The most effective approach to hip arthritis combines anti-inflammatory medication, targeted exercise, and lifestyle changes that reduce stress on the joint. Most people with mild to moderate hip osteoarthritis can manage their symptoms without surgery for years, and many never need it at all. The key is layering several strategies together rather than relying on any single one.
Anti-Inflammatory Medication Is the Strongest First Step
Oral NSAIDs (like ibuprofen, naproxen, or diclofenac) are the most strongly recommended non-surgical treatment for hip osteoarthritis. The American Academy of Orthopaedic Surgeons gives them its highest recommendation based on high-quality evidence, with studies uniformly showing improvement in both pain and physical function compared to placebo. If your stomach and kidneys can handle them, NSAIDs are the single most reliable way to reduce hip arthritis pain.
Among the options, diclofenac at prescription doses has shown stronger results than ibuprofen, naproxen, or celecoxib in head-to-head comparisons. That said, over-the-counter ibuprofen or naproxen still works well for many people. The goal isn’t just dulling the pain. NSAIDs reduce the inflammation driving that pain, which is why they tend to outperform acetaminophen (Tylenol), a pure pain reliever with no anti-inflammatory effect. Major guidelines now either recommend against acetaminophen for hip arthritis or suggest it only for short-term relief when NSAIDs aren’t an option.
Opioids are explicitly not recommended. Orthopaedic guidelines advise against using them for hip osteoarthritis due to the risk of dependence and the availability of better alternatives.
Exercise That Targets the Right Muscles
Physical therapy produces small but clinically meaningful improvements in hip pain and function, and those benefits stick around. Research shows that structured exercise programs lasting 6 to 12 weeks lead to significant pain reduction and improved mobility, with the gains sustained at follow-up assessments three to six months later. The best results come from combining three types of exercise: muscle strengthening, flexibility work, and aerobic activity.
Strengthening the muscles around the hip, especially the glutes, is the priority. Effective exercises include:
- Bridges: lying on your back and lifting your hips, progressing to single-leg bridges
- Side-lying hip abduction: lifting your top leg while lying on your side
- Sit-to-stand: rising from a chair with a resistance band above the knees
- Standing hip extension: pushing your leg backward against resistance band tension
- Single-leg squats: added as strength progresses
Sessions typically run 30 to 60 minutes, two to three times per week. You don’t need to do all of this in a gym. Many of these exercises work with a simple resistance band at home. Water-based exercise (pool walking, aqua aerobics) is another strong option because buoyancy takes weight off the hip joint while still allowing strengthening and range-of-motion work. Tai chi has also been studied specifically for hip arthritis and shown benefits.
The critical thing to understand: exercise for hip arthritis isn’t about pushing through pain. It’s about gradually building the muscular support around a deteriorating joint so the joint itself bears less of the load. Most people notice meaningful improvement around the 10-week mark.
Weight Loss and Diet
Every pound of body weight translates to roughly three to six pounds of force on your hip joint during walking. Losing even 10 to 15 pounds can meaningfully change how a hip with arthritis feels day to day. Weight loss is one of the first recommendations in clinical guidelines for a reason: it directly reduces the mechanical stress causing cartilage breakdown.
Beyond weight management, an anti-inflammatory dietary pattern may help reduce the low-grade inflammation that drives osteoarthritis symptoms. The Mediterranean diet has the strongest evidence here, emphasizing fatty fish (salmon, sardines, mackerel) rich in omega-3 fatty acids, fruits and vegetables high in vitamin C, nuts and seeds, and olive oil. These foods contain compounds that counteract the inflammatory processes in joints. You don’t need to overhaul your entire diet overnight. Adding two servings of fatty fish per week and swapping processed snacks for nuts and berries is a practical starting point.
Cortisone Injections: Short-Term Relief
Corticosteroid injections into the hip joint can reduce pain and improve function, but the effect is temporary. Studies show meaningful improvement lasting up to about eight weeks. This makes cortisone shots useful for getting through a particularly bad flare, bridging the gap before surgery, or enabling you to start a physical therapy program that pain was previously blocking.
Hyaluronic acid injections (sometimes called viscosupplementation or “gel shots”) are a different story. Despite being marketed for hip arthritis, high-quality evidence shows they don’t reduce pain or improve function better than a placebo injection. The AAOS strongly recommends against them for hip osteoarthritis. If someone suggests these for your hip, it’s worth knowing the evidence doesn’t support the cost.
Glucosamine and Chondroitin Supplements
These are among the most popular joint supplements, but the evidence for hip arthritis specifically is not encouraging. The American College of Rheumatology currently recommends against glucosamine alone or in combination with chondroitin for hip and knee osteoarthritis. Some people do report feeling better on them, and they’re generally safe and well-tolerated at standard doses (1,500 mg glucosamine and 1,200 mg chondroitin daily). But if you’ve been taking them for two to three months without noticeable improvement, the data suggests they’re unlikely to start working.
Walking Aids and Assistive Devices
A cane or walker isn’t a sign of giving up. It’s a tool that transfers weight away from your hip joint, directly reducing pain with every step. If you use a cane, hold it in the hand opposite your painful hip. So if your right hip hurts, the cane goes in your left hand. This counterbalances your body weight and takes the most pressure off the affected joint.
For people with arthritis in both hips or who feel unsteady, a two-wheeled or four-wheeled walker provides more support and stability than a single cane. Beyond walking aids, simple tools like reachers, long-handled shoehorns, and raised toilet seats can make daily tasks less painful by reducing how far you need to bend at the hip.
Sleeping With Less Hip Pain
Nighttime is often when hip arthritis feels worst because lying down puts direct pressure on the joint. If you sleep on your side, lie on the hip that doesn’t hurt and place one or two pillows between your knees. This keeps your hips aligned and prevents the top leg from pulling the joint into an awkward position. If you sleep on your back, place a pillow or rolled blanket under your knees and consider a second one under the small of your back to reduce strain on the hip flexors.
When Surgery Becomes the Right Option
Total hip replacement is one of the most successful operations in modern medicine, but it’s reserved for cases where conservative measures have genuinely failed. The primary indication is persistent pain in a hip that shows clear joint destruction on X-rays, despite consistent use of the strategies above: medication, exercise, weight management, activity modification, and assistive devices. If you’ve committed to these approaches for several months and your hip still limits your ability to walk, sleep, or do basic daily activities, replacement surgery offers a realistic path back to function. Most people who reach that threshold find the relief dramatic and lasting.