Osteoarthritis of the hip (hip arthrosis) | Cause, symptoms, exercises and treatment

Osteoarthritis of the hip is also known as cox osteoarthritis. Hip osteoarthritis (osteoarthritis) can cause symptoms such as joint pain, inflammation, reduced mobility and pain when you are out and about.

As the joint wear gets worse and reaches later stages of hip osteoarthritis, you can also expect a worsening in relation to the symptoms and pain you experience. It is therefore important to actively work on prevention to ensure that you have good functionality in your joints and muscles.

– Especially affects weight-bearing joints

Osteoarthritis can affect all joints in the body - but particularly affects weight-bearing joints, including the hips, knees and feet. As our joints become worn over the years, the cartilage inside the joints can gradually break down and in the most serious cases it can also lead to bone rubbing against bone in the affected joints.

"The article has been written and quality checked by publicly authorized health personnel. This includes both physiotherapists and chiropractors at Pain clinics Interdisciplinary Health (see clinic overview here). We always recommend having your pain assessed by knowledgeable healthcare personnel."

Tips: Further down in the guide, you will see a training video with seven recommended exercises and good advice adapted to hip osteoarthritis. Among other things relief by use of a sleeping pad when you sleep, shock absorption with heel dampers and training with minibands. Links to product recommendations open in a new browser window.

In the article we will go through:

1. Symptoms of osteoarthritis in the hip

2. The cause of osteoarthritis of the hip

3. Prevention of hip osteoarthritis (including exercises)

4. Self-measures against cox arthrosis

5. Treatment of hip osteoarthritis

6. Diagnosis of hip osteoarthritis

This guide covers most of what you need to know about hip osteoarthritis. But if you feel that there is still something you have questions about, just contact us. We are more than happy to help you.

1. Symptoms of osteoarthritis in the hip

Which symptoms you experience will directly depend on how extensive the osteoarthritis in the hip is. More significant versions of hip osteoarthritis will, naturally enough, also experience worsening symptoms and pain. Symptoms of hip osteoarthritis may include:

• Pain when you press on the hip joint

• Stiffness and reduced hip mobility

• Slight swelling in and around the hip

• Possible redness of the skin over the hip joint

• In the case of significant osteoarthritis, it can be painful to put weight on the bone

• Increased risk of biomechanical compensation in the back and pelvis

One often leads to the other. And this is also the case with reduced function in the hip. The hip joint is also very important for nearby areas, such as the pelvis and lower back. If the hip cannot do its job satisfactorily, this will cause these areas to gradually become overloaded and painful. In order to address these problems and pain, it is important that you take active measures and adapt your everyday life so that you can get better again.

- Why do I have pain in my hip in the morning or when I have been sitting still?

Characteristically, it is also true that hip osteoarthritis is worse in the morning and after sitting still for a long time. This is due, among other things, to the fact that, like the muscles after exercise, every night the body will try to repair the cartilage and carry out maintenance in the joints. The muscles will also have less blood circulation and the joints less synovial fluid, so it often takes a while to get started in the morning. An improved sleeping position with use of a sleeping pad can help reduce morning stiffness. This is because such a pillow provides an improved angle for the hips and knees when you sleep, which in turn means that circulation is maintained better. In addition, you can reduce the pressure on your hips when you sit by using ergonomic seat cushion.

Recommendation: Sleep with a pillow between your knees

Many pregnant women use pelvic floor pillow to relieve the hips and pelvis. But the truth is that this sleeping position is optimal for most of us. When we have a pillow between our knees when we sleep, this will change the angle of both hips and knees (see example below) - which results in less pressure and better circulation. Press here to read more about our recommendation.

In this illustration, you can see how a sleeping pillow can lead to an improved sleeping position. This can lead to better recovery and rest for the hip joint and pelvis, which in turn can result in less morning stiffness and morning pain. Such ergonomic pillows are also beneficial for relieving stress on pelvic joints (such as wood sacroilitis).

Our recommendation: Relief with an ergonomic seat cushion

In addition, it is the case that many of us sit for quite a few hours every day. The problem is that this helps reduce circulation in and around the hip. When we then have to stand up again, you will feel stiff and sore. You can read more about our recommended seat cushion here .

