Treatment for Hip Arthritis Without Surgery: Effective Non-Surgical Options

Effective treatment for hip arthritis without surgery is available and can significantly reduce pain, improve mobility, and delay or sometimes avoid the need for hip replacement. Osteoarthritis affects tens of millions of U.S. adults, more than 32.5 million by frequently cited CDC estimates, and the hip is one of the most commonly involved large joints. While total hip replacement is an excellent option for advanced cases, most people benefit from trying non-surgical approaches first. This article is for general education only and is not a substitute for advice from your own clinician.

This guide covers every major treatment for hip arthritis without surgery, from physical therapy and medications to injections and lifestyle changes. These strategies are supported by evidence and guidelines from the CDC, the National Institutes of Health (NIH), the American College of Rheumatology (ACR) and Arthritis Foundation, the Mayo Clinic, and the Cleveland Clinic.

Understanding Hip Arthritis

Hip arthritis most commonly refers to osteoarthritis (OA), a degenerative condition in which the cartilage that cushions the hip joint gradually breaks down. As cartilage wears away, the bones of the joint move against each other with less protection, causing pain, stiffness, and reduced range of motion. OA is a whole-joint condition, also involving bone, ligaments, and the joint lining, not simply “wear and tear.”

Other types of hip arthritis include rheumatoid arthritis (an autoimmune condition), post-traumatic arthritis (following a hip injury), and avascular necrosis (loss of blood supply to the femoral head). Each may require a different treatment approach, so an accurate diagnosis from a clinician is important before starting a plan.

Common symptoms of hip osteoarthritis include:

• Pain in the groin, outer hip, thigh, or buttock
• Stiffness, especially in the morning or after sitting
• Reduced range of motion (difficulty putting on shoes or getting in and out of cars)
• A grinding or clicking sensation during movement
• Pain that worsens with activity and improves with rest
• Limping or an altered gait

Risk factors include older age, excess body weight, previous hip injury, family history, and certain occupations involving heavy lifting or repetitive hip loading. A clinician diagnoses hip OA through a history, a physical exam, and imaging such as X-rays when appropriate.

Physical Therapy and Exercise

Physical therapy is widely considered the most valuable non-surgical treatment for hip arthritis. The American College of Rheumatology strongly recommends exercise as a cornerstone of osteoarthritis management, and it is one of the few interventions supported by high-quality evidence for both pain and function.

What physical therapy involves:

• Strengthening exercises for the muscles that support the hip (gluteus medius, quadriceps, and hip flexors)
• Range-of-motion exercises to maintain and improve flexibility
• Gait training to correct compensatory movement patterns
• Balance training to reduce fall risk
• Manual therapy (joint mobilization and soft-tissue techniques)
• Education on activity modification and joint protection

Exercise types that help hip arthritis:

• Low-impact aerobic exercise: Walking, swimming, cycling, and elliptical training improve cardiovascular fitness without excessive joint stress. Physical activity guidelines generally recommend working toward at least 150 minutes of moderate aerobic activity per week, built up gradually.
• Aquatic therapy: Exercising in warm water reduces joint loading while providing gentle resistance. The Arthritis Foundation recognizes aquatic exercise as helpful for hip and knee osteoarthritis.
• Yoga and tai chi: Both can improve flexibility, strength, and balance while being gentle on joints. Research has found that tai chi can reduce pain and improve function in people with osteoarthritis, and the ACR conditionally recommends mind-body movement of this kind.
• Strength training: Building muscle around the hip provides better support and reduces stress on the damaged joint. A focus on the hip abductors, quadriceps, and core is common.

Many physical therapy programs involve a course of supervised sessions over several weeks, transitioning to a home exercise program for long-term maintenance. Consistency matters more than intensity; the benefits fade if exercise stops. If you need help finding a specialist, our find an orthopedic doctor resource can help.

Medications for Hip Arthritis

Several medication categories can help manage hip arthritis pain. The notes below are general and educational; they are not dosing instructions. Your clinician and pharmacist should guide which medicine is appropriate for you, at what dose, and for how long, taking into account your other conditions and medications.

