Hip arthritis is one of the most common causes of hip pain in adults over 45 in the UK. As the second most commonly replaced joint (after the knee), hip osteoarthritis affects approximately 2.46 million people across England alone. Understanding the symptoms, getting an early diagnosis and knowing your treatment options can help you manage the condition effectively and maintain your quality of life. This comprehensive guide covers everything UK patients need to know about hip arthritis.
Quick answer: Hip arthritis symptoms typically develop gradually, often including groin pain that may radiate down the front of the thigh, stiffness, and reduced range of motion. You may also experience pain during or after activity, night pain, limping, and referred knee pain. If these symptoms persist for several weeks or worsen, see your GP.
Understanding Hip Arthritis
The hip is a ball-and-socket joint — the largest and one of the most important in the body. In a healthy hip, smooth cartilage covers the ball (femoral head) and socket (acetabulum), allowing frictionless movement. In hip osteoarthritis, this cartilage gradually deteriorates, leading to bone-on-bone contact, inflammation, pain and loss of movement. Other types of arthritis can also affect the hip, including rheumatoid arthritis (autoimmune), psoriatic arthritis, and ankylosing spondylitis (inflammatory spine and hip condition).
Key Symptoms of Hip Arthritis
Hip arthritis symptoms typically develop gradually over months or years. The key signs to watch for include:
1. Groin Pain
The most characteristic symptom. True hip joint pain is typically felt deep in the groin crease, not on the outside of the hip. Many people initially attribute this to a groin strain or muscle pull. The pain may radiate down the front of the thigh towards the knee. Crucially, if your main pain is on the outer hip, it may be trochanteric bursitis or tendonitis rather than hip arthritis — your GP can help distinguish these.
2. Stiffness
Difficulty putting on shoes and socks is one of the earliest functional signs. You may also notice difficulty getting in and out of cars, climbing stairs, crossing legs, or turning to look behind you while driving. Morning stiffness usually lasts less than 30 minutes in OA (longer in inflammatory arthritis).
3. Reduced Range of Motion
As cartilage wears, the hip loses its full range of movement. Internal rotation (turning the foot inward) is usually the first movement affected. Your GP can test this during examination.
4. Pain Patterns
- Activity-related pain — Worse during or after walking, standing or exercise. Eases with rest initially
- Start-up pain — Sharp pain when first standing after sitting, which settles after a few steps
- Night pain — In more advanced cases, pain that disrupts sleep and occurs even at rest
- Weather-related changes — Many patients notice worsening in cold or damp weather
5. Limping
An antalgic gait (limping to avoid weight on the painful hip) is common as the condition progresses. You may lean away from the affected side when walking.
6. Referred Knee Pain
Importantly, hip arthritis can cause pain in the knee — sometimes the knee pain is more prominent than the hip pain. This is because the hip and knee share nerve pathways. Always mention knee pain to your GP, as the source may actually be the hip.
When to See Your GP
See your GP if hip or groin pain persists for more than a few weeks, you have difficulty with daily activities like walking, dressing or climbing stairs, pain is worsening over time, you're taking painkillers regularly for hip pain, or you notice a limp or change in your walking pattern. In the UK, your GP can usually diagnose hip OA from your symptoms and a physical examination without needing X-rays. However, X-rays may be used to confirm the diagnosis, assess severity, or rule out other conditions.
NHS Treatment Pathway
Treatment follows a stepped approach recommended by NICE:
Step 1: Self-Management and Exercise
- Exercise — The single most important treatment. Swimming, cycling and walking are all excellent for hip arthritis
- Weight management — Every kilogram lost reduces hip joint loading by approximately 2.5 kg
- Education — Understanding your condition and how to manage it
- Pacing — Balancing activity and rest
- Physiotherapy — NHS referral for a tailored exercise programme
Step 2: Medication
- Paracetamol — First-line painkiller
- Topical NSAIDs — Less effective for deep joints like the hip compared to superficial joints
- Oral NSAIDs — Ibuprofen, naproxen at the lowest effective dose for the shortest time
- Steroid injections — Guided injections into the hip joint can provide significant short-term relief (weeks to months)
Step 3: Hip Replacement Surgery
When non-surgical treatments no longer provide adequate pain relief and your quality of life is significantly affected, hip replacement may be recommended. In the UK, approximately 100,000 hip replacements are performed annually. Modern hip replacements are highly successful — over 95% last more than 15 years. The NHS waiting list varies by region (typically 3–12 months). Your GP refers you to an orthopaedic surgeon, who will assess whether surgery is appropriate.
What to Expect from Hip Replacement
Surgery typically takes 60–90 minutes under general or spinal anaesthesia. Hospital stay is usually 1–3 days. Most people use a walking stick for 4–6 weeks. Return to driving at approximately 6 weeks. Full recovery takes 6–12 months but most feel significantly better within weeks. You'll receive physiotherapy and a home exercise programme.
Exercises for Hip Arthritis
- Hip bridges — Strengthen glutes; perform as described in our exercise guides
- Clamshells — Strengthen hip stabilisers
- Standing hip abduction — Lift leg sideways while holding a chair for balance
- Seated marching — Sit and lift knees alternately to improve hip flexion
- Cycling — Excellent for maintaining hip mobility with minimal impact
- Swimming — Gentle front crawl; avoid breaststroke kick if it causes pain
Hip arthritis is common but manageable. Early recognition of symptoms, appropriate exercise and the right treatment can help you stay active and comfortable for years. Our virtual assistant can provide personalised advice for your hip arthritis symptoms.
This article is for general information only. See your GP for diagnosis and personalised treatment advice.
Practical next steps for Hip Arthritis Symptoms UK: Signs, Diagnosis and Treatment Options
If you came here about Hip Arthritis Symptoms UK: Signs, Diagnosis and Treatment Options, pick one change you can keep for a fortnight rather than overhauling everything at once. Note what hurts, what helps, and what you have already tried, then take that list to your GP, rheumatology nurse or physiotherapist so the conversation stays concrete.In many areas you can ask your NHS trust about self-referral to physiotherapy or lifestyle support without waiting for a hospital letter. Check your GP surgery website or the NHS App for the route that applies where you live.
Preparing for appointments
Write three priorities before you go: main symptom, functional limit (stairs, sleep, work), and the question you most need answered. Bring a current medicine list including over-the-counter products. If English is not your first language, request an interpreter when you book.
Quick questions about Arthritis Symptoms Signs Diagnosis
Is this a substitute for seeing a clinician? No. Use it to prepare questions and understand options, then confirm decisions with your NHS team.How long before I judge whether a change helped? Give most habit or exercise changes at least two to four weeks, unless pain or swelling clearly worsens — in that case scale back sooner.
What should I track? Joint pain (0–10), morning stiffness time, sleep quality, and how far you can walk or how long you can type or stand. Patterns beat one-off ratings.
Safety and when to get urgent help
This page is general information for people in the United Kingdom, not personal medical advice. Seek urgent help via NHS 111 or A&E if you have sudden inability to move a joint, hot swollen joint with fever, chest pain, severe shortness of breath, or symptoms that feel immediately dangerous.
Keep learning with us
Explore related guides on Living With Arthritis UK — try the guides hub, diet hub, exercise hub, or site search to filter by topic and length. If benefits or work questions are on your mind, start at the Benefits & PIP hub.
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