What is hip osteoarthritis?
In a healthy joint, cartilage forms an elastic, well-lubricated cushion between the bones. In osteoarthritis, explains the Swiss League against Rheumatism, this cartilage gradually breaks down, which can cause pain and limit movement. According to the NHS, osteoarthritis most often affects the knees, hips and small joints of the hands.
Factors mentioned by the League and the NHS include age, family history, excess weight, repeated overload, past injuries or fractures of the joint, and inflammatory rheumatic conditions.
For causes and care options, see our Hip osteoarthritis page and the general Osteoarthritis page. This article focuses on symptoms and everyday life. If it is your knee that bothers you, read Knee osteoarthritis: understanding the pain.
Hip osteoarthritis (coxarthrosis): what are the symptoms?
According to the Swiss League against Rheumatism, the first signs of osteoarthritis are pains that appear when the joint is used under load:
- stiffness at the start of the day;
- fatigue pain, for example after standing for a long time;
- pain on exertion, for example after a hike.
For the hip, the League specifies that the pain is felt in the groin and sometimes spreads to the buttock or the knee. Hip osteoarthritis can make walking and sitting uncomfortable, and simple tasks such as putting on socks or tying shoelaces become harder. Over the years, a difference in leg length can appear.
Groin pain: the hip, the back or something else?
Groin pain is not always osteoarthritis. In a younger or sporty person, it may come from a muscle or tendon; it can also have a digestive, urinary or gynaecological origin.
The back often comes into the question. Pain from the buttock that travels below the knee, with tingling or numbness, points rather to an irritated nerve: read our article on sciatica. Low back pain lasting for months is more a matter of chronic low back pain. Hip and back problems often coexist: a medical examination sorts them out.
According to the UK NICE guideline, from age 45, when pain comes mainly with activity and morning stiffness lasts less than half an hour, a doctor can often diagnose it without an X-ray. Imaging is discussed if there are unusual features or doubt about another cause.
A stiff hip in the morning
The League describes stiffness after a period of rest, on getting up or after sitting for a long time, which eases as you move. A few ideas for the morning:
- start in bed: knees bent, make small leg movements;
- get up without rushing, then walk for a few minutes before sitting down.
Stiffness lasting well over 30 minutes, or warm, swollen joints in several places, does not match what is usually seen in osteoarthritis: NICE and the NHS list prolonged morning stiffness among the signs pointing to another cause, such as inflammatory arthritis. Talk to your doctor.
Hip osteoarthritis: what to do day to day?
The League sums it up: an osteoarthritic joint should be kept moving, but never overloaded. Protecting it too much weakens the nearby muscles that stabilise the hip.
Move regularly. NICE recommends tailored exercise for everyone with osteoarthritis: strengthening the muscles around the joint and general aerobic fitness. The League mentions cycling, swimming, water aerobics and walking on flat ground; in water, the body is supported, which relieves the hips and knees.
Accept some discomfort at first. According to NICE, pain may increase a little at first; regularity brings the benefit.
Weight. For people living with overweight, NICE states that losing weight, even modestly, can improve function and ease pain; it is a goal to build gradually, without pressure.
Everyday movements. A physiotherapist or occupational therapist can show you how to sit, stand up, carry or put on your socks while sparing the hip. For lower-limb osteoarthritis, NICE suggests considering a walking aid such as a stick.
What does the research say?
The NICE NG226 guideline (2022) puts tailored exercise, weight management and information at the heart of care. It suggests manual therapy for the hip and knee only alongside exercise, and advises against routine imaging for follow-up. Medicines are always discussed with your doctor. A joint replacement is discussed when symptoms weigh heavily on quality of life and non-surgical measures are not enough.
Warning signs: when to seek help without waiting
Most hip pain from osteoarthritis develops slowly. The following signs, however, call for prompt or even urgent medical advice:
Seek help immediately (emergency department) if you have:
- a fall followed by hip pain and inability to put weight on the leg;
- a very painful hip with fever or feeling generally unwell;
- groin pain with a painful lump, nausea or vomiting (possible trapped hernia).
See your doctor promptly if:
- the pain gets worse quickly or wakes you at night in an unusual way;
- you lose weight for no reason;
- you have a history of cancer and new or unusual pain: in these people, bone pain should be checked;
- morning stiffness lasts a long time or several joints swell.
In the vast majority of cases, none of these signs is present.
Looking beyond the joint
The first consultation lasts 1.5 to 2 hours (CHF 182). Bring your medical file, your test results (X-rays, MRI, reports) and the list of your medications. We review your situation and build your plan together. Follow-up is then adapted to your progress. We work alongside your GP and the other professionals who care for you, in particular your physiotherapist.
Which approaches can play a part at Centre Algos?
Depending on your situation, several approaches can be combined, alongside medical care and physical activity:
- Naturopathy: diet, weight, sleep and daily rhythm, to work on habits that can influence pain. See also our article on anti-inflammatory diet and osteoarthritis.
- Cupping: applied to the buttock and thigh, it can help release muscle tension around the hip.
- Percutaneous hydrotomy: subcutaneous micro-injections; it can be considered when the situation allows, after assessment, after warning signs have been ruled out and in agreement with your medical care. Price on quotation, set at the first consultation according to your situation.
Everyone responds differently: the aim is to live your days better and stay active, without promising a result.
When to seek help
What is happening in your case
This text gives general pointers. What keeps your hip pain going, in your particular daily life, deserves a real conversation rather than a generic answer.
A question before you decide? Book a free 10-minute call to see whether our approach suits you.