Over-the-counter options:

• Acetaminophen (Tylenol): May provide mild pain relief with fewer gastrointestinal effects than NSAIDs, though it is generally less effective than NSAIDs for arthritis pain. The ACR offers only a conditional recommendation for it.
• Oral NSAIDs (ibuprofen, naproxen): Often more effective than acetaminophen for arthritis pain because they reduce both pain and inflammation. However, they carry risks, including gastrointestinal bleeding, kidney effects, and cardiovascular events, particularly with long-term use or in older adults. Guidance is to use the lowest effective amount for the shortest necessary time, under clinician direction.
• Topical NSAIDs (diclofenac gel/Voltaren): Applied to the skin over the painful area, these provide localized anti-inflammatory effects with less systemic absorption. The ACR recommends topical NSAIDs, though the depth of the hip joint makes topical penetration less effective for the hip than for the more superficial knee.

Prescription options:

• Prescription-strength NSAIDs (such as meloxicam or celecoxib): Celecoxib (Celebrex) is a COX-2 selective NSAID that may carry lower gastrointestinal risk than some traditional NSAIDs, though cardiovascular and kidney considerations still apply.
• Duloxetine (Cymbalta): An SNRI that is FDA-approved for chronic musculoskeletal pain, including osteoarthritis. The ACR conditionally recommends it for people who cannot take, or do not respond well to, NSAIDs.
• Tramadol and opioids: The ACR recommends against routine use of opioids, including tramadol, for osteoarthritis because of limited benefit and significant risks, including dependence. They are reserved for narrow situations under close supervision.

Joint Injections

When oral medications and physical therapy provide insufficient relief, injections into the hip joint may help. Hip injections are typically performed under ultrasound or X-ray (fluoroscopic) guidance because the joint is deep and hard to target by feel alone.

Corticosteroid injections: Injecting a corticosteroid into the hip joint can provide pain relief lasting weeks to a few months for some people. Guidelines suggest limiting the frequency of injections, since repeated steroid injections may have downsides over time, and benefit varies from person to person. Your clinician weighs the trade-offs with you.

Hyaluronic acid injections (viscosupplementation): These aim to supplement the joint’s natural lubricating fluid. Hyaluronic acid is FDA-approved for knee osteoarthritis, but its use in the hip is off-label, and the evidence for the hip is weaker and mixed. The ACR does not recommend it for hip OA, so it is not a standard option for the hip.

Platelet-rich plasma (PRP) injections: PRP uses concentrated platelets from your own blood in an attempt to promote healing. Evidence for hip osteoarthritis remains limited, it is not an FDA-approved treatment for this use, and it is typically not covered by insurance.

Stem cell therapy: Marketed as regenerative medicine, stem cell injections for hip arthritis are still experimental. The FDA has warned against unproven stem cell products, and major guidelines do not recommend them outside of clinical trials.

Weight Management

Maintaining a healthy weight is one of the most impactful non-surgical treatments for hip arthritis. Because the hip bears much of the body’s load, each pound of body weight translates into several pounds of force across the joint during walking, so even modest weight loss can noticeably reduce hip stress.

Research summarized by the NIH indicates that losing even a modest amount of weight can reduce hip and knee pain and improve function in people who carry excess weight. The ACR strongly recommends weight loss for people who are overweight or obese and have hip or knee osteoarthritis; a loss of around 5 to 10 percent of body weight is often enough to produce meaningful symptom improvement, and combining weight loss with exercise works better than either alone.

Effective approaches include:

• Working with a registered dietitian to create a sustainable eating plan
• Combining dietary changes with low-impact exercise appropriate for your arthritis
• Avoiding crash diets, which are hard to maintain and can cost muscle
• Setting realistic, gradual goals rather than rapid weight loss

Assistive Devices and Lifestyle Modifications

Simple changes to daily activities can reduce hip stress and pain:

Assistive devices:

• Cane: Using a cane in the hand opposite the affected hip can meaningfully reduce hip joint loading. Ensure the cane is the correct height (the top roughly at wrist level when standing upright with arms relaxed).
• Shoe inserts or orthotics: Cushioned insoles can absorb shock; a clinician can advise whether custom orthotics are worthwhile for you.
• Raised toilet seats and grab bars: Reduce the deep hip bending required for sitting and standing.
• Long-handled shoe horns and sock aids: Reduce the need to bend the hip deeply.

