Hip arthritis occurs when the smooth, protective cartilage within the hip joint begins to break down. The hip is a ball-and-socket joint, and this cartilage acts as a shock absorber, allowing the femoral head (the ball) to glide effortlessly within the acetabulum (the socket). When the cartilage deteriorates, the joint space narrows, leading to friction and damage to the underlying bone. Osteoarthritis (OA) is the most common form, often called “wear-and-tear” arthritis, and it is a progressive disease that worsens with age.
Recognizing the Outward Signs
The first and most noticeable sign of hip arthritis is typically chronic pain, which is often felt not directly in the hip, but rather in the groin, outer thigh, or even the upper buttock area. This pain can range from a dull ache to a sharp, stabbing sensation and frequently intensifies with activity, such as walking or standing for long periods. Many people find their pain is worse in the morning or after extended periods of rest or sitting, a phenomenon known as “gelling”.
Stiffness is another common manifestation, making it difficult to move the leg through its full range of motion. Simple daily tasks become challenging, such as bending over to tie shoes, putting on socks, or getting in and out of a low car or chair. This limited mobility can eventually lead to a change in the way a person walks, often resulting in a noticeable limp or altered gait as they try to minimize pressure on the affected joint.
Patients may also experience auditory symptoms, described as a grinding, clicking, or catching sensation, which is medically termed crepitus. This noise occurs when the roughened cartilage surfaces or exposed bone ends rub against each other during movement. As the condition progresses, muscle weakness around the hip and thigh may develop due to decreased use and pain.
Structural Changes Visible on Imaging
While symptoms describe the patient’s experience, medical imaging reveals the internal structural changes that confirm hip arthritis. X-rays are the standard diagnostic tool, as they clearly show the dense structures of bone. The most telling sign is joint space narrowing, which indicates the loss of the cartilage layer between the ball and socket.
As the cartilage disappears, the underlying bone attempts to repair itself, leading to the formation of osteophytes, commonly called bone spurs, on the edges of the joint. These spurs change the joint’s shape and restrict movement. The bone tissue beneath the cartilage, known as subchondral bone, may also appear denser on the X-ray, a change called subchondral sclerosis, due to the increased pressure it endures.
In more advanced stages, fluid-filled sacs called subchondral cysts may form within the bone. Magnetic Resonance Imaging (MRI) provides a more detailed look at soft tissues, revealing early cartilage defects and bone marrow lesions.
Next Steps After Diagnosis
Following a hip arthritis diagnosis, the first steps involve non-surgical management strategies focused on reducing pain and maintaining function. Lifestyle modifications are often recommended, including weight management, as reducing body weight significantly lowers the force placed across the hip joint. Even a small amount of weight loss can substantially reduce strain.
Physical therapy is highly beneficial, focusing on specific exercises to strengthen the muscles supporting the hip and improve the joint’s flexibility and range of motion. Using a cane or other assistive device can also reduce the load on the painful joint. Pain management involves over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen to reduce inflammation and discomfort.
If initial treatments are insufficient, doctors may suggest other interventions, such as corticosteroid injections into the joint for temporary pain relief. For cases where the pain is severe and mobility is significantly compromised, advanced interventions are considered. These include joint preservation surgeries or, most commonly for end-stage arthritis, total hip replacement surgery, which replaces the damaged joint surfaces with prosthetic components.