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Hip Osteoarthritis Treatment in Southampton

It might be a deep ache in your hip when you’re walking. It might be stiffness when you’re first getting up in the morning. Or it might be struggling to get out of that chair that was so comfortable until you sat down a little too long ago, followed by feeling you’re hobbling a few steps before your hip loosens up to walk more normally.

In technical terms, hip osteoarthritis can be described as a degenerative joint condition, characterised by changes to smooth articular cartilage, hardening or sclerosis of underlying bone, formation of bone spurs and changes to surrounding soft tissues, such as synovitis affecting the joint capsule. Degenerative might sound a scary term. It might sound like an inevitable and long slow wait for things to get worse, but that does not need to be the case. The condition does not inevitably worsen over time with the right management (Wieczorek et al., 2020). At Southampton Physio, we are here to help you understand, learn how best to manage your symptoms, rebuild strength and return to what matters most to you.

According to the organisation Arthritis UK, approximately 3.2 million people in the UK have hip osteoarthritis, so if you are in that number, you are far from being alone.

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Is This What You're Feeling?

Hip osteoarthritis typically presents with the following signs and symptoms:
  • Location - deep groin pain, buttock pain or pain in a “C shape” around the hip (imagine making a C with your index finger and thumb, placing the hand over the side of your hip). The pain may also refer down the front of the thigh or into the knee.
  • Aggravated by walking, stairs, or getting in and out of the car.
  • Pain and stiffness after static periods, especially longer periods, such as driving, working at a desk, watching TV.
  • Morning stiffness. Tightness and difficulty moving on getting up in the morning, usually easing within 30 minutes of getting up and moving around.
  • Reduced joint mobility. The hip might feel less flexible, particularly in rotating your leg inwards or outwards, causing difficulty with putting on shoes and socks.
  • Changes to walking pattern. Stride length and walking speed can change, alongside developing a limp or “antalgic gait”.
  • Flare ups. Symptoms can fluctuate and it is common to have flare ups lasting days or weeks, which then settle in time to normal levels.
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Why Is This Happening?

Hip osteoarthritis develops when the demands placed on the hip joint exceeds its capacity to adapt and repair over time.

Inflammatory and mechanical factors contribute to the development, progression and severity of osteoarthritis:

  • Inflammatory changes are significant to progression and severity of osteoarthritis (Robinson WH et al., 2016, Sanchez-Lopez E et al., 2022)
  • Obesity or being overweight. Adipose tissue results in low grade systemic inflammation. (Ouchi et al, 2011; Wang & He 2018)
  • Previous hip injuries can predispose to development of osteoarthritis later in life.
  • Developmental changes, such as Perthes disease and developmental dysplasia.
  • Reduced hip strength and control. Weakness in the gluteal muscles and hip stabilisers changes how load is distributed across the joint during walking, stairs, and single-leg activities
  • Movement patterns. How you walk, stand, and move influences joint loading and muscle strength.
woman holding her lower back
senior couple taking a break from fitness routine

How Southampton Physio Treats Hip Osteoarthritis

We identify what’s driving your symptoms and what your hip can tolerate right now. Your first session includes a detailed discussion of your history, a physical assessment of hip strength, range of motion, and movement patterns, and a clear explanation of what’s happening and why. You’ll leave with a specific plan, not generic advice, and usually some exercises or modifications you can start immediately.
Manual therapy may help reduce pain and improve mobility in the short term, providing sufficient relief for engagement other aspects of treatment, but evidence does not support its use in isolation to bring long lasting improvements (Runge et al., 2022; Beumer et al., 2015). Consequently, NICE guidelines (2022) state that manual therapy should only be used in conjunction with therapeutic exercise. Techniques could include joint mobilisation, passive hip movement or if there is secondary muscle tightness around the hip soft tissue work. Acupuncture and electrotherapy modalities are not recommended in the NICE guidelines (NICE 2022).

NICE Guidelines for osteoarthritis recommend education, exercise, and weight management, if applicable. Manual therapy and other interventions may help in the short term, but exercise is the strongest evidence-based intervention for long-term improvement.

