Hip osteoarthritis
Why is my hip stiff and painful in the groin?
A common cause of groin and hip pain after middle age. Exercise and education are first-line treatment in every major guideline.
What it feels like
Pain in the groin or front of the hip, sometimes spreading to the thigh or knee, with stiffness after sitting and difficulty putting on socks or shoes. It is most common after 50 and tends to fluctuate.
What is actually happening
Osteoarthritis is a change in the whole joint. It is not simply wear and tear, and imaging findings often do not match symptoms. The joint responds well to appropriate loading.
When to see a doctor
See a doctor promptly if hip pain follows a fall and you cannot bear weight, or comes with fever, feeling unwell, constant night pain or a history of cancer.
How it is assessed
Assessment includes your symptoms and goals, hip range of motion, especially rotation, hip and trunk strength, walking and functional tasks, and screening of the low back.
How it is treated
The Hip Osteoarthritis clinical practice guideline, OARSI and NICE all recommend exercise and education as core treatment, and the hip guideline also supports manual therapy. A Cochrane review found that exercise reduces hip pain and improves physical function. Treatment is a progressive strengthening and mobility programme, a plan to stay active, and practical advice on pacing and walking aids if needed. If symptoms remain severe, referral to an orthopaedic surgeon may be discussed.
What to do first
Stay active with walking, cycling or swimming, start simple strengthening such as sit-to-stands and bridges, and expect some discomfort with exercise that settles within a day.
Where this is assessed
- The Runner's Academy St. Clair West · Mon/Wed/Fri · 3:00 PM – 6:30 PM Book at Runner's Academy
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
References
This page is based on the following clinical practice guidelines and research.
- Cibulka MT, Bloom NJ, Enseki KR, et al. Hip Pain and Mobility Deficits-Hip Osteoarthritis: Revision 2017. J Orthop Sports Phys Ther. 2017;47(6):A1-A37.
- Fransen M, McConnell S, Hernandez-Molina G, et al. Exercise for osteoarthritis of the hip. Cochrane Database Syst Rev. 2014;2014(4):CD007912.
- Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589.
- National Institute for Health and Care Excellence (NICE). Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226. 2022.