New to shockwave or in pain for more than 3 months? Book a Telehealth to see if we can help you!
If you or a loved one are dealing with hip osteoarthritis, you know how everyday movement starts to hurt – from climbing stairs to putting on socks. We understand how frustrating it is when simple activities trigger hip pain. Hip osteoarthritis (hip OA) is a degenerative joint condition where the cushioning cartilage in your hip wears down, leading to joint pain and stiffness. It often creeps in gradually but can eventually make walking, bending, or even sleeping a challenge. You might feel like this pain is just part of getting older, but take heart: there are treatments that can help you find relief and stay active. In this post, we’ll explain what hip osteoarthritis is, why it causes pain, and evidence-based ways to manage it, including some advanced therapies we use at Unpain Clinic. (As always, results may vary; please consult a healthcare provider for personalized advice.)
Hip osteoarthritis is essentially “wear-and-tear” arthritis of the hip joint. The hip is a ball-and-socket joint where smooth cartilage normally allows your thigh bone to glide in the socket. In osteoarthritis, that cartilage breaks down over time. As the protective cushion thins, bones can rub together, causing pain, inflammation, and stiffness. People with hip OA often report a deep ache in the groin or outer hip, reduced range of motion (like trouble crossing your legs), and increased pain after inactivity (for example, stiffness when getting up in the morning or after sitting).
Why does this happen? Age is a big factor – years of use can wear out the joint – but it’s not the only one. Obesity is a well-known risk factor, since extra weight adds stress to the hip and also contributes to systemic inflammation. Prior injuries or developmental issues (like an old sports injury or hip dysplasia) can predispose the joint to earlier degeneration. Even lifestyle factors matter: a sedentary lifestyle can weaken the muscles that support the hip. Weak glutes and tight hip flexors alter how force is distributed in the joint, potentially accelerating wear. In other words, hip osteoarthritis usually builds up over years due to a combination of mechanical stress and the body’s reduced ability to repair cartilage as we age.
When cartilage deteriorates, the body tries to compensate but often in ways that cause more issues. The bone under the cartilage may thicken or form bony spurs. The surrounding muscles may tighten up to protect the hip, leading to groin or thigh pain. Over time, an arthritic hip can become chronically inflamed and stiff, creating a cycle of pain – you move less because it hurts, but then the lack of movement causes more stiffness and muscle weakness, which in turn makes pain worse.
Why the pain persists: A key reason hip OA pain can become chronic is that many treatments focus only on symptoms, not root causes. For instance, taking painkillers or getting a cortisone injection might reduce inflammation temporarily, but they don’t fix the underlying joint damage or biomechanics. If weak hip stabilizer muscles or bad movement patterns are not addressed, the irritation keeps coming back. As one research review noted, even though standard treatments (like pain meds, injections, basic exercises) are widely used, the majority of patients “do not fully recover from their pain” with those measures. In other words, simply resting or masking the pain often isn’t enough – without correcting the imbalances or joint issues causing the pain, it tends to return.
It’s also worth noting that pain can persist due to “pain memory” in the nervous system. Chronic pain sometimes causes nerves to become hypersensitive, so the area keeps hurting even if the tissue damage has stabilized. This is why a comprehensive approach is needed: to not only target the joint wear-and-tear but also retrain muscles and calm the nervous system.
The bottom line: Hip osteoarthritis is a degenerative condition, but it’s not something you just have to “live with.” By understanding why it hurts – aging, weight, past injuries, muscle imbalances – we can take steps to reduce strain on the hip and manage pain. In the next sections, we’ll look at what research says about managing hip OA and then explore the treatment options (including some cutting-edge therapies) available to you at Unpain Clinic.
Living with hip osteoarthritis can be challenging, but research offers hope in multiple areas. Here’s a summary of key findings from scientific studies and guidelines on managing hip OA:
Exercise is Beneficial: Exercise is considered a first-line treatment for osteoarthritis, and yes, it does help. A 2023 systematic review of 18 randomized trials found that exercise therapy leads to modest but significant improvements in both pain and physical function for people with hip OA. In practical terms, exercises like strengthening (especially for the glutes, quads, and core) and gentle aerobic activity can reduce pain and improve your ability to move. The effects may be “small but real” – think of being able to walk a bit farther or having less discomfort doing daily tasks. The takeaway: staying active within your limits is better than becoming sedentary. Even if it’s just light stretching and short walks, movement helps keep the joint lubricated and muscles strong to support the hip.
