Hip Osteoarthritis (Coxarthrosis): Causes, Symptoms, and Treatment
Also known as: Coxarthrosis, Hip OA, Osteoarthritis of the hip
Overview
Hip osteoarthritis, also called coxarthrosis, is a degenerative disease of the cartilage in the hip joint. It involves the progressive breakdown of joint cartilage, which leads to pain, stiffness, and loss of function. It becomes more common with age and occurs most often in people 50 and older, though it can affect younger people too. Hip osteoarthritis is a common source of disability that can weigh heavily on quality of life, and it is the most common reason for total hip replacement surgery.
Causes and risk factors
Coxarthrosis can be primary (no identifiable cause) or secondary to an underlying condition. Common risk factors include:
- Age, with risk rising after 50
- Excess weight and obesity, which add mechanical load to the joint
- Congenital or developmental structural abnormalities such as hip dysplasia, slipped capital femoral epiphysis, and Legg-Calvé-Perthes disease
- Past joint injuries such as fractures or dislocations
- Avascular necrosis of the femoral head
- Physically demanding work involving heavy lifting or repetitive joint overuse
- Family history, reflecting a documented genetic component
Symptoms
Coxarthrosis mainly presents with:
- Mechanical hip pain, typically felt in the groin and sometimes radiating to the thigh or knee, worse with activity and relieved by rest
- Morning joint stiffness, usually brief (less than 30 minutes)
- Reduced range of motion, especially internal rotation
- Shorter walking distance with a developing limp
- Clicking or grinding with hip movement
- In advanced stages, nighttime pain and persistent stiffness
Diagnosis
Diagnosis of coxarthrosis is mainly clinical and radiologic. The doctor reviews functional signs and examines hip mobility. A pelvic X-ray (front view) with a femoral neck view is the standard test. It can show narrowing of the joint space, thickening of the bone beneath the cartilage, bone spurs (osteophytes), and cysts. MRI or CT is reserved for atypical cases or when another condition is suspected.
Treatments
Care for coxarthrosis is tailored to the stage of disease and usually combines several approaches:
- Medication: first-line pain relief with acetaminophen, short courses of NSAIDs, and corticosteroid injections for painful flare-ups
- Physical therapy: rehabilitation to maintain joint mobility and strengthen the surrounding muscles
- Lifestyle measures: weight loss if overweight, and adjusting activity by favoring swimming or cycling over running
- Assistive devices: a cane or orthopedic shoe inserts
- Dietary supplements: glucosamine and chondroitin are widely used, but the evidence does not show they help hip osteoarthritis. Talk with your doctor before trying them
- Surgery: total hip replacement when medical treatment no longer controls symptoms and quality of life is significantly affected
Prevention
While primary coxarthrosis cannot always be prevented, several measures can lower the risk and slow its progression:
- Maintain a healthy body weight to limit mechanical strain on the hip
- Get regular, appropriate exercise such as swimming, cycling, or walking to preserve cartilage and strengthen stabilizing muscles
- Address structural abnormalities early, including dysplasia and leg-length differences
- Adjust your work environment to reduce heavy lifting
- See a doctor promptly for persistent hip pain to avoid further damage
When should you see a doctor?
See a doctor if you have persistent groin or hip pain lasting more than a few weeks, growing limitation of movement or a limp, or pain that wakes you at night. Sudden, intense pain after a fall or impact needs urgent care to rule out a fracture.
Sources
- AAOS OrthoInfo, patient education from the American Academy of Orthopaedic Surgeons
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), official U.S. government osteoarthritis information
- MedlinePlus, U.S. National Library of Medicine health information
- Arthritis Foundation, patient education and resources
- Osteoarthritis (StatPearls, NCBI Bookshelf), that X-ray findings include osteophytes, joint space narrowing, subchondral sclerosis, and cysts, and that avascular necrosis is a secondary cause
- Diagnosis and Treatment of Osteoarthritis (AAFP), that hip osteoarthritis limits range of motion especially internal rotation, and that morning stiffness usually lasts less than 30 minutes
- Slipped Capital Femoral Epiphysis (StatPearls, NCBI Bookshelf), that SCFE can lead to early-onset hip osteoarthritis
- AAOS OrthoInfo: Perthes Disease, that Legg-Calve-Perthes disease can lead to early-onset arthritis of the hip
- Total Hip Arthroplasty Techniques (StatPearls, NCBI Bookshelf), that end-stage symptomatic hip osteoarthritis is the most common indication for total hip replacement
- Hip Joint Injection (StatPearls, NCBI Bookshelf), that hip pain and dysfunction are a common source of disability affecting quality of life
- NCCIH: Glucosamine and Chondroitin for Osteoarthritis, that evidence does not support glucosamine or chondroitin benefit for hip osteoarthritis