Osteoarthritis can lead to calcifications in the hip joint

Osteoarthritis is also known as osteoarthritis and with joint wear there will also be physical changes in the hip joint. Joint wear and tear also increases the risk of inflammation in the joint capsule, which can cause local swelling and oedema. But as mentioned, it is also the case that when the cartilage in the joints breaks down and bones almost rub against bone, the body will respond by making a wholehearted attempt to repair itself. This can result in extra bone tissue being laid down, i.e. calcifications and bone spurs.

- Hip osteoarthritis is not visible to the naked eye

In the hip, it is not the case that these calcifications will be visible or that you will notice them with the naked eye. This is in contrast to osteoarthritis in the big toe, where you will then be able to see a large ball of bone at the base of the big toe. The more calcifications - the more impaired and reduced your functionality will be.

Shorter stride length and limp

The hip is essential for normal walking - it acts as a shock absorber and as a weight transmitter when you put your legs on the ground. But if the cartilage in the hip joint is worn, this can cause problems.

– Reduced hip joint mobility results in shorter steps

This is because it can lead to you having less range of motion in the hip - and thus it can lead to you taking shorter steps when you walk, which in turn helps to prevent increased mobility. Normal movement is maintenance in itself, as it ensures blood circulation and synovial fluid into the hip, but with a short gait and a limp, you lose this natural mobilization of joints and muscles.

- In the event of further deterioration, it may progress to lameness

As the condition worsens, it can also cause you to start limping on the leg where the hip osteoarthritis is most significant. This is bad news, as it will lead to further compensatory pain in nearby muscles, nerves and joints. Try to take active measures before it gets that far. But also note that there is much that can be improved even with significant hip osteoarthritis.

2. Reason: Why do you get osteoarthritis in the hip?

Osteoarthritis of the hip occurs as we get older. This is usually due to natural strain over a longer period of time, but hip osteoarthritis can also be accelerated due to several risk factors. Some of these include:

• High BMI

• Earlier damages

• Overstressing

• Skewness in the back (scoliosis)

• Weakened stability muscles

• Genetics (some are more prone to osteoarthritis than others)

• Gender (women have a higher incidence of osteoarthritis than men)

• Autoimmune conditions (for example, rheumatoid arthritis that attacks the cartilage)

It is also important to mention that stronger stability muscles can relieve the hip joint, and help with shock absorption and injury prevention. In addition, joints and cartilage depend on good blood circulation to be able to access nutrients for repair and maintenance. As we get older, the body's ability to repair cartilage and soft tissue weakens. If the hip osteoarthritis worsens, it also becomes an ever greater task for the body, which will continue to do its best to repair the condition. If you yourself know that you walk a lot on hard surfaces in connection with work or the like, it may be worth using heel dampers in the shoes. These absorb part of the shock load when walking and standing.

Tips: Use heel shock absorbers for better shock absorption

Silicone gel heel cushions are a good and effective way to reduce stress on heels, knees and hips. A simple measure that can have positive ripple effects. Read more about these here .

3. Prevention of osteoarthritis in the hip (including exercises)

There are several measures and preventive steps that can reduce the risk of hip osteoarthritis. A healthy weight, regular exercise and good mobility are among the most important factors in reducing the development of hip osteoarthritis. A targeted focus on strengthening the hip muscles, while maintaining hip joint mobility, can slow down the negative development.

VIDEO: 7 exercises against arthrosis in the hip

Here shows chiropractor Alexander Andorff seven good exercises for you with hip osteoarthritis. The exercises aim to stimulate circulation and provide better mobility. In addition to these mobility exercises, we can also recommend training with mini-bands (specially adapted training bands).

Feel free to subscribe our YouTube channel (click here) for more free exercise programs and health knowledge.

Recommendation: Complete set of training tights in 6 different strengths

Training with mini-band training tights ensures that the load comes from the directions you want to optimize hip trainingn your Such bands come in different strengths and it is recommended that you gradually increase the resistance as you get stronger. You can read more about mini bands here .

