Hip Osteoarthritis: Causes, Symptoms, and Physiotherapeutic Treatment

Hip osteoarthritis, also known as coxarthrosis, is a degenerative condition affecting the hip joint. Unlike knee osteoarthritis (see our other post), this condition specifically targets the hip joint. It can cause significant pain and restrict mobility, severely impacting the daily lives of those affected. It is important to note that some wear and tear of the joint surface is part of the natural aging process. We refer to pathological osteoarthritis in the physiotherapy context when pain and/or movement restrictions significantly hinder daily activities.

It’s also crucial to mention that existing hip osteoarthritis cannot be “cured” or “disappear” through physiotherapy. The loss of cartilage tissue cannot be reversed by physical therapy. Physiotherapeutic treatment primarily aims to improve the pain situation, maintain the blood circulation and nutrition of the cartilage as much as possible, preserve movement, and slow down cartilage degradation.

Causes of Hip Osteoarthritis

Hip osteoarthritis occurs due to the wear and tear of the cartilage covering the hip joint. This cartilage acts as a shock absorber and allows smooth movement of the joint. Over time, the cartilage can become worn or damaged due to various factors. The main causes of hip osteoarthritis include:

  • Age: The body’s ability to repair damaged cartilage decreases with age.
  • Overweight: Excess weight puts additional stress on the hip joint and accelerates cartilage wear.
  • Genetic predisposition: A family history of osteoarthritis can increase the risk of developing the condition.
  • Injuries: Previous hip injuries, such as fractures or dislocations, can contribute to the development of osteoarthritis.
  • Misalignments:  Congenital or acquired misalignments of the hip joint can unevenly load the cartilage, leading to premature wear.

Gender and Age Distribution

Hip osteoarthritis affects both men and women, but there are some differences in distribution:
Women are more frequently affected by hip osteoarthritis than men, especially after menopause. Hormonal changes may play a role in the development of osteoarthritis.
Men often develop osteoarthritis at a younger age, particularly if they engage in physically demanding activities or have had previous hip injuries.

Hip osteoarthritis is particularly common in older adults. The likelihood of developing hip osteoarthritis increases with age:
People over 50 years are most commonly affected, with prevalence increasing with age.
Younger people can also be affected, especially if they have predisposing factors such as genetic predisposition or previous injuries.

Symptoms of Hip Osteoarthritis

The symptoms of hip osteoarthritis usually develop gradually and can intensify over time. The most common symptoms include:

  • Pain: Pain can occur in the groin, thigh, or buttocks and sometimes radiates to the knee. Initially, pain often occurs only with activity, later also during rest.
  • Stiffness: The hip joint can be stiff and immobile, especially after long periods of rest or in the morning.
  • Movement restrictions: Everyday movements, such as putting on socks or getting in and out of a car, can become difficult.
  • Crepitus: Audible or palpable grinding noises may occur when moving the hip joint-
  • Reduced endurance: Prolonged standing, walking, or climbing stairs can be challenging due to pain and stiffness.

Physiotherapeutic Treatment Options

Physiotherapy plays a crucial role in treating hip osteoarthritis. The goal of therapy is to alleviate pain, improve mobility, and strengthen the muscles to relieve the joint. Here are some of the most important physiotherapeutic measures:

Strengthening Exercises

Targeted exercises to strengthen the muscles around the hip joint are essential. Strong muscles can better stabilize and relieve the joint. Typical exercises include:
Hip flexor and extensor exercises: These exercises strengthen the muscles at the front and back of the hip joint.
Abduction and adduction exercises: These train the muscles that move the leg to the side and back.
Core training: A strong core supports hip stability.

Mobilization Techniques

Mobilization techniques help improve the hip joint’s mobility and stretch the joint capsule. These techniques are often performed manually by the therapist and may include passive movements and stretches.

Pain Relief Measures

Various physical therapies can be used to relieve pain and inflammation:
Heat and cold therapy: Heat can promote blood circulation and relax muscles, while cold has anti-inflammatory and pain-relieving effects.
Electrotherapy: Low-frequency electrical currents can help relieve pain and stimulate muscles.
Ultrasound therapy: Ultrasound waves can penetrate deep into the tissue and have anti-inflammatory effects.

Advice on Everyday Management

An important part of physiotherapeutic treatment is advising patients on managing their condition in everyday life. This includes:
Ergonomic tips: Adjustments in the home and work environment can help relieve the joint.
Gentle movements: Techniques and strategies to avoid painful movements and minimize stress on the hip joint.
Staying active: Recommendations for moderate physical activity to maintain joint mobility and strengthen muscles.

Home Exercises

Here are some simple exercises that affected individuals can do at home to strengthen the hip muscles and improve mobility:

Hip Bridge

1. Lie on your back with your knees bent and feet hip-width apart on the floor.
2. Lift your pelvis until your body forms a straight line from your knees to your shoulders.
3. Hold the position for a few seconds and slowly lower the pelvis back down.
4. Repeat the exercise 10-15 times.

Side Leg Raise

1. Lie on your side with your legs stretched out and stacked on top of each other.
2. Slowly lift the top leg without rotating the hip.
3. Slowly lower the leg back down.
4. Repeat the exercise 10-15 times per side.

Hip Extension on All Fours

1. Get on all fours, with your hands under your shoulders and knees under your hips.
2. Extend one leg back, keeping the leg straight and the hip level.
3. Slowly lower the leg back down.
4. Repeat the exercise 10-15 times per side.

Knee to Chest

1. Lie on your back with your legs stretched out.
2. Pull one knee towards your chest and hold it with your hands.
3. Hold the position for 20-30 seconds, then switch legs.
4. Repeat the exercise 3-5 times per side.

Step Lunges

1. Stand upright with your feet shoulder-width apart.
2. Take a large step forward with one leg and slowly lower the back knee towards the ground.
3. Keep your upper body straight and ensure that the front knee does not extend beyond the toes.
4. Push back into the starting position and switch legs.
5. Repeat the exercise 10-15 times per side.

Standing Hip Stretch

1. Stand behind a stable chair or surface and hold onto it.
2. Place one foot behind the other, keeping the back leg straight and the front knee slightly bent.
3. Bend the front knee slightly until you feel a stretch in the hip and thigh of the back leg.
4. Hold the stretch for 20-30 seconds, then switch legs.
5. Repeat the exercise 3-5 times per side.

Clamshell Exercise

1. Lie on your side with your legs stacked and knees slightly bent.
2. Lift the top knee without rotating the pelvis or separating the feet.
3. Hold the position for a few seconds and slowly lower the knee back down.
4. Repeat the exercise 10-15 times per side.

These additional exercises help further strengthen the hip muscles and promote mobility. Remember to perform all exercises in a controlled and pain-free manner. If you have any questions or uncertainties, feel free to contact us – we support you on your path to more mobility and pain relief.


Hip osteoarthritis can be a significant burden for those affected, but targeted physiotherapeutic measures and regular exercises can alleviate symptoms and improve quality of life. In our physiotherapy practice, we offer individualized treatment plans tailored to your specific needs. Don’t hesitate to contact us and schedule an appointment. Together, we achieve health!