Hip Arthritis

A degenerative joint condition that may cause pain, stiffness, and reduced mobility

Hip arthritis is a progressive condition that affects the smooth cartilage lining of the hip joint, leading to inflammation, joint damage, and discomfort during movement. As the cartilage wears away over time, the bones may begin to rub together, causing pain, stiffness, and reduced range of motion. This condition can have a significant impact on your ability to walk, exercise, work, or enjoy everyday activities. While hip arthritis is often associated with ageing, it can also affect younger people due to injury, joint abnormalities, or underlying health conditions.

Dr George Awwad provides comprehensive assessment and care for patients living with hip arthritis, offering a wide range of non-surgical and surgical treatment options tailored to your lifestyle and needs. This page explains what hip arthritis is, common symptoms to look out for, and how it may be managed.

What causes hip arthritis?

Hip arthritis occurs when the cartilage that lines the hip joint gradually wears away or becomes damaged. This protective cartilage allows the ball-and-socket joint of the hip to move smoothly. When it breaks down, the bones can rub together, leading to pain, stiffness, and inflammation. Several factors may contribute to the development of hip arthritis:

Age-related joint wear (Osteoarthritis)

Osteoarthritis is the most common cause of hip arthritis and is often associated with ageing. Over time, the cartilage in the hip joint may naturally degenerate due to years of repetitive use, leading to joint changes that cause discomfort and reduced mobility.

Previous hip injury or trauma

Fractures, dislocations, or other traumatic injuries to the hip can damage the joint surfaces. Even if treated, these injuries may increase the likelihood of developing post-traumatic arthritis years later.

Structural abnormalities (Hip dysplasia or impingement)

Some people are born with differences in the shape of their hip joint. Conditions like hip dysplasia or femoroacetabular impingement (FAI) can cause uneven loading or restricted motion in the joint, accelerating cartilage wear and increasing the risk of early arthritis.

Inflammatory conditions

Autoimmune conditions such as rheumatoid arthritis or psoriatic arthritis can cause chronic inflammation in the hip joint, leading to cartilage breakdown over time. These conditions may affect multiple joints and often require medical management.

Genetic factors

A family history of osteoarthritis or other forms of arthritis can increase your risk. Certain inherited traits may influence how your joints are shaped or how your cartilage responds to stress and wear.

Obesity and joint load

Carrying excess body weight places greater stress on the hip joints. Over time, this added pressure may contribute to faster cartilage breakdown and increase the risk of arthritis.

Lifestyle and activity level

Physically demanding occupations or high-impact sports may accelerate joint wear, particularly if performed repetitively over many years. On the other hand, a sedentary lifestyle can also negatively affect joint health by reducing muscle support around the hip.

Types of hip arthritis

Several types of arthritis can affect the hip joint. While osteoarthritis is the most common form, other types may also lead to joint degeneration, inflammation, and pain. Understanding the specific type of arthritis can help guide treatment decisions and long-term management.

Osteoarthritis (OA)

Osteoarthritis is a degenerative condition where the cartilage in the hip joint gradually wears down over time. It is most commonly associated with ageing but can also be linked to joint overuse, previous injuries, or structural abnormalities. As the protective cartilage deteriorates, bone-on-bone contact can occur, causing pain, stiffness, and reduced range of motion.

Rheumatoid arthritis (RA)

Rheumatoid arthritis is an autoimmune condition in which the body’s immune system mistakenly attacks the joint lining (synovium), leading to chronic inflammation. Over time, this inflammation can damage cartilage and bone within the hip joint. RA usually affects both hips and may be associated with fatigue, morning stiffness, and other systemic symptoms.

Post-traumatic arthritis

This form of arthritis can develop after an injury to the hip, such as a fracture, dislocation, or severe sprain. Even when initial injuries are treated effectively, damage to the cartilage or bone can accelerate joint wear and lead to arthritic changes over time.

Psoriatic arthritis

This inflammatory arthritis occurs in some people with the skin condition psoriasis. It may affect one or both hips and often involves other joints, as well as tendons and ligaments. Psoriatic arthritis can lead to both joint pain and stiffness, as well as skin and nail changes.

Ankylosing spondylitis

This is a form of inflammatory arthritis that primarily affects the spine and sacroiliac joints but may also involve the hips. It commonly begins in younger adults and can lead to progressive stiffness and limited mobility if not managed appropriately.

Avascular necrosis (osteonecrosis)

Although not technically a form of arthritis, avascular necrosis can lead to arthritis of the hip. It occurs when the blood supply to the femoral head is disrupted, causing bone tissue to die and the joint surface to collapse. This can result in secondary osteoarthritis and may require surgical intervention.

Common symptoms of hip arthritis

Hip arthritis can develop gradually, and symptoms often worsen over time. While every person experiences the condition differently, there are several common signs that may suggest arthritic changes in the hip joint.

Hip pain

Persistent pain in the groin, buttock, or outer thigh is one of the most common symptoms. The pain may be dull and aching or become sharp during movement. It often worsens with activity, prolonged standing, or after periods of rest.

