| What We Treat
Hip Osteoarthritis
Hip arthritis is often felt deep in the groin, but it refers to the buttock, side, thigh and knee too. That spread is why it is so often mistaken for something else.
Overview
What It Is
Hip osteoarthritis involves change to the cartilage and bone of the ball-and-socket joint. Pain is often felt in the groin, but it can equally present in the buttock, over the side of the hip, down the thigh or at the knee, and many people have it in more than one of those places at once. The most recognisable gesture is the C-sign: cupping the hand above the hip with the thumb behind and the fingers into the groin, which tells you the pain is deep in the joint rather than superficial.
Tap a structure, or use the buttons, to see what may be involved.
Where the Arthritis Is
The cartilage lining the socket and the head thins over years. On an X-ray this shows as the joint space narrowing, and it is the finding the diagnosis rests on.
Symptoms
How It Tends to Feel
These are the features that point towards this diagnosis rather than another:
The C-Sign
Cupping the hand above the hip, thumb behind and fingers into the groin. It signals pain deep in the joint rather than a superficial structure.
Groin Pain
The most commonly reported site, though far from the only one.
Buttock, Side or Thigh Pain
All are genuine referral patterns from the hip joint, and all are frequently attributed to the back or the tendons instead.
Loss of Internal Rotation
The earliest and most reliable examination finding, often present before pain is severe.
Difficulty With Socks and Shoes
A practical marker of how much rotation has been lost.
Referred Knee Pain
The hip not uncommonly presents as knee pain, which is a recognised cause of delayed diagnosis.
Causes & Risk Factors
What Drives It
The usual contributors, in rough order of how often they turn out to matter:
Age
The dominant factor, with incidence rising steadily from the fifties.
Hip Dysplasia
A shallow socket concentrates load and is a leading cause of arthritis before fifty.
Femoroacetabular Impingement
Associated with earlier onset in some people.
Previous Injury or Perthes
Childhood hip conditions raise long-term risk considerably.
How We Can Help You
Treatment & Management
Treatment is built around what the assessment finds, but generally follows this shape:
When to Seek Help
Red Flags — Don’t Ignore These
Most presentations are straightforward. These features are the exceptions, and warrant prompt assessment:
⚠ Seek Medical Advice If You Notice
- A hot, swollen hip with fever — infection must be excluded urgently
- Sudden inability to weight bear, particularly after a fall — consider fracture
- Rapidly progressive pain and stiffness over weeks
- Night pain with unexplained weight loss, or a history of cancer
If any of these apply, contact your GP or seek urgent medical care rather than waiting for a physiotherapy appointment.
Common Questions
Frequently Asked Questions
Why does my knee hurt if the problem is my hip?
The hip refers pain to the knee through shared nerve supply. It is common enough that knee pain without a clear knee cause should always prompt a hip examination.
My pain is in my buttock, not my groin. Is it still my hip?
It may well be. The hip refers to the buttock, the side, the thigh and the knee as well as the groin, and many people have it in several places at once. Tenderness to lie on the side makes gluteal tendinopathy more likely, but the two frequently coexist.
Should I keep walking?
Yes. Walking within tolerance maintains the joint and your general health. Stopping reduces capacity and makes everything harder.
Not Sure If This Is What You Have?
An assessment will tell you what is actually going on and what to do about it. I see everyone myself, and you will leave with a plan rather than a leaflet.
Book Your Initial AssessmentThis page is for general information only and isn’t a substitute for individual medical advice. If you’re experiencing any of the warning signs above, contact your GP or seek emergency medical care as appropriate.