Why your hips hurt with arthritis, and what you can do about it

Hip arthritis happens when the cartilage inside your hip joint wears down, causing the bone underneath to rub directly against bone. This friction creates pain, stiffness, and sometimes swelling. Your hip is a ball-and-socket joint that bears your body weight every time you stand, walk, or climb stairs — so when it starts to fail, almost every movement hurts.

The pain usually starts in the groin or deep in the hip itself, and it often radiates down the front of your thigh or into your buttock. You might notice you can't lift your leg as high, you walk with a limp, or you need to sit down more often. The good news is that you have real options — from movement and physical therapy to medication and, if needed, surgery — that can reduce pain and keep you mobile.

Key Takeaways

  • Hip arthritis pain typically starts in the groin or deep inside the hip and worsens with weight-bearing activities like walking or climbing stairs.
  • Physical therapy and low-impact exercise like swimming or water aerobics can reduce pain and improve your range of motion without stressing the joint.
  • Over-the-counter pain relievers, heat and ice, and weight management all play a role in managing symptoms at home.
  • A doctor can prescribe stronger medications or recommend injections if over-the-counter options are not enough.
  • Hip replacement surgery is an option if conservative treatments stop working, and many people report significant pain relief and restored mobility afterward.

How to recognize hip arthritis pain

Hip arthritis pain has a specific pattern. It usually starts in the groin or deep inside the hip joint itself, not on the outside of your hip. You might feel it in the front of your thigh, your buttock, or even down toward your knee. The pain is often worse in the morning when you first get out of bed, improves slightly as you move around, then gets worse again as the day goes on.

Activities that load your hip — walking, climbing stairs, getting in and out of a car, putting on shoes while standing — tend to hurt more than activities where your hip is supported. You might notice you're limping without meaning to, or that you can't cross your legs the way you used to. Some people describe a catching or grinding sensation inside the joint, or a feeling that the hip is unstable.

Pain that starts on the outside of your hip, near the top of your thigh bone, is usually hip bursitis rather than arthritis. Bursitis is inflammation of the fluid-filled sacs that cushion your hip, and it responds differently to treatment. If you're not sure where your pain is coming from, describe it to your doctor — the location tells them a lot about what's happening.

Movement and exercise that reduces hip pain

The instinct to stop moving when your hip hurts is understandable, but staying still actually makes arthritis worse. Movement keeps the joint lubricated, maintains the muscles that support your hip, and prevents stiffness from taking over. The key is choosing activities that don't pound or twist the joint.

Water-based exercise is often the best starting point. Swimming, water walking, and water aerobics let you move your hip through its full range of motion while the water supports your weight. The buoyancy reduces stress on the joint by up to 50 percent, depending on how deep you are. Many community pools and senior centers offer arthritis-specific water classes. Even 20 to 30 minutes, two or three times a week, can reduce pain and improve how far you can walk on land.

Walking on flat, even ground is usually tolerable if you start slowly and don't overdo it. A cane or walker in the hand opposite your painful hip can reduce the load on the joint by up to 25 percent. Avoid hills, uneven ground, and long distances until you know what your hip can handle.

Gentle stretching and strengthening done at home or in physical therapy protects your hip by keeping the muscles around it strong and flexible. Weak muscles force your hip joint to work harder. A physical therapist can show you which exercises are safe for your specific situation — some movements that help one person can hurt another, depending on how far the arthritis has progressed.

Avoid high-impact activities like running, jumping, or aerobics classes. Also avoid repetitive twisting, deep squatting, or movements that require you to cross your legs tightly.

Pain relief at home: heat, ice, and over-the-counter options

Heat and ice work differently, and which one helps depends on what's happening in your joint. Heat — from a heating pad, warm bath, or warm shower — relaxes tight muscles and improves blood flow. It works best for stiffness, especially in the morning. explore heat for 15 to 20 minutes at a time. Ice reduces swelling and numbs sharp pain. Use it after activity if your hip feels hot or puffy. explore ice for 10 to 15 minutes, wrapped in a towel so it doesn't touch your skin directly.

Many people find that alternating heat and ice works best: heat in the morning to loosen up, ice after activity if there's swelling. Pay attention to what your hip responds to and stick with it.

Over-the-counter pain relievers can help you stay active. Ibuprofen (Advil, Motrin) and naproxen (Aleve) are nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce both pain and inflammation. Acetaminophen (Tylenol) reduces pain but not inflammation. Take these as directed on the package, and talk to your doctor before using them regularly if you have heart disease, high blood pressure, kidney problems, or stomach ulcers — NSAIDs can cause problems in these situations.

Weight management matters because every pound you carry puts extra stress on your hip joint. You don't have to reach an "ideal" weight to see improvement — even losing 5 to 10 pounds can reduce pain and improve how far you can walk. Talk to your doctor about a realistic goal for your situation.

