Overview

Hip osteoarthritis (OA) is the gradual wearing of the smooth cartilage that covers the bones inside the hip joint. It is sometimes called "wear-and-tear arthritis," and it is one of the most common causes of hip pain in adults over 50, though it can start earlier.

As cartilage thins, the joint space narrows and the bones can develop spurs. The good news is that osteoarthritis does not have to mean a steady decline: exercise, weight management and activity adjustment are core treatment, and most people manage well for years without surgery.

Typical Pattern

Pain in the groin — the most common location — sometimes spreading to the thigh, buttock or knee
Stiffness in the morning or after sitting for a while, usually easing within about 30 minutes of moving
Pain with walking, stairs, getting up from a chair or bending to tie shoes
Aching after vigorous activity, and sometimes at night
Grinding or catching sensations with movement
Difficulty with activities that require rotating the hip, like putting on socks

Why It Develops

Risk factors include:

Increasing age
Family history of osteoarthritis
Previous injury to the hip
Excess body weight, which adds load to the joint
Hip shape differences, such as developmental dysplasia or femoroacetabular impingement

Some people develop OA without any of these factors. The process is gradual, and pain can come on slowly or suddenly after a period of increased activity.

How It Is Diagnosed

A clinician talks with you about symptoms, examines the hip and usually orders X-rays, which can show joint-space narrowing, bone changes and spurs. MRI or CT are used less often, when soft-tissue problems or other diagnoses need to be ruled out.

The degree of arthritis on X-ray does not always match the amount of pain someone feels, which is why symptoms and function guide treatment.

Treatment

Core treatment: exercise and activity

Exercise is a strongly recommended part of hip OA care. The goal is to strengthen the muscles around the hip, keep the joint moving and maintain function. Low-impact options — walking, cycling, swimming and water exercise — are often well tolerated, and strengthening exercises for the glutes and hip muscles help support the joint.

Other first-line options

Weight management: losing weight reduces load through the hip and can meaningfully reduce pain
Activity adjustment: switch high-impact activities to lower-impact ones; modify aggravating movements like stairs where helpful
Pain relief: medications such as acetaminophen or anti-inflammatories if appropriate for you, and topical options
Walking aids: a cane (held in the opposite hand) or other support can reduce hip load when walking is painful
Education: understanding that activity is safe and that some discomfort with exercise is normal

When surgery is considered

Joint replacement is considered when pain is disabling, sleep is disturbed and nonsurgical treatment is no longer helping. Hip replacement reliably relieves pain and restores function for most people. It is a major decision made with your surgeon, not a first or automatic step.

When to Get Assessed

Hip pain that is not improving despite sensible self-care
Pain limiting daily activities, sleep or your ability to work
Difficulty bearing weight or a change in the way you walk
A hip that suddenly becomes hot, red or severely swollen — needs prompt assessment
Pain after a fall, especially with inability to bear weight

References

AAOS OrthoInfo. "Osteoarthritis of the Hip." https://www.orthoinfo.org/diseases--conditions/osteoarthritis-of-the-hip/
Journal of Orthopaedic & Sports Physical Therapy. "Hip Pain and Mobility Deficits—Hip Osteoarthritis: Revision 2025 Clinical Practice Guideline." https://www.jospt.org/doi/full/10.2519/jospt.2025.0301
Merck Manual. "Osteoarthritis (OA)." https://www.merckmanuals.com/home/bone-joint-and-muscle-disorders/joint-disorders/osteoarthritis-oa

This information is for education only and is not a medical diagnosis. InjuryAtlas does not replace an assessment by a qualified health professional. If you have severe pain, visible deformity, numbness, loss of function, or symptoms that are getting worse, seek medical care promptly.

Hip Osteoarthritis