Activity modifications:

• Swap high-impact activities (running, jumping) for low-impact alternatives
• Take breaks during prolonged standing or walking
• Use chairs with armrests to assist with sitting and standing
• Try sleeping with a pillow between your knees to reduce hip stress
• Avoid positions that consistently aggravate your hip, such as prolonged leg crossing

Heat and cold: Applying heat can ease stiffness before activity, while cold can help calm a flare or reduce swelling afterward. Use a barrier to protect the skin and limit each application to short sessions. For comprehensive condition management, visit our conditions guide.

When Surgery Is Considered

Non-surgical care is the starting point for most people, but surgery, most often total hip replacement, becomes a reasonable discussion when conservative measures no longer control the problem. Signs that it may be time to talk with an orthopedic surgeon include pain that persists despite a genuine trial of exercise, weight management, medications, and injections; pain that disturbs sleep or occurs at rest; and a loss of function that limits walking, work, or daily activities. The decision is individual and weighs your symptoms, imaging, overall health, and goals. Choosing to explore surgery does not erase the value of non-surgical work; staying active and fit beforehand can improve recovery afterward.

Frequently Asked Questions

Can hip arthritis be cured without surgery?

Osteoarthritis cannot be cured by any treatment, surgical or non-surgical. However, non-surgical treatments can effectively manage symptoms and maintain quality of life for many years. Some people with hip arthritis manage their condition successfully without ever needing surgery, especially with early, consistent care.

How long can you delay hip replacement with non-surgical treatment?

This varies widely. Some people delay hip replacement for many years with effective non-surgical management, while others have more rapidly progressive arthritis that responds less well to conservative treatment. Factors that influence the timeline include the degree of cartilage loss, body weight, activity level, and how the joint responds to treatment.

Are cortisone shots safe for hip arthritis?

Corticosteroid injections are generally considered reasonable when used infrequently and appropriately. Short-term effects can include a temporary pain flare, a short-lived rise in blood sugar in people with diabetes, and facial flushing. A concern with frequent, repeated injections is potential harm to the joint over time. Discuss the risks and benefits, and the right spacing, with your clinician.

What exercises should I avoid with hip arthritis?

Many people do better limiting high-impact activities like running, jumping, and heavy squatting, along with deep lunges and movements that force extreme hip rotation, if these clearly worsen symptoms. The better path is low-impact strengthening, stretching, and aerobic exercise. A physical therapist can design a safe, effective program tailored to your specific condition.

Does glucosamine or chondroitin help hip arthritis?

Research results are mixed. Some people report improvement with glucosamine and chondroitin supplements, but large clinical trials have not consistently shown benefit over placebo, and the ACR does not recommend them for hip OA. If you try these supplements, allow a couple of months to assess any effect, discuss them with your clinician (especially if you take blood thinners), and discontinue if you notice no improvement.

Build a Comprehensive Non-Surgical Treatment Plan

Effective treatment for hip arthritis without surgery combines several strategies rather than relying on any single fix. Start with regular physical therapy and exercise, use medications thoughtfully and as directed for pain control, work toward a healthy weight, and modify the activities that aggravate your symptoms. Partner with an orthopedic specialist or rheumatologist to build a personalized plan and monitor your condition over time. Many people live active, fulfilling lives with hip arthritis using non-surgical management alone, and even those who eventually need surgery benefit from optimizing their fitness and function beforehand.

Sources

• Centers for Disease Control and Prevention (CDC) — Osteoarthritis and arthritis data
• American College of Rheumatology / Arthritis Foundation — Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee
• Mayo Clinic — Osteoarthritis: diagnosis and treatment; hip pain
• Cleveland Clinic — Hip osteoarthritis
• National Institutes of Health / NIAMS — Osteoarthritis