Hip arthritis (osteoarthritis) means the cartilage lining the ball and socket of your hip has worn thinner, and the joint has become stiffer. It usually causes pain in the GROIN or front of the thigh, and trouble with things like putting on socks or cutting your toenails.
The first treatments are exercise, learning about your hip, and losing weight if you carry extra. They’re recommended for everyone with hip arthritis, at every stage.
Hip replacement is one of the most reliable operations in orthopedics. It makes sense when your hip is limiting your life despite doing the basics WELL, not because of how an X-ray looks.
Symptoms
- Groin pain: the classic spot. It can also be felt in the buttock, the front of the thigh, or even the knee
- Stiffness: first thing in the morning or after sitting, usually easing within half an hour
- Trouble reaching your feet: putting on socks and shoes, cutting toenails, getting in and out of the car
- A limp after walking a while, or pain at the end of a long day
- Pain at night in more advanced arthritis
Pain only on the OUTSIDE of the hip, worse lying on it, is more often a tendon problem than arthritis. See hip bursitis.
Your X-ray isn’t the whole story
- How bad the X-ray looks and how bad the hip feels often don’t match
- Your pain, how far you can walk and what you can do matter more than the picture
- Arthritis doesn’t always get steadily worse. Many people have flares and calmer spells for years
- Exercise won’t wear the joint out faster. Stronger muscles take load off the hip
An arthritic hip still needs moving. Rest makes it stiffer, and strength makes it steadier.
What helps
- A structured exercise and education program: group programs run by physios, such as GLA:D, teach you about arthritis and build strength and control over several weeks. This is the core treatment
- Strengthening: the buttock and thigh muscles especially. Bridges, sit-to-stands, step-ups and side-lying leg lifts, two to three times a week
- Keeping the hip moving: gentle range-of-motion work, cycling and swimming or water exercise help stiffness
- Staying active: walking in shorter, more frequent bouts. Some ache during activity is fine if it settles within a day
- Weight loss, if needed: less weight means less load on the hip with every step, and it helps pain and function
- Pain relief: anti-inflammatory tablets can help in flares. Ask your doctor what suits you, especially if you have stomach, kidney or heart problems
- A cane in the OPPOSITE hand: hold it on the side of your good hip. It takes load off the sore one
- Practical aids: a sock aid, long-handled shoehorn, raised toilet seat and firm, higher chairs make daily life easier
Injections
- A cortisone shot into the hip can calm a bad flare. The relief is short-term, usually weeks rather than months. See how long a cortisone shot lasts
- If surgery is coming, surgeons usually want a gap of a few months between an injection and a hip replacement. Ask yours before having one
- Gel (hyaluronic acid) and PRP injections aren’t routinely recommended for hip arthritis
What doesn’t help much
- Keyhole hip surgery (arthroscopy) for arthritis: people with arthritis tend to do poorly, and many need a replacement soon after. See hip labral tear
- Complete rest: weakens the muscles and makes the hip stiffer
- Glucosamine and similar supplements: little benefit in good-quality trials
When to consider hip replacement
- Pain is limiting your daily life, sleep or work despite a proper go at exercise, weight management and pain relief
- Your world is shrinking: you’re turning down walks, trips or time with family because of your hip
- Night pain is regularly waking you
- There’s no “right” X-ray or age. It’s your decision, with your surgeon, based on how much the hip costs you
- Getting stronger beforehand makes the early weeks after surgery easier
If you’re having one, see hip replacement recovery week by week and hip replacement precautions.
Get seen today if
- You fell and can’t put weight on the leg, or it looks shorter or turned out. It could be a fracture
- The hip is suddenly very painful, hot or swollen and you have a fever or feel unwell
- Your calf is swollen, warm or painful
Get it checked if
- Pain is getting quickly worse over weeks, not months
- Pain is keeping you awake most nights
- You have unexplained weight loss, night sweats or a history of cancer
- You’ve done 12 weeks of exercise with no change
Strengthen first, and let the life you’re missing decide when it’s time for a new hip.