Hip & Thigh

What It Is

Line drawing of the hip bone and the top of the thigh bone, showing the cup-shaped socket in the pelvis and the rounded ball of the thigh bone that fits into it. — Osteoarthritis wears the cartilage lining this ball and socket, which is why some hip movements get stiff and blocked.

Hip osteoarthritis is often called wear and tear arthritis of the hip joint. In osteoarthritis, the smooth protective cartilage on the ends of the bones breaks down, causing pain, swelling and problems moving the joint, and small bony growths can develop around it (NHS, 2023a). Like other joints that carry your weight, the hips are prone to osteoarthritis. The exact cause isn't known, but things that raise your risk include getting older, a previous joint injury, being overweight, a family history of osteoarthritis and being a woman (NHS, 2023a). The glistening and smooth cartilage at the end of the bones that allows the hip joint to glide smoothly may end up wearing thin.

The first sign of osteoarthritis might be some pain and stiffness in the groin or thigh, sometimes spreading to the buttock or knee. Pain and stiffness may be worse in the morning or after sitting or resting for a while (American Academy of Orthopaedic Surgeons, n.d.). Pain often gets worse the more you use the joint (NHS, 2023a).

Hip arthritis sufferers will notice that their hip pain can flare up, or settle down, over any particular week. Symptoms of osteoarthritis can come and go, and they vary a lot from person to person (NHS, 2023a). If you have any pain in the groin or hip, make sure you see me or your family doctor or nurse practitioner, because treatment can help ease the pain and stiffness in the joint.

Some people may notice some pain travelling down the front of the thigh to the knee, and this is referred pain from the hip (American Academy of Orthopaedic Surgeons, n.d.). You may also notice you are having difficulty getting your socks or shoes on in the morning as you gradually lose the ability to bend the hip.

At very late stages, the pain may no longer be relieved by resting. The cartilage may wear away, so that the bones rub against one another, and bony growths form around the joint which make it difficult to move. You can lose the ability to flex, rotate or extend your hip. If you are less active in an attempt to avoid the pain, the muscles that control the joint become weak and you might start limping (American Academy of Orthopaedic Surgeons, n.d.).

Hip Osteoarthritis Anatomy

The hip joint, like the shoulder joint, is a ball and socket joint. It's designed for mobility and stability, so it has a deep socket.

This allows good movement but helps to keep the joint secure. There are plenty of ligaments and muscles around the hip. The main muscles are the gluteal muscles (buttock muscles), the adductors (groin muscles), the quadriceps (front thigh muscles) and the hamstrings (back thigh muscles). The main bone in the hip is the femur, and the ball at the end of the femur is called the femoral head. There is a femoral neck just before the femoral head. The socket is called the acetabulum and is part of the pelvis (American Academy of Orthopaedic Surgeons, n.d.).

It is worth noting the difference between osteoarthritis of the hip and osteoporosis of the hip. The former is degenerative change or wear and tear. The latter is where the hip joint suffers from bone thinning. Osteoporosis leaves patients vulnerable to fracture if they fall.

Walking Stick

Use a walking stick or crutch if your mobility gets too bad, it will help to offload strain on the hip (NICE, 2022). Hold the stick on the opposite side of your body to your painful hip so that it takes some of your weight (NHS, 2023b). I can help you set up a stick and practise walking with it.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Hip Osteoarthritis

Hands-on treatment (manual therapy) is best used alongside an exercise programme rather than on its own (NICE, 2022). I can help with both: strengthening and mobility exercises, hands-on work to ease pain and stiffness, and advice on sleeping, moving and using heat or cold. See the My Approach tab for how I work.

1. Gentle Mobility

The big question is, should you rest or do exercise? The answer is: exercise. Exercise is one of the most important treatments for osteoarthritis, whatever your age or fitness (NHS, 2023b). Lower impact activities such as walking, swimming, water aerobics and cycling put less stress on the hip than high-impact ones like jogging (American Academy of Orthopaedic Surgeons, n.d.). Start slowly and build up your fitness carefully, following the plan I give you, because doing too much too quickly can be harmful (NHS, 2023b). Your hip may ache a little more when you first start exercising. This is normal, and keeping up regular exercise is good for your joints in the long run (NICE, 2022). If the pain is severe or doesn't settle, come back and see me.

2. Hot or Cold Packs

Applying a hot or cold pack to the joint can relieve pain in some people. A hot water bottle filled with either hot or cold water, or a pack that can be heated or cooled, can be used (NHS, 2023b). I can help you work out which suits you best.

3. Pain Relief Medicines

OrthoInfo says anti-inflammatory painkillers (NSAIDs), such as ibuprofen or naproxen, may relieve pain and reduce inflammation from hip osteoarthritis (American Academy of Orthopaedic Surgeons, n.d.). The NHS says a family doctor or nurse practitioner may prescribe an NSAID, and that NSAID tablets are not suitable for everyone, for example some people with asthma, a stomach ulcer, angina, or a past heart attack or stroke (NHS, 2023b). (This medicine information comes from OrthoInfo and the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) Medicines are best used alongside exercise, not instead of it (NICE, 2022).