Weight Loss Helps (if applicable): If you are carrying extra weight, losing even a moderate amount can ease hip OA symptoms. In fact, a 2025 study of over 1,400 adults with hip OA found a clear dose-response relationship between weight loss and pain relief. Patients who lost >10% of their body weight saw the greatest improvement in hip pain, stiffness, and quality of life. Every bit counts – another analysis noted that for patients with osteoarthritis who are overweight, weight loss consistently helps improve pain and function. The reason is twofold: less weight means less mechanical stress on the hip joint (reducing wear and tear), and weight loss also lowers inflammation in the body, which can otherwise aggravate joint pain. (For perspective, experts often say that each pound of weight can put an extra 4 to 6 pounds of force on the hip with every step, so shedding even 10 pounds could spare your hips a lot of stress.) Always approach weight loss gradually and with medical guidance, but know that it is a high-impact strategy for hip OA relief if weight is part of the issue.
Standard Treatments Have Limits: Traditional treatments like NSAID medications, steroid injections, or basic physical therapy exercises can provide temporary relief for many people, especially in early or mild cases. However, with persistent or advanced hip OA, these measures often aren’t enough on their own. A notable review in JAMA pointed out that most patients with hip or knee osteoarthritis still report chronic pain despite using these standard treatments. Pain may return once the medication wears off, or improvements plateau after a course of generic exercises. This doesn’t mean these treatments are useless – they can be important parts of a management plan – but it highlights why researchers are exploring additional therapies to truly improve joint function and long-term relief.
Physical Therapy & Manual Therapy: Guidelines from orthopedic experts emphasize that a combination of targeted exercise and manual therapy yields the best outcomes for hip osteoarthritis. Manual therapy means hands-on techniques by a physiotherapist or chiropractor – for example, joint mobilizations to improve your hip’s range of motion, or soft tissue release for tight muscles around the hip. These techniques can reduce pain and stiffness in the short term and help you move better. In some studies, tailored manual therapy plus exercise had superior results in pain relief and hip function compared to exercise aloneacademic.oup.com. The evidence can be mixed (one trial even found no difference between physio and sham therapy), but overall, clinical experts still recommend manual therapy as an adjunct. The likely reason is that manual treatments can free up a sticky joint or relieve muscle tension, making it easier for you to do your exercises effectively. Think of manual therapy as “tuning up” the joint and muscles, while exercise strengthens and stabilizes the improvements.
Advanced Modalities (Shockwave Therapy): An exciting area of research in the past few years is the use of extracorporeal shockwave therapy (ESWT) for hip pain and hip osteoarthritis. Shockwave therapy is a non-surgical treatment that delivers high-energy sound waves to the affected area, and it has been used successfully for problems like plantar fasciitis and tennis elbow. You might wonder, can sound waves really help an arthritic hip? Emerging evidence says maybe yes. In fact, a 2023 randomized controlled trial – the first of its kind – tested shockwave therapy on patients with hip osteoarthritis. In this study of 148 people, one group received focused shockwave therapy to the hip, another got radial shockwave (a more diffuse, less intense form), and a third group received a sham treatment (placebo). After 4 weekly sessions, both shockwave groups had significantly less pain and better hip mobility than the placebo group, and the focused shockwave group showed the greatest improvement. By 8 weeks (1 month after the last treatment), patients who received shockwave reported better function and less pain on the WOMAC index (a standard osteoarthritis questionnaire) compared to those who got sham treatment. In plain terms, those sound waves helped arthritic hips hurt less and move more – at least in the short term – without surgery. Notably, before this trial, no research had examined shockwave in human hip OA, so this provides a promising proof-of-concept that shockwave therapy “worked” where standard care had not. The focused type of ESWT (which penetrates deeper into the joint) was especially effective, outperforming radial shockwave in reducing pain and stiffness.