When to see a doctor and what treatments they can offer

See your doctor if hip pain is limiting your daily activities, if over-the-counter pain relief isn't working, or if the pain is getting worse despite your efforts. Your doctor will examine your hip, ask about your symptoms, and may order an X-ray to see how much cartilage damage has occurred.

If over-the-counter options aren't enough, your doctor may prescribe stronger NSAIDs like prescription-strength ibuprofen or meloxicam. They may also recommend topical creams that you rub directly on the skin over your hip — these deliver pain relief to the area without affecting your whole body.

Corticosteroid injections into the hip joint can reduce inflammation and pain for several weeks to several months. Your doctor uses ultrasound or X-ray to guide the needle into the joint. The injection itself takes a few minutes, though you may feel pressure or a brief sting. Results vary — some people get significant relief, others feel little difference. You can usually have these injections a few times a year, but not more frequently because repeated injections can damage the joint.

Hyaluronic acid injections (sometimes called viscosupplementation) work differently. Hyaluronic acid is a substance that naturally occurs in joint fluid and acts as a lubricant and shock absorber. The injection adds more of it to your hip. These injections may help some people, though research on their effectiveness for hip arthritis is less clear than for knee arthritis. Your insurance may or may not cover them.

Hip replacement surgery: when and why

If conservative treatments stop working and pain is seriously limiting your life, your doctor may discuss hip replacement surgery. In this procedure, the surgeon removes the damaged ball-and-socket joint and replaces it with an artificial joint made of metal, plastic, or ceramic.

Most people consider surgery when they can't walk more than a short distance, when pain wakes them at night, or when they can no longer do activities that matter to them — like playing with grandchildren or gardening. Surgery is elective, meaning you and your doctor decide together whether the benefit is worth the recovery time and risks.

The surgery itself takes one to two hours. Recovery is gradual: you'll use a walker or crutches for a few weeks, then transition to a cane. Physical therapy starts within days of surgery and continues for several weeks. Most people can return to light activities within 6 to 8 weeks and resume normal activities within 3 to 6 months. Pain relief is often dramatic — many people say they forgot what it felt like to walk without pain.

Complications are uncommon but possible: blood clots, infection, dislocation of the new joint, or nerve or blood vessel injury. Your surgeon will discuss these risks with you before the procedure. The artificial joint typically lasts 15 to 20 years, though newer materials may last longer.

Daily habits that protect your hip

Beyond exercise and medication, small changes in how you move through your day can make a real difference. Use a cane or walker if it reduces pain — there's no shame in it, and it protects your joint. Avoid sitting in low chairs or couches that require you to bend your hip deeply; use a firm chair with armrests instead. When getting dressed, sit down to put on pants and shoes rather than standing on one leg. Use a long shoehorn and sock aid if reaching your feet is difficult.

Sleep position matters too. If you sleep on your side, place a pillow between your knees to keep your hip in a neutral position. Avoid sleeping on the painful side. Some people find that a body pillow helps them stay in a good position all night.

Pace yourself throughout the day. Do your most demanding activities when you're least tired and your pain is lowest — usually mid-morning for many people. Break activities into smaller chunks rather than doing one long task. Rest when you need to, without guilt.

Frequently Asked Questions

Can hip arthritis get better on its own?

No, hip arthritis does not reverse or heal on its own because the cartilage damage is permanent. However, pain can improve with movement, weight management, and treatment. Some people have periods where pain is less bothersome, then it flares again. The goal is to manage pain and stay as active as possible, not to cure the arthritis itself.

Is it safe to exercise when my hip hurts?

Yes, gentle movement usually helps more than resting. Pain that gets worse during activity and doesn't improve with rest within a few hours is a sign to ease back. Sharp, sudden pain is different from the dull ache of arthritis — stop if you feel sharp pain. Talk to your doctor or physical therapist about which exercises are safe for your specific situation.

How long does it take to feel better after a hip injection?

Corticosteroid injections usually start working within a few days, with peak effect around one to two weeks. Relief typically lasts several weeks to a few months. Hyaluronic acid injections work more slowly — it can take several weeks to feel the full benefit. Your doctor can tell you what to expect based on the type of injection.

What's the difference between hip arthritis and hip bursitis?

Hip arthritis is wear and tear inside the joint itself; hip bursitis is inflammation of the fluid sacs that cushion the hip. Arthritis pain is usually in the groin or deep inside; bursitis pain is on the outside of the hip. They're treated differently, so it's important to know which one you have. Your doctor can determine this with an exam and imaging if needed.

Can I prevent hip arthritis?

You can't prevent arthritis entirely if it runs in your family or if you've had a hip injury, but you can slow its progress. Stay active with low-impact exercise, maintain a healthy weight, avoid high-impact activities like running, and treat hip injuries promptly. If you have a job that requires repetitive hip stress, talk to your doctor about modifications.