Hip osteoarthritis
A common cause of activity-related pain, stiffness and reduced hip movement.
Hip Assessment
Hip Pain & Hip Arthritis
Persistent hip pain should be assessed before treatment is chosen. Osteoarthritis is common, but pain around the hip can also come from other joints, tendons, bursae or the lower back.
Diagnosis firstClinical assessment · imaging when useful · treatment matched to the cause
Quick Answer
When should hip pain be assessed?
Consider specialist assessment when pain or stiffness is persistent, worsening, disturbing sleep, limiting walking or affecting work and day-to-day activities.
Hip osteoarthritis often causes
- groin or upper-thigh pain
- stiffness and reduced movement
- difficulty with shoes, socks, stairs or getting in and out of a car
- reduced walking distance and activity
Possible Causes
Hip pain is not always arthritis
A careful history and examination help identify where the symptoms are coming from.
Soft-tissue conditions
Tendon and bursal problems can cause pain around the outside of the hip and may need different treatment.
Referred pain
Symptoms felt around the hip may sometimes come from the lower back or another nearby structure.
How is hip osteoarthritis diagnosed?
NICE advises that osteoarthritis can often be diagnosed clinically in adults aged 45 or over who have activity-related joint pain and either no morning stiffness or morning stiffness lasting no more than 30 minutes. Routine imaging is not always necessary for a typical presentation.
X-rays or other imaging can be useful when symptoms are atypical, another diagnosis is being considered, or surgery is being planned. The severity seen on an X-ray does not always match how much pain or disability a person experiences.
The decision about treatment should not be based on an X-ray alone. Symptoms, examination, general health and what matters to you are all important.
What treatments may be considered?
For hip osteoarthritis, treatment may include education and self-management, tailored exercise, weight management where appropriate, walking aids and medicines where clinically suitable. In some situations, a corticosteroid injection may be considered for short-term symptom relief.
If symptoms remain severe despite appropriate non-surgical treatment, a hip replacement assessment may be appropriate.
When should hip pain be assessed urgently?
Seek urgent medical assessment rather than waiting for a routine private appointment if there is sudden severe pain after injury, inability to bear weight, a hot swollen joint with fever or feeling very unwell, or other rapidly worsening symptoms.
Evidence & Further Reading
UK guidance used for this page
The page is designed to give clear general information and does not replace an individual consultation.
NICE NG226 — Osteoarthritis in over 16s
Clinical diagnosis, core treatment and referral for joint replacement.
View NICE guidance →NHS — Hip replacement
When replacement may be considered, preparation, recovery and complications.
View NHS information →Common Questions
Hip pain FAQs
Do I need an MRI before seeing a hip surgeon?
Usually not. For suspected hip osteoarthritis, the history, examination and plain X-rays are often more useful. Additional imaging is arranged only when it is likely to change diagnosis or treatment.
Does severe arthritis on X-ray mean I need surgery?
No. Surgery is considered when symptoms and loss of function have a substantial effect on quality of life and non-surgical treatment is ineffective or unsuitable.
Can hip pain come from my back?
Yes. Pain around the hip can sometimes be referred from the lumbar spine or other structures, which is why diagnosis comes before treatment.
