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Hip osteoarthritis:
symptoms, what it means, and practical next steps

Hip osteoarthritis (knee OA) is common as we get older, but “wear and tear” isn’t the full story and it doesn’t automatically mean you’re heading for a knee replacement. OA describes age-related changes in the joint that can lead to pain, stiffness, and reduced confidence with walking, stairs, or exercise.

 

This page explains what hip OA usually looks like, what current guidelines say about imaging and treatment, and how exercise, education, and sensible load management can help.

 

It’s written for adults 45–70 in Camberwell and Melbourne’s inner east who want clear, realistic information and a plan that fits real life.

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What you’ll learn on this page

  • Typical hip OA symptoms and how they tend to behave over time

  • Why movement and exercise are core treatments, not last resorts

  • When X-rays, injections, or surgery are usually discussed and when they’re not

Typical symptoms & patterns

Hip OA can present in a few ways, but common patterns include: 

  • Deep ache in the groin, buttock, or side of the hip

  • Pain or stiffness when you start moving after sitting, often easing a little once you “get going”

  • Difficulty or pain with walking, hills, stairs, getting in/out of the car, or putting on shoes and socks

  • Reduced hip range of motion, especially twisting or turning the leg

  • Occasional pain radiating into the front or side of the thigh

  • Symptoms that flare with higher loads (long walks, busy days, heavy gardening) and settle somewhat with sensible rest

 

You can have OA changes on X-ray without much pain, and you can have quite a bit of pain even if scans don’t look “severe”. Symptoms and function matter more than the picture alone

Why it happens

Osteoarthritis is a whole-joint condition, not just “worn cartilage”. Over time, the cartilage, bone, joint lining, ligaments, and surrounding muscles can all change. Factors that may contribute include: 

  • Ageing and natural joint changes

  • Previous injuries (e.g. meniscus tears, ligament injuries, fractures)

  • Genetics and biology – some people’s joints are simply more prone

  • Higher body weight, which increases mechanical load and inflammatory drive

  • Long periods of low activity, which can reduce muscle strength and joint tolerance

 

Importantly, the joint is adaptable. Well-structured activity and strengthening help the joint tissues and surrounding muscles cope better with load, which is one reason exercise is considered a core treatment – not a last resort.

When to see someone – and when to scan

​When to see a physio

It’s sensible to seek help if:

  • Hip pain or stiffness has persisted for several weeks or months

  • You’re struggling with stairs, walking, or daily tasks

  • You’re cutting back on activity you value because of knee symptoms

  • You’re unsure which exercises are safe, or worried about “doing damage”

 

A physio assessment can clarify what’s driving your symptoms, rule out red flags, and build a plan around your goals.

 

When scans may be considered

Current guidelines are clear:

  • Imaging is not always needed to diagnose hip OA. A good history and physical exam are often enough.

  • X-rays can be helpful if the picture is unclear, symptoms are atypical, or decisions around injections or surgery are on the table.

  • MRI is rarely required for straightforward OA and is often over-used.

 

In short: scans can be useful in the right context, but they’re not the starting point for most people.

How we assess & plan at The Hip and Knee Physio (Camberwell)

In an initial hip OA consultation, we typically:

  • Listen to your story – where and when the knee hurts, what you’re avoiding, and what matters most to you (walking, stairs, travel, grandkids, sport)

  • Check movement and function – walking, sit-to-stand, stairs, balance, and knee range of motion

  • Assess strength and control in the hips, knees, and ankles

  • Screen for red flags or other causes of knee pain, and review any existing imaging

 

From there, you’ll leave with:

  • An explanation of what’s likely going on

  • A prioritised exercise plan, not an overwhelming list – usually 2–4 key exercises to start

  • Clear guidance on activity (what to keep, what to tweak, what to park for now)

  • A sense of what progress might look like, acknowledging that everyone’s timeline is different

 

Where needed, we’ll also collaborate with your GP or specialist about medicines, imaging, or surgical options.

 

For more on general knee care, you can explore the Hip Physiotherapy service page and our return to sport after total hip replacement blog, then come back to this page when you’re ready to book.

FAQs – Hip Osteoarthritis

1. Will exercise make my hip osteoarthritis worse?

Appropriately dosed exercise is considered safe and beneficial for most people with hip OA. Systematic reviews show exercise therapy improves pain and function, and current evidence doesn’t support the idea that well-planned exercise accelerates joint damage.

 

You may feel some temporary increases in discomfort as you build strength, but programs are adjusted so that symptoms stay manageable.

 

2. Is walking or Pilates still OK with hip OA?

Often yes. For many people, staying active is part of the treatment, not something to avoid. You may need to adjust distance, pace, surfaces, or specific exercises, but the aim is usually to keep you doing the activities you value, within a tolerable symptom range.

 

A physio can help tailor how you walk, climb stairs, or approach Pilates/gym work so your hip gets enough load to adapt, without repeated flare-ups.

 

3. When should I think about seeing a surgeon?

Surgical opinions are typically considered when:

  • Hip pain and stiffness are clearly limiting daily life and sleep,

  • You’ve had a good trial of non-surgical care (exercise, education, load management, appropriate medicines), and

  • Imaging confirms structurally advanced OA that fits your symptoms

 

Even then, surgery is a choice, not an obligation. Many people continue with conservative care if they feel their current symptom level is manageable.

 

4. Will I definitely end up needing a hip replacement?

No. Some people eventually decide on hip replacement and do very well; others manage their hip OA for years with non-surgical care and never have surgery. There is no rule that X-ray changes must lead to replacement. The focus is on maximising function and quality of life now, and reviewing options over time​.

Local practicals – Camberwell clinic

​The Hip and Knee Physio consults from 1/3 Prospect Hill Road, Camberwell, a short walk from Camberwell Junction and public transport. The building offers good access and facilities, including accessible entry and amenities, and there is parking available nearby.

Book Now

If your hip pain is starting to limit your walking, stairs, or confidence, a structured assessment can help you understand what’s going on and what to do next.

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  • Book a Hip Arthritis consult in Camberwell – Book Now Hip and Knee Physio

  • Prefer to talk first? You can contact the clinic to discuss whether an appointment is appropriate for your situation

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