Advanced Modalities (Other Therapies): Shockwave isn’t the only tool being studied. There are other non-invasive technologies – some relatively new – that have shown potential for relieving musculoskeletal pain. For example, EMTT (Extracorporeal Magnetotransduction Therapy) is a pulsed electromagnetic field treatment that can reduce inflammation at the cellular level. While research on EMTT specifically for hip OA is still growing, early clinical use indicates it may help by modulating pain signals and promoting tissue repair (more on this later). Similarly, neuromodulation techniques (like specific nerve stimulation therapies) are used to “calm down” an overactive nervous system in chronic pain conditions. These techniques have a basis in scientific understanding of chronic pain: over time, your nerves can become sensitized (like they’re stuck in a pain loop). By gently stimulating or soothing the nerves (for instance, with mild electric currents or electromagnetic pulses), neuromodulation aims to reset nerve firing patterns. Patients often experience it as a mild warmth or tingling, with the goal of reducing pain signals. Combining such therapies with physical treatments can address both the “hardware” (joint, muscle, tissue) and the “software” (nerve signaling) of pain.
No Quick Fix, but a Holistic Approach Works: The consensus in research is that managing hip osteoarthritis typically requires a multimodal approach – there is rarely a single “magic cure.” Exercise, weight management, and education are foundational. Medications or injections can help flares in the short term. And newer therapies like shockwave or EMTT can be added to actually stimulate healing processes. Each therapy might provide partial relief, but together they can significantly improve quality of life. The good news is none of these treatments preclude the others – you can often combine them. For instance, one might take an anti-inflammatory for pain flare-ups, do targeted physio exercises daily, and undergo weekly shockwave therapy for a few sessions to kickstart healing in the hip. A whole-body, tailored plan – rather than just relying on one pill or one exercise – has the best chance of success. In the next section, we’ll explain how we implement this combined approach at Unpain Clinic, using both conventional therapies and cutting-edge treatments to tackle hip osteoarthritis from all angles.
(Disclaimer: Every individual is different. The research findings above are general – what works for “most people” may not work for everyone. Always consult with your healthcare provider or physiotherapist to create a plan suited to your condition.)
At Unpain Clinic, our approach to hip osteoarthritis is holistic and evidence-based. We don’t just ask, “Where does it hurt?” – we dig into “Why does it hurt?” This means your treatment plan will address the root causes of your hip pain, not just the symptoms. Here are the key treatment modalities we often combine for hip OA, and how each one helps:
One of our core treatments for stubborn hip pain is Shockwave Therapy (ESWT). Why? Because unlike therapies that just mask pain, shockwave can actually stimulate repair in tissues that are degenerated or chronically inflamed. Shockwave therapy uses acoustic waves delivered through a handheld device – it feels like rapid tapping on the skin over the hip area. It’s not particularly painful (some spots can be tender during treatment, but most patients tolerate it well), and each session is quick (about 15-20 minutes of actual shockwave application).
How shockwave helps: The sound waves create tiny micro-traumas in the tissue, which jump-starts your body’s healing response. Think of it as sending a wake-up call to a sluggish area. Research shows shockwaves promote the formation of new blood vessels (neovascularization) in tissues, which improves blood flow and nourishment to the hip joint. They also trigger the release of growth factors that lead to tissue regeneration and collagen production. In addition, shockwave has a pain-relieving effect: it can reduce the sensitivity of nerve fibers and create an anti-inflammatory environment in the hip. Uran Berisha, our clinic founder, explains it this way: shockwave “stimulates real healing by breaking down scar tissue, increasing blood flow, and triggering collagen production” in the damaged joint. Essentially, we use shockwave to help reset a chronically irritated hip by encouraging the body to rebuild and strengthen the tissues.
