What is hip osteoarthritis?
Hip osteoarthritis develops when the smooth cartilage that cushions the ball-and-socket hip joint gradually thins and roughens. As the protective layer wears, bone begins to rub against bone, causing pain in the groin, thigh or buttock, stiffness after rest, and a shrinking range of movement. It most commonly affects people over 50, though previous hip injury, a physically demanding job, excess weight and family history can all bring it on earlier.
Diagnosis usually starts with your GP, who will examine the hip and ask how symptoms affect daily life. An X-ray typically confirms the diagnosis by showing narrowing of the joint space and bony changes. Severity on X-ray does not always match how much pain you feel, so treatment decisions are based on both together.
Common symptoms
- Deep aching pain in the groin, thigh or buttock
- Stiffness, especially after sitting or first thing in the morning
- Pain that worsens with walking or activity
- Reduced range of movement, such as difficulty putting on socks
- Grinding or clicking sensations in the joint
- A limp or shortened stride
- Disturbed sleep from night-time pain
How long will you wait?
Routine referral to an NHS orthopaedic clinic and on to hip replacement commonly takes six to twelve months or more at many trusts, as trauma and orthopaedics remains one of the most pressured specialties.
Privately, you can typically see a hip specialist within 3–7 days, with surgery usually scheduled within 2–6 weeks of deciding to proceed.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Physiotherapy and exercise. Targeted strengthening and stretching keeps the joint mobile and can meaningfully reduce pain in early disease.
- Weight management and activity modification. Losing excess weight reduces load on the hip and can slow symptom progression.
- Pain relief and steroid injections. Anti-inflammatory medication or an image-guided steroid injection can ease flare-ups, though injection benefit is often temporary.
- Total hip replacement. The worn joint is replaced with an artificial ball and socket, a highly successful operation for advanced osteoarthritis.
What does private treatment cost?
As a guide, self-pay total hip replacement in the UK typically costs around £12,500–£16,000, including the consultant, hospital stay and standard implant.
Does health insurance cover hip osteoarthritis?
Private medical insurance normally covers diagnosis and surgery for hip osteoarthritis, including hip replacement, provided the condition began after your policy started. If you already had hip symptoms or a diagnosis when you took out cover, it will usually be excluded as pre-existing, at least initially. Osteoarthritis is a long-term condition, so insurers cover the acute episodes of treatment (such as surgery) rather than indefinite ongoing management.
Frequently asked questions
How do I know when it is time for a hip replacement?
Surgery is usually considered when pain limits everyday activities such as walking, sleeping or working despite good non-surgical care, including physiotherapy, weight management and pain relief. There is no fixed threshold on X-ray; it is a shared decision with your surgeon based on how much the hip is affecting your quality of life.
How long does a hip replacement last?
Modern hip replacements are very durable. Registry data from joint replacement programmes suggests most implants last well beyond 15 years, and many last 25 years or more. Younger, more active patients place greater demands on the implant, which is one reason surgeons sometimes advise delaying surgery where symptoms allow.
Can physiotherapy cure hip osteoarthritis?
Physiotherapy cannot reverse cartilage loss, but it can significantly reduce pain and improve function, particularly in mild to moderate disease. Strengthening the muscles around the hip supports the joint and can delay or sometimes avoid the need for surgery, so it is recommended for almost everyone with the condition.
Related guides
- ACL Injury
- Bunions (Hallux Valgus)
- Carpal Tunnel Syndrome
- Dupuytren's Contracture
- Frozen Shoulder
- Ganglion Cyst