Coxarthrosis (hip osteoarthritis): symptoms and treatment

Coxarthrosis is osteoarthritis of the hip: wear of the cartilage covering the head of the femur and the socket of the pelvis. It causes groin pain and stiffness, especially when you start moving. It's very common from 50 onwards, and exercise is the first treatment: in most cases it keeps you active for years before a hip replacement is considered, if one is ever needed.

What your report means

Right or left coxarthrosis: osteoarthritis in that hip.
Bilateral coxarthrosis: in both hips. It's common, and it doesn't usually progress at the same pace in each.
Grade (mild, moderate, severe, or grades 1 to 4): describes how much joint space has been lost on the X-ray. X-ray and pain don't always match: some people have a lot of wear and little pain, and vice versa.
Coxopathy: a general term for a hip problem, often used for osteoarthritis.

Symptoms

Groin pain, which can run down the front of the thigh to the knee. Sometimes the knee hurts more than the hip.
Stiffness when starting to move in the morning or after sitting, easing within a few minutes.
Difficulty putting on socks, cutting your toenails or crossing your legs.
Pain walking long distances, with a limp in advanced stages.
Less range of movement, especially turning the hip inwards.

Pain on the outside of the hip when lying on that side usually comes from the buttock tendons, not osteoarthritis.

Causes and risk factors

Age and genetics.
Hip shape: dysplasia (a shallow socket) or femoroacetabular impingement from a young age.
Previous hip injuries.
Excess weight.
Heavy manual work or high-impact sport over many years.

Treatment without surgery

Exercise: strengthening the buttocks and thighs and keeping mobility reduces pain and improves function. Guidelines recommend it for everyone with hip osteoarthritis.
Walking, swimming and stationary cycling: activities that load the hip without heavy impact.
Losing weight if needed.
Manual therapy alongside exercise: in a trial of people with hip osteoarthritis, manual therapy improved pain and mobility in the short term more than exercise alone (Hoeksma et al., Arthritis Care & Research, 2004).
A walking stick in the opposite hand to the painful hip, if walking becomes hard.
Pain relief prescribed by your doctor, and sometimes injections.

When a hip replacement is considered

When pain seriously limits your life (walking, sleeping, working) despite good conservative care. Hip replacement is one of the most successful operations. The decision is made with your orthopaedic surgeon, based on how it affects you, not just the X-ray.

How we treat it at the clinic

We work alongside your doctor or orthopaedic surgeon. We assess the hip, lower back and knees, and combine gentle mobilisation of the hip and spine with a progressive exercise programme and advice on walking, sleeping and moving at home. We don't use forceful techniques on an arthritic hip.

When to see a doctor

Sudden, severe hip pain, or not being able to bear weight after a fall (possible fracture, especially in older people).
Fever with hip pain.
Pain that wakes you at night and doesn't change with position.
Severe groin pain in a young adult with no clear cause.
Rapid worsening over a few weeks.

Frequently asked questions

What is bilateral coxarthrosis? Osteoarthritis in both hips. Treatment is the same; one hip often hurts more than the other.

Can coxarthrosis be cured? Cartilage doesn't regrow, but pain and function can improve a lot with exercise and weight control. If it becomes severe, a hip replacement solves it.

Is walking good for coxarthrosis? Yes, at a pace and distance you can tolerate. Several short walks are better than one long one if that leaves you sore.

Why does my knee hurt if the arthritis is in my hip? Because hip pain can travel down the thigh to the knee. If your knee hurts and the knee examination is normal, the hip needs checking.

Does chiropractic cure coxarthrosis? No. It can help with pain and mobility as part of care that includes exercise and medical follow-up.