Exercise, movement re-education and self-management strategies are how lasting improvement occurs. We work along the same guidelines and evidence base which guide NHS management. NICE guidelines (2022) for osteoarthritis recommend:

  • Tailored therapeutic exercise
  • Supervised therapeutic exercise
  • Long term adherence with exercise
  • Education
  • Behaviour change
  • Weight loss for those who are overweight or live with obesity
  • Consideration of mobility aids

We can tailor your exercise and physical activity to your symptoms and lifestyle, support you to learn to listen to your body and work with it, not against it. We will explore the impact other conditions have, to widen your understanding and ability to manage on your own for long after you have seen us.

Your programme will likely include:

  • Progressive strengthening exercises, targeting the muscles that stabilise and move your hip, progressing from non-weight bearing, to bodyweight to loaded resistance as appropriate and tolerated
  • Movement retraining, addressing compensatory patterns in walking, stairs, and single-leg activities
  • Aerobic exercise. Walking, cycling or swimming to improve overall fitness, reduce or manage systemic inflammation as well as improve the hip tolerance.

Evidence supports exercise for management of osteoarthritis. For example, a 2025 UK trial (Wainwright et al., 2025) found that a cycling and education programme was effective for hip osteoarthritis. Many patients report improved comfort moving in water.

NHS Physical Activity guidelines guidelines both recommend 150 minutes of moderate-intensity aerobic activity per week, alongside resistance training 2 to 3 times per week. We’ll tailor this to your current capacity and build gradually.

For some people, especially those who’ve tried multiple treatments without lasting results, we offer a more comprehensive pathway through our Clinical Personal Training servic. This integrates our full team over 12 to 16 weeks and is designed for persistent or complex issues that need a deeper root-cause approach.

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What You Can Start Doing Today

Before your first appointment, these evidence-based strategies can help:
  • Keep moving within tolerance. Complete rest is not recommended. Walking, gentle cycling, or swimming maintain hip mobility and reduce stiffness. Start with short, manageable distances and gradually increase as tolerated
  • Modify aggravating activities. If prolonged walking brings on pain, break longer walks into shorter segments with rest. If stairs are difficult, use a handrail and take your time
  • Consider weight management if appropriate. If you're overweight, weight loss of 5-10% of body weight significantly reduces joint loading and improves symptoms. This is a strongly recommended intervention across all major guidelines (EULAR 2023, NICE NG226, OARSI 2019, ACR/AF 2020)
old woman grandmother patient hands holding knee
Physiotherapist assessing hip range of motion with patient lying on treatment table, clinical

Why Choose Southampton Physio for Hip Osteoarthritis?

Our team has extensive experience managing hip osteoarthritis across all ages and activity levels, from office workers struggling with daily tasks to runners and cyclists aiming to return to sport. We integratephysiotherapy, osteopathy, sports therapy and clinical personal training under one roof at our Bedford Place clinic, and we treat the underlying drivers of your symptoms, not just the pain itself.

We combine hands-on treatment, tailored rehabilitation exercises, and education grounded in current evidence. You’ll work with clinicians who understand that hip osteoarthritis is not a barrier to an active life. It’s a condition that responds to the right approach.

I have severe osteoarthritis in my major joints requiring hip replacement in December. Ewan worked with me during that time and came up with a schedule which strengthened my various joints, pushing me when I needed and backing off when I had a flare up. Surgery went really well and so much better having worked the various muscle groups around my hip.
Len Bates
We also serve patients from across Southampton, including Shirley, Portswood, Eastleigh, Chandlers Ford, and Bishops Waltham. You’ll find us at Southampton Physio, 35 Bedford Place, Southampton, SO15 2DG. Our team includes Andy Killen, Ian Greaves, Richard Beak, and Ewan Gadsby, all experienced in managing hip conditions.
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Frequently Asked Questions About Hip Osteoarthritis in Southampton

