What Does Hip Arthritis Feel Like?

What is happening inside an arthritic hip?

The hip is a ball-and-socket joint lined with smooth cartilage. In osteoarthritis, that cartilage slowly wears away and becomes rough, the space between the bones narrows, and the body grows bone spurs around the edges. The American Academy of Orthopaedic Surgeons notes it is most common after age 50, though it can begin earlier.

Other things raise the odds, including a hip shape problem such as dysplasia or impingement, a past hip injury, extra body weight and a family history of arthritis. Inflammatory types of arthritis, such as rheumatoid arthritis, can affect the hip too and often involve both hips and other joints.

Cleveland Clinic notes that the hip is the second most common joint affected by osteoarthritis and that the average age when it develops is 65. It often affects one hip at a time, and having it on one side does not mean the other hip will follow. Because it develops slowly, most people have time to learn their options and try several treatments before any decision about surgery.

What does early hip arthritis feel like?

Early on, people describe a groin ache after a long walk, a round of golf or a day on their feet. The hip feels stiff when getting out of the car or rising from a chair, then loosens after a few minutes of moving. Many notice it first when they bend to put on shoes and socks or trim their toenails.

The X-ray at this stage may look close to normal or show only mild narrowing of the joint space. That gap between symptoms and pictures is common. Research on hip and spine pain shows that how bad the X-ray looks does not reliably match how much the hip hurts.

How does it change in the moderate stage?

As arthritis progresses, the ache comes on with less activity and lasts longer. Stiffness can make it hard to lift the leg, cross the legs or swing into a car. Some people start to limp, especially at the end of the day. Others hear grinding or feel a catch as rough surfaces and loose fragments move inside the joint.

Pain often travels. OrthoInfo describes groin or thigh pain that can spread to the buttock or the knee, which is why some people are first sent for a knee X-ray. On the hip X-ray, the joint space is clearly narrower and bone spurs are visible.

What does severe hip arthritis feel like?

In the later stages, pain shows up at rest and at night, not only with activity. Walking distance shrinks, stairs become a project, and a cane may start to feel necessary. Range of motion may be quite limited, and the leg can feel shorter or turned out.

The X-ray may show little or no joint space left, often called bone on bone, along with larger spurs and changes in the bone itself. Even so, the decision about surgery is based on how much the hip limits your life, because the picture alone does not tell the whole story.

How can I tell it's arthritis and not something else?

A few features lean toward arthritis inside the joint, while others suggest a different problem. Our team checks all of these, plus the lower back, at the first visit.

• Arthritis: groin ache, stiffness after rest, trouble with shoes and socks, gradual loss of motion.
• Outside-of-hip tendon pain: tender point on the side of the hip, pain lying on that side, but usually no trouble reaching your feet.
• Lower back problems: pain in the buttock or down the leg, often with numbness or tingling.
• Red flags: hip pain with fever, sudden severe pain without an injury, or pain after a fall with trouble bearing weight need same-day care.

What can I do before considering hip replacement?

There is no treatment that regrows cartilage, but many steps can ease pain and keep you active, often for years. Most people climb this ladder gradually:

These steps tend to help most in combination and over time, so judge them over weeks rather than days. A physical therapist can show you how to stay active without flaring the hip, and simple changes such as limiting long stair climbs help too. An injection can ease a flare for a period of time, and your doctor will help you decide how often it makes sense.

• Stay active with lower-impact choices such as cycling, swimming and walking on flat ground in place of jogging or jumping.
• Work with a physical therapist on hip strength and flexibility.
• Lose weight if needed, which reduces load on the hip and can ease pain.
• Use a cane in the opposite hand on bad days, and tools like a long-handled reacher or shoehorn.
• Try acetaminophen or anti-inflammatory medicine if they are safe for you.
• Consider an image-guided cortisone injection for a flare.

When is it time to see a hip specialist?

Book a visit if groin or thigh pain has lasted more than a few weeks, if stiffness is changing how you walk or dress, or if pain is waking you at night. Early diagnosis helps you protect the joint, choose the right activities and know what to watch for.

At that visit, our team watches you walk, checks how far the hip moves in each direction, and examines the lower back and knee, since both can mimic or add to hip pain. Standing X-rays show the joint space and any bone spurs. An MRI is rarely needed for typical arthritis, and is saved for cases where the story and the X-ray do not match.

When non-surgical care no longer keeps up and arthritis limits walking, sleep or daily life, hip replacement is a reliable option to discuss, and the timing is your decision. The Saturday Hip Pain Clinic offers a convenient place to start, with X-rays taken during the visit when they are needed.

Questions patients ask