Stiffness

You may notice difficulty moving your hip after sitting for a while or first thing in the morning. This stiffness can make tasks like putting on shoes, getting in and out of a car, or walking up stairs more challenging.

Reduced range of motion

As the condition progresses, the hip may lose its normal flexibility, making it harder to bend or rotate the leg. Simple activities such as squatting or tying shoelaces may become limited.

Limping or altered walking pattern

To compensate for pain or joint instability, many people begin to limp or shift their weight to the opposite leg. This change in gait can further strain other joints or muscles over time.

Activity-related discomfort

Pain may flare during or after activities such as walking, climbing stairs, or exercising. In advanced cases, discomfort may persist even during rest or at night.

Clicking or grinding sensation

Some individuals experience a sensation of catching, grinding, or clicking in the hip during movement. This can be caused by the roughened joint surfaces rubbing together as cartilage wears away.

Diagnosing the type of arthritis affecting your hip

Diagnosing hip arthritis involves more than confirming joint wear, it also requires identifying the specific type of arthritis responsible for your symptoms. This helps guide your treatment plan and anticipate how the condition may progress.

Clinical consultation and history

Dr Awwad will begin by discussing your symptoms, medical history, and lifestyle factors. Important clues include when your pain began, what activities make it worse, and whether other joints are affected. A history of autoimmune disease, previous injuries, or childhood hip conditions can also be relevant.

Physical examination

A thorough hip examination is performed to assess your range of motion, joint stability, muscle strength, gait, and areas of tenderness. Specific clinical tests may help identify whether the source of pain is within the joint or coming from surrounding structures.

X-rays

Standard X-rays are the most commonly used imaging tool to detect hip arthritis. They can show joint space narrowing, bone spurs, cysts, or changes in the shape of the joint, all of which suggest degenerative or inflammatory changes. Different types of arthritis can produce distinct patterns on X-ray.

Advanced imaging

If more detail is needed, Dr Awwad may recommend an MRI or CT scan. These provide detailed images of the cartilage, soft tissues, and bone, helping to detect early arthritis, assess labral or cartilage damage, or confirm subtle fractures or conditions such as avascular necrosis.

Blood tests

If inflammatory arthritis is suspected, blood tests may be ordered to check for markers of autoimmune conditions, such as rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis. These tests may include rheumatoid factor (RF), anti-CCP antibodies, HLA-B27, and markers of inflammation like ESR or CRP.

Non-surgical hip arthritis treatment options

Not every patient with hip arthritis needs surgery. In many cases, symptoms can be effectively managed with non-surgical treatments designed to reduce pain, improve function, and slow disease progression. Dr Awwad will tailor a management plan to suit your lifestyle, goals, and the severity of your condition.

Lifestyle and activity modifications

Adjusting your daily activities may help reduce strain on the hip joint. This might include:

Weight loss, even a small amount, can significantly reduce pressure on your hip joint, potentially improving symptoms.

Physiotherapy

A tailored physiotherapy program can help maintain joint mobility, strengthen supporting muscles, and improve balance. Physiotherapists may also teach pacing strategies and exercises that can be done at home. Aquatic therapy can be particularly beneficial for those with more advanced symptoms.

Medications

Pain and inflammation may be managed with:

Paracetamol: Often used as a first-line option for mild pain.
Non-steroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen or meloxicam, which can help reduce inflammation and provide relief.
Topical anti-inflammatory gels: These may offer localised relief with fewer systemic side effects.
Prescription medications: In cases of inflammatory arthritis, disease-modifying antirheumatic drugs (DMARDs) or biologic therapies may be recommended by a rheumatologist.

Always consult with your GP or specialist before starting or changing medications.

Injections

For selected patients, image-guided injections may provide temporary relief:

Walking aids and orthotic support

Walking sticks, canes, or supportive footwear can offload pressure from the arthritic hip and help with stability during movement.

When surgery may be considered

If non-surgical treatments no longer provide adequate relief, or if hip arthritis begins to significantly affect your ability to perform daily activities, hip replacement surgery may be considered. Dr Awwad will assess your symptoms, imaging results, and overall health to determine whether surgery is an appropriate next step.

Signs that surgery may be appropriate

Surgical intervention may be recommended if you are experiencing:

Persistent or worsening hip pain despite medications and physiotherapy
Difficulty walking, climbing stairs, or getting out of chairs
Reduced range of motion that limits independence or quality of life
Sleep disturbance due to hip pain
Reliance on walking aids without significant improvement

These symptoms may suggest advanced joint degeneration, where replacing the damaged joint with a prosthetic implant may offer more durable pain relief and improved function.

Individualised decision-making

The decision to proceed with surgery is always individual. Dr Awwad will consider:

Surgery is not always immediate. In some cases, patients may choose to continue with conservative care until symptoms become more limiting.

If you’re living with hip pain or stiffness that’s affecting your quality of life, a thorough assessment can help determine the cause and guide the right treatment path.