Hip Osteoarthritis: Complete Guide to Symptoms, Causes, and Treatment

Key Takeaways

Hip osteoarthritis causes groin pain, stiffness, and difficulty walking that gradually worsens over time
Conservative treatments like physical therapy, medications, and injections can provide significant relief for months or years
Hip replacement surgery is highly successful when conservative treatments no longer work
Staying active with low-impact exercise helps maintain hip function and reduces pain

Hip osteoarthritis affects more than 10% of adults over age 60, making it one of the most common causes of hip pain and disability in older adults. If you’re experiencing deep groin pain, morning stiffness, or difficulty putting on your shoes, you may be dealing with hip arthritis.

This guide explains everything you need to know about hip osteoarthritis—from early symptoms to treatment options that can help you stay active and independent.

What Is Hip Osteoarthritis?

Hip osteoarthritis (OA) is a degenerative joint condition where the protective cartilage cushioning your hip joint gradually breaks down. Think of cartilage as the smooth coating that lets your hip ball glide freely in its socket. As this coating wears away, bone rubs against bone, causing pain, inflammation, and stiffness.

Understanding Your Hip Joint

Your hip is a ball-and-socket joint:

The femoral head (top of your thigh bone) forms the ball
The acetabulum (cup-shaped socket in your pelvis) cradles the ball
Smooth cartilage covers both surfaces, allowing friction-free movement
Synovial fluid lubricates the joint, like oil in an engine

When osteoarthritis develops, this cartilage gradually thins and roughens. Your body tries to compensate by producing extra bone (bone spurs), which can further limit movement and cause pain.

Common Symptoms of Hip Arthritis

Hip osteoarthritis symptoms typically develop slowly over months or years. Many people notice the pain comes and goes at first, then becomes more constant as the condition progresses.

Primary Symptoms

Pain in the groin or front of the hip is the hallmark symptom. The pain often:

Starts as a dull ache after activity
Becomes sharper with prolonged standing or walking
Radiates to the buttock, thigh, or knee
Worsens with weight-bearing activities like climbing stairs

Morning stiffness is another telltale sign. You might notice your hip feels “locked up” when you first wake up or after sitting for a while. This stiffness typically improves within 30 minutes of moving around.

Decreased range of motion makes everyday tasks challenging:

Difficulty putting on socks or shoes
Trouble getting in and out of a car
Problems bending down to pick things up
Reduced ability to spread your legs apart

Walking changes often develop as your hip becomes more painful:

Limping to avoid putting weight on the affected hip
Taking shorter steps
Feeling unstable or off-balance
Needing a cane or walker for support

When Pain Strikes

Hip arthritis pain follows predictable patterns:

Worse with activity: Walking, standing, climbing stairs
Better with rest: Sitting or lying down provides relief
Nighttime pain: Many people experience aching that disrupts sleep, especially when lying on the affected side
Weather sensitivity: Some people report increased pain during cold, damp weather

What Causes Hip Osteoarthritis?

Hip OA develops when the balance between cartilage breakdown and repair tips in the wrong direction. Several factors increase your risk:

Age and Genetics

Age is the biggest risk factor. After age 50, the cartilage’s ability to repair itself slows down while normal wear and tear continues. Most people with hip OA are over 60.

Family history matters. If your parents or siblings had hip arthritis, you’re more likely to develop it too. Researchers have identified specific genes that affect cartilage strength and joint shape.

Previous Hip Injuries

Any injury that damages your hip joint increases arthritis risk:

Hip fractures
Labral tears (cartilage rim tears)
Hip dislocations
Sports injuries

Even injuries from decades ago can lead to arthritis later in life. This is called post-traumatic arthritis.

Hip Structure Problems

Some people are born with hip abnormalities that cause uneven wear on the cartilage:

Hip dysplasia: When the socket doesn’t fully cover the ball
Femoroacetabular impingement (FAI): When extra bone on the hip causes pinching
Leg length differences: When one leg is significantly shorter than the other

Other Risk Factors

Excess weight puts extra stress on your hip joints. For every 10 pounds of excess weight, you add 30-60 pounds of force on your hips with each step.

Repetitive stress from certain occupations or activities can accelerate cartilage breakdown. Jobs requiring heavy lifting, squatting, or prolonged standing increase risk.

Other medical conditions can contribute to hip OA:

Rheumatoid arthritis or other inflammatory conditions
Avascular necrosis (loss of blood supply to the hip bone)
Paget’s disease of bone

How Hip Osteoarthritis Is Diagnosed

Your doctor will use several approaches to diagnose hip OA:

Medical History and Physical Exam

Your doctor will ask about:

When your symptoms started and how they’ve progressed
What activities make your pain better or worse
Previous hip injuries or surgeries
Family history of arthritis

During the physical exam, your doctor will:

Watch how you walk
Check your hip’s range of motion
Look for muscle weakness or leg length differences
Press on areas around your hip to locate tenderness

Imaging Tests

X-rays are the primary tool for diagnosing hip OA. They show:

Joint space narrowing (indicating cartilage loss)
Bone spurs (extra bone growth)
Changes in bone shape
Bone cysts or sclerosis (hardening)

MRI scans aren’t usually needed but may be ordered if:

X-rays look normal but symptoms are severe
Your doctor suspects a different problem (like a labral tear)
Surgery is being considered

Blood tests typically aren’t needed for osteoarthritis diagnosis, but may be done to rule out inflammatory arthritis like rheumatoid arthritis.

Conservative Treatment Options

Most people with hip OA can manage their symptoms effectively without surgery. The key is finding the right combination of treatments for your situation.

