Hip arthritis without surgery: how to build a useful plan

Confirm what is driving the hip pain

Groin pain, stiffness and difficulty walking can fit hip osteoarthritis, but the consultation should still connect the history, examination and any images. Ask whether a tendon, the back or another problem may be contributing. Not every pain around the hip comes from the same structure.

Bring a few concrete examples: putting on socks, walking a usual route or getting out of a car. Describe the activities that remain comfortable as well. This helps the clinician understand what a successful nonsurgical plan would need to change.

Sources: AAOS OrthoInfo: Hip Osteoarthritis

Make exercise a treatment you can sustain

A useful exercise plan is tailored to your strength, motion, fitness and symptom tolerance. NICE recommends therapeutic exercise as a core part of osteoarthritis care. Ask how to begin, what to do during a flare and when the program should progress or be adjusted.

If an earlier program was too painful, bring it to the appointment. The response may help identify a better starting level or a different activity. Ask how the team will balance strengthening with work, family responsibilities and the activity you want to keep doing.

Sources: NICE NG226: Osteoarthritis in Over 16s—Recommendations

Ask about small changes that protect your day

Footwear, a walking aid or changes to the way you tackle difficult activities may make daily life easier. Ask whether a cane or other device would be useful and have someone show you how to use it. These are tools for maintaining independence, not a judgment about age or ability.

Talk about the practical obstacle: a long grocery trip, a steep driveway or standing through dinner preparation. A specific problem is easier to solve than the vague instruction to “avoid overdoing it.” Bring home and work constraints into the plan.

Sources: AAOS OrthoInfo: Hip Osteoarthritis

Give medications and injections clear boundaries

Ask what a medication or injection is expected to improve, how long benefit may last and what side effects matter with your health history. Include kidney or stomach problems, blood thinners and prescriptions from other clinicians in that discussion. Do not assume an over-the-counter option is suitable for everyone.

Temporary symptom relief can be useful, but it should not be confused with regrowing an arthritic joint. If a regenerative treatment is proposed, ask about evidence for hip osteoarthritis specifically, costs, uncertainty and whether it changes later options.

Sources: AAHKS: Relieving Hip Pain Without Surgery

Agree on the point for reconsidering surgery

You do not have to decide on replacement at the first conversation. Ask how the team will judge whether nonsurgical care is helping enough and when to reassess. Worsening sleep, declining walking tolerance or loss of independence may be more meaningful than a single pain score.

If symptoms substantially affect quality of life despite appropriate care, a replacement discussion may become useful. Ask what you can continue safely while considering that choice. A clear review plan lets you pursue conservative care with purpose rather than feeling that you are only postponing an inevitable decision.

Sources: NICE NG226: Osteoarthritis in Over 16s—Recommendations

Explore our hip and joint team

Our team includes Dr. Andrew Wassef, Dr. Prem Ramkumar and Dr. Christopher Combs, whose practices cover hip and joint care, including replacement when appropriate. Their provider pages offer more about their individual focus. Patient experiences below can help you learn about communication and support before a conversation about the options that fit your symptoms and priorities.

Know which injection evidence fits hip osteoarthritis

The AAOS hip osteoarthritis guideline supports physical therapy as an option for mild to moderate symptoms and describes corticosteroid injections as an option for short-term relief. Its patient summary does not recommend hyaluronic acid injections for hip arthritis because benefit over placebo has not been demonstrated.

If an injection is proposed, ask about the specific product and the expected duration and purpose of relief. Clarify how it will support daily activity or rehabilitation and what the next step would be if it does not help. Discuss relevant risks and costs before treating an injection as an inevitable part of care.

Sources: Management of Osteoarthritis of the Hip

Make maintaining activity a goal you can recognize

HSS describes how hip pain can reduce activity, while reduced activity can weaken the muscles that help control the joint. A nonsurgical plan should therefore explain how you can remain active within a tolerable, individualized program, rather than leaving you uncertain about every movement.

Choose an everyday goal to discuss, such as putting on socks, walking to a nearby shop or finishing a work shift. Ask how the therapist will choose a starting level and adjust it if symptoms increase. Reassess both comfort and function at follow-up; less activity alone can make pain look better without restoring the life you want.

Sources: Hip Arthritis

Sources & further reading

• AAOS OrthoInfo: Hip Osteoarthritis
• AAHKS: Relieving Hip Pain Without Surgery
• NICE NG226: Osteoarthritis in Over 16s—Recommendations
• Management of Osteoarthritis of the HipAmerican Academy of Orthopaedic Surgeons · Published December 1, 2023
• Hip ArthritisHospital for Special Surgery

We use these medical sources to help explain your options and prepare you for a conversation with our team. Our guides feature our own clinicians; patient reviews describe individual experiences.

Read as Markdown