Written and reviewed by the BPR clinical team. Last reviewed: 30 July 2026. This article is for education and is not a substitute for individual assessment, diagnosis or treatment by a qualified healthcare professional.
Hip osteoarthritis tends to announce itself in small, frustrating ways — an ache in the groin, stiffness getting out of a chair, a struggle to put on socks or shoes. And, like knee osteoarthritis, it comes with a lot of gloomy messaging about joints “wearing out.” The honest picture is more balanced: there's no cure, but there's a lot you can do, and staying active remains central.
What is it?
Osteoarthritis (OA) is a change affecting the whole joint — the cartilage, the bone beneath it and the surrounding tissues — as the joint tries to adapt and repair. It becomes more common with age, and the hip is one of the joints it affects most. As with the knee, what shows on a scan often doesn't match a person's pain, so it's diagnosed mainly from your symptoms and examination rather than an X-ray (NICE, 2022).
Why does it happen?
Age, previous hip injuries, the shape of your hip joint, genetics and body weight all contribute. It's rarely a single cause. And it's worth saying clearly: normal activity and exercise don't “wear out” the joint — keeping the muscles around the hip strong actually helps.
What does it feel like?
Hip OA usually causes pain felt in the groin, and sometimes the outer hip, buttock or thigh. There's stiffness after rest or first thing in the morning, and a gradual loss of movement — turning the hip in and out often becomes limited. Everyday tasks like walking distances, stairs and reaching your feet become harder, and most people have better and worse spells.
How it's assessed
We'll ask how the hip affects your daily life, then examine how it moves — loss of internal rotation is a common finding — and check the surrounding muscles and your walking. In a typical presentation, scans usually aren't needed to make the diagnosis (NICE, 2022).
What the evidence says
- Exercise is recommended as core treatment. National and international guidelines recommend therapeutic exercise and education for everyone with OA, ahead of injections or surgery (NICE, 2022).
- For the hip specifically, the effect on pain is modest. The most recent Cochrane review found that exercise probably improves hip pain and function, though the size of that benefit may be small (Hall et al., 2026). We share this honestly — it doesn't mean exercise isn't worthwhile.
- Education plus exercise has wider benefits. Structured programmes reduce painkiller use and the perceived need for surgery, and keep you strong, mobile and independent (Skou and Roos, 2017).
How it's treated
The sensible first step, recommended by guidelines, is a combination of exercise and education (NICE, 2022): strengthening the muscles around the hip, keeping the joint moving, and building general fitness. If extra weight is loading the joint, gradual weight management helps. Pain relief and a walking aid can support you through flare-ups.
When symptoms are advanced and a good course of conservative care hasn't given enough relief, a hip replacement is a highly effective operation — but it sits at the end of the ladder, not the start. The aim throughout is to keep you active and comfortable for as long as possible.
What you can do yourself
Keep moving with hip-friendly activities such as walking, cycling and swimming, and strengthen the muscles around the hip and thigh. Pace your activities across the day, manage your weight if relevant, and don't fall into the trap of resting the hip into weakness. Flare-ups are normal — ease off briefly, then return.
When to seek help
When to seek help. Seek prompt review if the hip suddenly becomes hot, red and swollen, if you can't bear weight after an injury, or if you have hip pain with unexplained weight loss, fever or feeling generally unwell. Otherwise, see a clinician if hip pain is limiting your daily life or not responding to activity and self-care.
Frequently asked questions
Is walking bad for hip arthritis?
No — walking is one of the better things you can do. Build up gradually; a little discomfort that settles afterwards is fine.
Will I definitely need a hip replacement?
No. Many people manage well for years with exercise, weight management and pain relief. Replacement is considered only when conservative care no longer controls symptoms.
Do I need a scan?
Usually not. Guidelines advise diagnosing hip OA from your symptoms and examination, as scan changes are common even in pain-free hips (NICE, 2022).
Will exercise wear my hip out faster?
No. Appropriate exercise strengthens the muscles that support the joint and helps symptoms; it doesn't accelerate 'wear.'
What kind of exercise is best?
A mix of strengthening for the hip and thigh, plus low-impact aerobic exercise you enjoy and will keep doing. A clinician can tailor this to you.
How BPR can help
At BPR we'll confirm the diagnosis without unnecessary scans, give you a straight and balanced picture of what helps, and build a strengthening plan that keeps you moving comfortably. You can book an assessment at bpr.rehab.
References
- National Institute for Health and Care Excellence (NICE) (2022) Osteoarthritis in over 16s: diagnosis and management. NICE guideline [NG226]. Available at: https://www.nice.org.uk/guidance/ng226 (Accessed: 30 July 2026).
- Hall, M., Dobson, F., Van der Esch, M. et al. (2026) 'Exercise for osteoarthritis of the hip', Cochrane Database of Systematic Reviews, CD007912.pub3. doi:10.1002/14651858.CD007912.pub3.
- Skou, S.T. and Roos, E.M. (2017) 'Good Life with osteoArthritis in Denmark (GLA:D): evidence-based education and supervised neuromuscular exercise delivered to 1845 patients with knee and hip osteoarthritis', BMC Musculoskeletal Disorders, 18, 72. doi:10.1186/s12891-017-1439-y.