Yes. Current guidelines from NICE (National institute of clinical excellence), EULAR (European Alliance of Associations for Rheumatology), and OARSI (Osteoarthritis Research Society International), all based on comprehensive review of a wide base of evidence, recommend that exercise therapy is the most effective non-surgical treatment for hip osteoarthritis. Physiotherapy provides structured, progressive exercise programmes alongside education and manual therapy where appropriate. Most people see meaningful improvements in pain and function within 8 to 12 weeks.
Physiotherapy for hip osteoarthritis focuses on three areas: education (understanding your condition and how to manage it), exercise (strengthening the hip and improving load tolerance), and manual therapy (short-term symptom relief). The exercise component is the foundation. Research shows this provides the most sustained benefit over time.
Hip osteoarthritis typically causes a deep ache in the groin, buttock, or front of the thigh. Pain is often worse with walking, stairs, or standing for long periods, and improves with rest. Morning stiffness lasting 20 to 30 minutes is common. Some people also experience pain when putting on shoes or getting in and out of a car due to reduced hip mobility.
You can self-refer directly to Southampton Physio without seeing your GP first. If your hip pain is gradual in onset, related to activity, and improves with rest, physiotherapy is an appropriate first step. See your GP urgently if you have severe pain after a fall, sudden inability to bear weight, fever alongside joint pain, or unexplained swelling and warmth in the hip. These may indicate fracture or infection.
Most people see initial improvements within 8 to 12 weeks of starting a structured exercise programme. Benefits are typically sustained at 6 to 9 months when exercise is continued. Hip osteoarthritis is a long-term condition, so ongoing activity and strength work are important to maintain improvements. Treatment duration varies depending on your symptoms, goals, and response.
The best exercises are those that progressively strengthen the hip muscles and improve load tolerance. This typically includes resistance exercises, aerobic activities (cycling, swimming), and flexibility work. NHS physical activity guidelines recommend a minimum of 150 minutes of moderate aerobic activity per week plus strengthening exercises 2 to 3 times weekly. Your physiotherapist will tailor this to your current capacity.
Yes. Exercise is safe and strongly recommended for hip osteoarthritis. Pain during or after exercise does not mean you are causing damage. Some discomfort is normal as your hip adapts to increased load. The key is to progress gradually and stay within tolerable limits. Your physiotherapist will guide you on what is safe and appropriate for your hip.
You do not need to avoid activities entirely, but you may need to modify them. Avoid high-impact activities that cause prolonged pain flare-ups (though some people tolerate running or jumping well). Prolonged sitting or inactivity can worsen stiffness. You should also avoid excessive hip abduction movements (such as deep yoga poses) if these aggravate symptoms. Current guidelines do not recommend acupuncture or heel wedge insoles for hip osteoarthritis.
Not usually. NICE guidelines (NG226, 2022) state that imaging should not routinely be used to diagnose osteoarthritis unless there are atypical features or features suggesting an alternative diagnosis. Osteoarthritis is diagnosed based on your symptoms and physical assessment. X-ray or MRI findings do not predict your pain levels or function, and many people with significant imaging changes have no symptoms.
This varies depending on your symptoms, goals, and response to treatment. Most people attend 4 to 6 sessions over 8 to 12 weeks, with exercises to continue independently between sessions. Some people with more complex or persistent symptoms may benefit from longer-term support through our Clinical Personal Training pathway.

There is strong evidence that hip osteoarthritis does not inevitably worsen over time (Systematic Review by Wieczorek et al., 2020). We know that symptoms can fluctuate, and flare-ups are common. However, many people improve significantly with the right management, in terms of pain, reliance on pain relief medication, improved quality of life, reduction in sick leave and reduction in desire for surgery (Jönsson et al, 2019).

Exercise, weight management, and education can reduce pain and improve function even in people with advanced imaging changes. Progression to surgery is not inevitable.

Both physiotherapists and osteopaths are trained to assess and treat hip osteoarthritis. Physiotherapists typically emphasise exercise rehabilitation and movement retraining. Osteopaths may use more hands-on manual therapy techniques alongside exercise. At Southampton Physio, we integrate both approaches depending on what you need. You can read more about our osteopathy service.
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Ready to Get Moving Again?

Hip osteoarthritis is a condition that responds to the right treatment. You don’t need to accept reduced activity, and you don’t need to wait for symptoms to worsen. Most people see meaningful improvements in pain and function within a few months of starting a structured exercise programme, and many return to the activities they thought they’d lost.

If you’re ready to take control of your hip pain and work with a team that understands what works, book your assessment today. Call us on 023 8110 2077 or use the link below.

023 8110 2077
Book your hip osteoarthritis assessment