4. Sleep

Make sure your body is getting an adequate amount of sleep every night. Your body needs time to recover between activities so as to avoid undue stress.

5. Lose Weight

If you are currently overweight, losing any excess weight reduces the stress on the hip joint, which can mean less pain and better function (American Academy of Orthopaedic Surgeons, n.d.; NICE, 2022).

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Prescription anti-inflammatory medicines: a family doctor or nurse practitioner can advise whether an NSAID is suitable for you and may prescribe one (NHS, 2023b).
Steroid injection: an injection into the joint that may be offered when other treatments haven't worked (NHS, 2023b).
Hip replacement: an operation to replace the worn joint with an artificial one, considered when other treatments haven't helped or your daily life is seriously affected (NHS, 2023b).

How I can help (see the My Approach tab)

Exercises to strengthen your hip and keep it moving

Hands-on work to ease pain and stiffness

Help with pacing, walking aids and staying active

Tips

Up to 8.5 million people in the UK are thought to have joint pain that may be caused by osteoarthritis (NICE, 2014).
If you have a family history of the disease, you are at an increased chance of getting the disease (NHS, 2023a).
For those who are overweight, older, or have had injuries to the hip, you are at an increased risk of osteoarthritis (NHS, 2023a).
Even if you have no other risk factors, you can still develop the condition (American Academy of Orthopaedic Surgeons, n.d.).
If you think you may have the condition, make sure to speak with your doctor or with me.

Treatment

My Approach

Hip osteoarthritis is a long-term condition, so I treat it as steady, ongoing care rather than a quick fix. My aim is to ease pain and stiffness, keep your hip moving, and build the strength around it so it supports you better day to day.

I start by assessing how your hip moves, the strength of the muscles around it, and how you walk, get up from a chair and manage stairs. I'll also ask what you're finding hard, such as putting on socks and shoes.

Hands-On Treatment

Relaxing massage around the hip and leg, then work on the muscles crossing the joint and the areas that compensate, like the low back, thigh and other hip
Gentle joint mobilisation and a slow, sustained pull along the leg to help the joint move and feel less compressed, with modest pressure where there are bony changes
Gentle stretching, including contract-relax stretches for tight muscles
Warm applications for a stiff hip, or cool ones if it has flared, and I'll show you how to use heat or cold at home

Exercise

Gentle range-of-motion work and pain-free holds for the hip and buttock muscles, building to sit-to-stands, step-ups, bridges and gym-based work if you lift
Balance work, and low-impact fitness such as walking, swimming or cycling
A home programme you can keep up long term

Day to Day

Pacing your day and balancing activity with rest
Setting up a walking stick for the hand opposite your sore hip, and simple changes at home such as raised seats

Work on the buttock and hip muscles is only with your informed consent and a written consent form, and you can say no at any time. After a hip replacement, I need your surgeon's okay before hands-on treatment. If the pain keeps getting worse or no longer settles with rest, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: This is a long-term condition, so care is ongoing. Most people come weekly at first, sometimes twice a week, with a reassessment at about 4 to 6 weeks, then every few weeks as you take over the home programme. Most people notice less pain and easier movement after 6 to 12 weeks of regular exercise, and keeping it up keeps the benefit going.

What I Focus On

Assessment

Gentle Joint Mobility

Soft Tissue Release

Hip Strength

Pacing & Low-Impact Activity

Sources

References

NHS (2023a) Osteoarthritis. Available at: https://www.nhs.uk/conditions/osteoarthritis/ (Accessed: 7 October 2026).
NHS (2023b) Osteoarthritis – treatment and support. Available at: https://www.nhs.uk/conditions/osteoarthritis/treatment/ (Accessed: 8 October 2026).
American Academy of Orthopaedic Surgeons (n.d.) Hip osteoarthritis. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/osteoarthritis-of-the-hip/ (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (NICE) (2022) Osteoarthritis in over 16s: diagnosis and management (NG226) – Recommendations. Available at: https://www.nice.org.uk/guidance/ng226/chapter/Recommendations (Accessed: 7 October 2026).
National Institute for Health and Care Excellence (NICE) (2014) Total hip replacement and resurfacing arthroplasty for end-stage arthritis of the hip (TA304) – 2 Clinical need and practice. Available at: https://www.nice.org.uk/guidance/TA304/chapter/2-clinical-need-and-practice (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooHip Osteoarthritis

What It Is

Hip Osteoarthritis Anatomy

Walking Stick

Self-Care & Treatment

How to Treat Hip Osteoarthritis

1. Gentle Mobility

2. Hot or Cold Packs

3. Pain Relief Medicines

4. Sleep

5. Lose Weight

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Exercise

Day to Day

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooHip Osteoarthritis

What It Is

Hip Osteoarthritis Anatomy

Walking Stick

Self-Care & Treatment

How to Treat Hip Osteoarthritis

1. Gentle Mobility

2. Hot or Cold Packs

3. Pain Relief Medicines

4. Sleep

5. Lose Weight

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Hands-On Treatment

Exercise

Day to Day

Typical Course

References

Related Conditions

Knee Osteoarthritis

Greater Trochanteric Bursitis

Hip Capsulitis

Book a session