Physical Therapy and Exercise

Physical therapy is often the first treatment recommended. A physical therapist can:

Teach you exercises to strengthen hip muscles
Improve your range of motion
Correct walking problems
Show you ways to protect your hip during daily activities

Low-impact exercises are essential for hip health:

Swimming or water aerobics (water supports your weight)
Cycling (stationary bikes work well)
Elliptical machines (less impact than walking)
Tai chi (improves balance and flexibility)

Aim for 30 minutes of gentle movement most days. Contrary to old advice, staying active helps more than rest.

Weight Management

If you’re carrying extra pounds, losing even 10-15 pounds can significantly reduce hip pain. Every pound lost takes 3-6 pounds of pressure off your hip joints with each step.

Medications

Over-the-counter pain relievers help many people:

Acetaminophen (Tylenol) for mild to moderate pain
NSAIDs like ibuprofen (Advil) or naproxen (Aleve) for pain and inflammation

Prescription medications may be needed for severe pain:

Stronger NSAIDs
Topical pain patches
Tramadol for short-term pain relief

Always discuss medication options with your doctor, especially if you have other health conditions or take other medications.

Hip Injections

When oral medications aren’t enough, injections directly into the hip joint can provide relief:

Corticosteroid injections reduce inflammation quickly and can provide relief for several weeks to months. Most doctors limit these to 3-4 per year to avoid potential side effects.

Hyaluronic acid injections work differently by supplementing the joint’s natural lubricating fluid. While FDA-approved for knee osteoarthritis, some doctors use them off-label for hip OA. These injections may provide relief for several months. Learn more about this option in our hyaluronic acid treatment guide.

Assistive Devices

Don’t hesitate to use helpful tools:

A cane (held in the hand opposite your painful hip) reduces joint stress by 20-30%
Shoe inserts or orthotics can improve alignment
Grab bars and raised toilet seats make daily activities easier

When to Consider Hip Replacement Surgery

Hip replacement is one of the most successful surgeries in modern medicine, with satisfaction rates above 95%. Your doctor might recommend surgery when:

Conservative treatments no longer provide adequate relief
Pain significantly limits your daily activities
Your quality of life is seriously affected
Hip damage is severe on X-rays

What to Expect from Hip Replacement

During hip replacement surgery:

The damaged ball and socket are removed
An artificial ball (metal or ceramic) is placed on a stem inserted into your thigh bone
An artificial socket (metal with a plastic or ceramic liner) is secured in your pelvis

Most people:

Stay in the hospital 1-3 days
Start walking with assistance the day of or after surgery
Return to most normal activities within 3-6 months
Experience dramatic pain relief and improved function

Modern hip replacements typically last 15-20 years or longer. Many people say they wish they hadn’t waited so long to have the surgery.

Living Well with Hip Osteoarthritis

Whether you’re managing hip OA conservatively or waiting for surgery, these strategies can help you maintain quality of life:

Stay Active Safely

Choose low-impact activities that don’t aggravate your hip
Break up prolonged sitting with movement breaks
Use proper form during exercise
Listen to your body—some discomfort during activity is normal, but sharp pain is a warning sign

Modify Your Daily Activities

Use a reacher to pick things up from the floor
Sit in higher chairs (adding a cushion helps)
Organize your home to minimize stair climbing
Consider adaptive equipment for dressing and bathing

Heat and Ice Therapy

Apply heat before activities to loosen stiff joints
Use ice after activities to reduce inflammation
Never apply heat or ice directly to skin (wrap in a towel)

Sleep Better

Try different sleeping positions (on your back or non-painful side)
Place a pillow between your knees when side-sleeping
Use a supportive mattress
Take pain medication before bed if recommended by your doctor

Join a Support Group

Connecting with others managing hip arthritis can provide emotional support and practical tips. Look for local arthritis support groups or online communities.

Frequently Asked Questions

Is hip arthritis the same as hip bursitis?

No. Hip bursitis is inflammation of the fluid-filled sacs (bursae) that cushion the outside of your hip. It causes pain on the outer hip and thigh, while hip arthritis typically causes groin pain. You can have both conditions at the same time.

Can I prevent hip osteoarthritis from getting worse?

While you can’t reverse existing cartilage damage, you can slow progression by maintaining a healthy weight, staying active with low-impact exercise, and avoiding activities that stress your hip. Physical therapy and appropriate use of medications and injections also help protect your joint.

How long can I wait before getting hip replacement surgery?

There’s no perfect timing—it depends on your pain level, function, and quality of life. Waiting too long can lead to muscle weakness and walking problems that make recovery harder. However, hip replacements don’t last forever, so if you’re younger, delaying surgery might mean you’ll need a revision surgery later in life. Discuss timing with your orthopedic surgeon.

Will I need hip replacement on both sides?

About 10-20% of people who have one hip replaced eventually need the other hip replaced. If you have arthritis in both hips, your surgeon may recommend spacing the surgeries several months apart or occasionally doing them together.

Are there any supplements that help hip arthritis?

Glucosamine and chondroitin are popular supplements, but research shows mixed results. Some people report relief, while studies show modest benefits at best. Talk with your doctor before starting supplements, especially if you take blood thinners or have shellfish allergies.

Can diet affect hip osteoarthritis?

While no specific diet cures arthritis, anti-inflammatory foods may help reduce pain. Focus on fruits, vegetables, whole grains, fatty fish (rich in omega-3s), and limiting processed foods and added sugars. Maintaining a healthy weight through diet is one of the most effective ways to reduce hip stress.

This article provides educational information and should not replace advice from your healthcare provider. Always consult with a doctor for diagnosis and treatment of hip pain.

Last medically reviewed: March 2025