Osteoarthritis of the hip joint occurs when the smooth cartilage that covers the ends of our bones becomes brittle and breaks down. This can in turn cause joint inflammation and the formation of ‘bony spurs’ (outgrowths of bone) as the body tries to repair the damage. Osteoarthritis is not simply ‘wear and tear’ as has previously been thought.

What causes hip osteoarthritis?

The exact cause of hip osteoarthritis is unclear, but some risk factors have been identified. These include:

  • being overweight or obese
  • a family history of osteoarthritis
  • older age – people over 45 are more at risk
  • previous hip joint injury or significant trauma to the joint.

How do I know if I have hip osteoarthritis?

The symptoms of hip osteoarthritis can vary significantly from one person to the next. Some common symptoms include:

  • pain in the groin, buttock or at a point deep between the two
  • hip joint stiffness
  • grinding, rubbing or crunching sensation when moving the hip.

If you are experiencing any of these symptoms it is important that you consult your doctor or physiotherapist. They can diagnose your hip joint pain.

How can physiotherapy help with hip osteoarthritis?

Physiotherapy can help manage your hip osteoarthritis by providing treatments, as well as advice and education that help you manage your condition in the way that best suits you.

Your physiotherapist can assess your hip and identify particular muscles that may be weak. They can teach you specific strengthening exercises for these muscles. Strengthening the muscles around the hip joint will support and protect the joint. You may be given exercises to continue on your own at home, or you could be referred to a group exercise class or a hydrotherapy (water exercise) class. Hands-on techniques such as specific joint mobilisation or massage techniques can also assist with pain reduction. Together with other exercises, these can help you try to maintain as much joint motion as possible.

Your physiotherapist may also assess your balance and gait (the way you walk), and teach you exercises to help you walk well. If needed, they can teach you how to use a walking stick or crutches to help with walking.

Your physiotherapist is the best person to advise you about activities to avoid, sports participation, and techniques you can use to help minimise joint pain. Physiotherapists can also talk to you about managing your weight to minimise the pressure on your joints and, if necessary, can refer you to a dietician.

How effective is physiotherapy for hip osteoarthritis?

There is no cure for hip osteoarthritis but research shows it can often be managed effectively using exercise, weight loss and medications, with no need for surgery in many cases. Your physiotherapist is qualified to help you figure out the best type of exercise to do for your condition. The best available evidence indicates that exercise therapy (whether land-based or water-based) is more effective than no exercise in managing the pain associated with hip osteoarthritis in the short term.

There is some evidence for the benefits of manual therapy for people with hip osteoarthritis. Larger high-quality RCTs (randomised controlled trials) are needed to establish the effectiveness of exercise and manual therapies in the medium and long term.

There is little clear research evidence for other treatments such as TENS, ultrasound, laser or acupuncture for hip osteoarthritis.

What can I do at home?

It is important to maintain your regular exercise and physical activity, as much as your hip symptoms allow. Avoid activities and positions that bring on pain in the hip or that make the pain worse.

It is best to talk to your doctor about which medications are best for you to help manage your symptoms.

Some people find hot or cold therapy (such as a heat pack or ice packs) applied to the hip joint are helpful, but you will need to try a few different things and figure out what works best for you.

How long until I feel better?

Each person with hip osteoarthritis will have different symptoms, and will progress in a different way. It is important not to compare your symptoms to others, and to consult your doctor or physiotherapist about the best way to manage your condition.