteoarthritis (OA), that cartilage gradually thins and roughens, the bone underneath responds by thickening, and the joint capsule becomes tight. The result is a deep ache in the groin or front of the thigh, stiffness after sitting, and a hip that no longer moves as freely as it did.
Hip OA is common from the fifties onwards and becomes more so with age, although it can appear earlier in people with a previous hip injury, hip dysplasia or femoroacetabular impingement. It is a long-term condition, but it does not follow a straight downhill path: many people have long stable periods, and symptoms often fluctuate with activity levels, weight and general fitness.
Importantly, the amount of wear seen on an X-ray does not predict how much pain someone has. Strong muscles, a mobile joint and a good understanding of the condition make a real difference to day-to-day function, and NICE guidance places exercise and education at the centre of OA care.
Causes and risk factors
- Age — cartilage wear accumulates over decades
- Previous hip injury, fracture or surgery
- Hip shape differences such as dysplasia or impingement (FAI)
- Being overweight, which increases joint load with every step
- Heavy manual work or long-term high-impact sport
- A family history of osteoarthritis
- Being female, particularly after the menopause
How we may be able to help
Your assessment looks at how your hip moves, which movements reproduce your pain, the strength of your gluteal and thigh muscles, your walking pattern, and your lower back — since back and hip problems often overlap. We will explain what OA means for you and set realistic goals, whether that is walking further, climbing stairs comfortably or returning to a favourite activity.
Our physiotherapists use manual therapy and joint mobilisation to ease stiffness and capsule tightness, which many people find reduces pain in the short term. The lasting benefit comes from a structured strengthening programme for the hips and legs, built up gradually and tailored to your current level. Our chiropractor can also mobilise the hip and the lumbar spine where stiffness there is adding to your load.
Interferential therapy may be used as an adjunct for pain during flare-ups. A 3D posture scan can show pelvic tilt and leg alignment, which helps target your exercises. If pain is limiting you despite good conservative care, an online private GP consultation can be arranged to discuss medication, imaging or a referral for a specialist opinion.
What you can do at home
- Keep active: walking, cycling and swimming are well tolerated and help the joint
- Strengthen your glutes and thighs with sit-to-stands, bridges and step-ups
- Work towards a healthy weight — even modest loss reduces hip load noticeably
- Use heat for stiffness and ice for 10–15 minutes after activities that flare the joint
- Avoid long periods of sitting; stand and move every 30 minutes
- Pace activity: spread tasks through the week rather than one big day
When to seek urgent help
If you have any of the following, call us straight away for an urgent same-day appointment — we can examine you and arrange fast-track X-ray or MRI through our imaging partner. If you cannot reach us, go to A&E. For loss of bladder or bowel control, numbness around the groin, chest pain, a sudden severe headache or rapidly worsening weakness, call 999 or go to A&E immediately:
- Sudden severe hip pain after a fall with inability to bear weight — possible fracture, go to A&E
- A hot, swollen, very painful hip with fever or feeling unwell
- Hip pain with unexplained weight loss, night sweats or a history of cancer
- Rapidly worsening pain and loss of movement over days rather than months
Frequently asked questions
Do I need an X-ray to confirm hip arthritis?
Often the diagnosis can be made from your history and examination. An X-ray is useful if the picture is unclear or if a specialist opinion is being considered. We can arrange a private GP referral if imaging is appropriate.
Will exercise wear the joint out faster?
No. Evidence consistently shows that appropriate exercise reduces pain and improves function in hip OA. Strong muscles absorb load and protect the joint. We tailor the programme so it challenges you without flaring the hip.
Will I need a hip replacement?
Many people with hip OA never need one. Surgery is generally considered when pain significantly limits daily life and sleep despite a good trial of exercise, weight management and other conservative care. If that point comes, we can help you prepare for and recover from surgery.
Can I still run or play sport?
Often yes, with sensible adjustments. Lower-impact options and gradual loading tend to be better tolerated. We help you find the balance between staying active and not overloading the joint.
This page is general information, not a diagnosis. A clinician will assess you before recommending any treatment. Outcomes vary from person to person. Written with reference to NHS and other peer-reviewed guidance.
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