4. Own measures against cox arthrosis

Earlier in the article, we gave several tips on self-help and self-measures you can try for osteoarthritis of the hip. But here is a small summary of them:

• Sleeping pillow (improved sleeping position for the hip)

• Seat cushion (relieving the hip when sitting)

• Heel dampers (for shock absorption)

• Training with elastic (to train the hip muscles)

5. Treatment and rehabilitation for hip osteoarthritis

By everyone our interdisciplinary clinical departments belonging to the Vondtklinikkene Multidisciplinary Health, we are keenly interested in achieving the best possible results for our patients. Many people are surprised when they hear that manual treatment techniques for muscles and joints are actually even more effective than rehabilitation exercises for hip osteoarthritis.¹ At our clinics, we naturally combine such treatment with rehabilitation exercises and training, but it is important to know that the combination of the two is more effective than exercises alone.

Physical treatment of hip osteoarthritis

Our physiotherapists and chiropractors always combine treatment modalities with individually adapted rehabilitation exercises. Active treatment techniques can help improve blood circulation in and around the hip joint, break down pain-sensitive damaged tissue and increase hip joint mobility. Techniques we regularly use in the treatment of cox arthrosis include, among others:

• Physiotherapy

• Sports Chiropractic

• Laser Therapy

• Joint Mobilization

• Massage techniques

• Muscle knot treatment

• Rehabilitation exercises

• Traction Treatment

• Training guide

• Shockwave Therapy

• Dry needling (Intramuscular stimulation)

Which combination of treatment techniques you receive will be individually determined, and the treatment setup will be based on a thorough functional examination.

Surgical operation: Hip prosthesis

When you are in the very last stages of osteoarthritis, things have gone very far. In those stages, it is almost bone against bone inside the hip joint, which in turn can lead to avascular necrosis - that is, bone tissue dies due to lack of blood circulation. When it has gone this far, hip replacement is normally the next step, but this does not mean that you have to stop exercising and moving, quite the opposite. Pre-operative and post-operative training helps to keep the soft tissue and tendons around the prosthesis healthy and fine, so make sure you follow the rehabilitation training you are taught to the letter.

6. Diagnosis of hip osteoarthritis

An initial consultation will start with a conversation with your clinician. Here, the therapist will go through the symptoms and pain you are experiencing. In addition, relevant follow-up questions will be asked. The consultation then proceeds to the functional examination. This usually consists of:

• Hip examination

• Joint mobility tests

• Muscle testing

• Orthopedic tests

• Palpatory examination of soft tissues

If osteoarthritis in the hip is suspected, a doctor or chiropractor can refer you to an imaging examination. For the investigation of hip osteoarthritis, it is most common to use an X-ray. This is because X-ray examinations are best for mapping wear and tear changes in bone tissue, including the cartilage and any calcifications.

Example: X-ray of the hip

In the picture on the left you can see that there is plenty of space inside the hip joint. In the picture to the right we see significant osteoarthritis and the joint is considerably narrower than it should be.

Summarizeering: Osteoarthritis of the hip

You can live well with osteoarthritis in the hip. The most important thing is that you take active steps yourself and seek professional help for mapping and guidance. A clinician will be able to help you put together a rehabilitation exercise program and also help you with active, symptom-relieving treatment. Remember that you can also, completely without obligation, contact us and ask us questions.

The pain clinics: Your choice for modern treatment

Our clinicians and clinic departments always aim to be among the elite in the investigation, treatment and rehabilitation of pain and injuries in muscles, tendons, nerves and joints. By pressing the button below, you can see an overview of our clinics - including in Oslo (incl Lambert seats) and Akershus (Raw wood og Eidsvoll Sound). Feel free to contact us if you have any questions or are wondering about anything.

See clinic overview

Article: Osteoarthritis of the hip

Written by: Our publicly authorized chiropractors and physiotherapists at Vondtklinikkene Tverrfaglig Helse

Fact check: Our articles are always based on serious sources, research studies and research journals, such as PubMed and the Cochrane Library. Please contact us if you spot any errors or have comments.

Research and sources

1. French et al, 2011. Manual therapy for osteoarthritis of the hip or knee – a systematic review. Man Ther. 2011 Apr;16(2):109-17.

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