In practical terms, if you have hip osteoarthritis, we might use focused shockwave on specific deep points of degeneration (like the front of the hip joint or groin area) and radial shockwave over broader muscle areas if needed (like tight thigh or glute muscles). We often recommend a series of 3-6 shockwave sessions, about one week apart, as studies and clinical experience suggest cumulative treatments yield the best results. Many patients notice some improvement after the first 1-2 sessions (e.g. a bit less pain at night) and significant relief after a full course of therapy. The improvements from shockwave tend to be long-lasting because we are changing the tissue health, not just numbing the pain. (For example, in some studies for related hip conditions like trochanteric bursitis, shockwave patients had better outcomes at 4 months and 1 year compared to those who only got steroid injections.) Shockwave is also very safe – the main side effects are temporary soreness or mild bruising at the treatment site, and there’s no downtime required. It’s a non-invasive way to tackle hip OA head-on.
To complement shockwave therapy, Unpain Clinic also offers EMTT (Extracorporeal Magnetotransduction Therapy) for hip osteoarthritis. If shockwave is about rebuilding tissue, think of EMTT as about reducing inflammation and pain. EMTT is a state-of-the-art therapy that uses high-frequency pulsed electromagnetic fields. Don’t let the long name intimidate you – the experience is actually very gentle. You lie or sit comfortably while a loop or paddle is placed near the hip; when the EMTT device runs, you might feel a mild warmth or nothing at all.
How EMTT helps: EMTT’s pulsed magnetic field penetrates into the body and interacts with cells, encouraging anti-inflammatory effects and metabolic activity. It’s kind of like an MRI-strength magnet rapidly pulsing, but in a therapeutic way. Patients usually don’t feel much during EMTT – perhaps a gentle warmth or tingling – because it’s not a forceful mechanical action. Yet, at the cellular level, it’s telling your cells and nerves to calm down. In plain language: EMTT helps reduce inflammation and modulate pain signals without any pressure or intense sensation. We often describe it as telling the irritated nerves “shhh, quiet down” while the shockwave is telling the tissues “hey, time to rebuild!”. This one-two punch can significantly speed up recovery for a painful hip.
By adding EMTT, we aim to decrease swelling in the joint and surrounding tissues and give pain pathways a chance to reset. For very chronic hip osteoarthritis cases that have been flaring on and off for years, EMTT can be a game-changer – it’s like hitting the “reset” button on the inflammation. Studies on EMTT and related magnetic therapies have indicated benefits for musculoskeletal pain and even nerve-related pain. And since it’s non-invasive and painless, it’s an excellent adjunct therapy. Typically, an EMTT session might be done right before or after shockwave in the same visit, each session lasting around 10-15 minutes. Not every patient will need EMTT, but if your hip pain has a significant inflammatory or nerve sensitivity component, we may include this to enhance your results.
Chronic hip pain doesn’t just affect the joint – it can affect your nervous system, too. Over time, the nerves carrying pain signals from your hip can become sensitized, meaning they fire danger signals more readily even when the trigger is mild. That’s why some people with hip OA have pain that lingers or spreads beyond the joint. To address this, we incorporate gentle neuromodulation techniques when appropriate, especially if we suspect a “nerve pain” component in your case.
What is neuromodulation? It’s a fancy word for therapies that alter nerve activity. In our context, this could involve techniques like therapeutic ultrasound, TENs (transcutaneous electrical nerve stimulation), or other specialized electrotherapy devices that soothe the nerves. These treatments are typically very relaxing – patients might feel a mild tingling or warmth but no significant discomfort. The idea is to calm down overactive pain pathways. For example, with long-standing hip issues, sometimes nerves in the lower back or pelvis (like the sciatic or femoral nerve) become extra reactive. Neuromodulation sends a benign stimulus through those nerves which can normalize their response, essentially telling them “it’s okay, we don’t need the alarm bells ringing so loud.”
By pairing neuromodulation with the other therapies, we make sure to treat both the “hardware” (joint and muscles) and the “software” (nerve signaling) of your pain. Imagine you’ve fixed the structural issues as much as possible with manual therapy and shockwave, but you still have pain because the nerves are used to screaming. Neuromodulation helps turn that volume knob down. Many patients find these treatments pleasant – some even catch a quick nap during a session because it can be that gentle. While not everyone with hip osteoarthritis will need specific neuromodulation therapy, it’s a powerful tool for those who have elements of neuropathic pain (sharp, burning, or radiating pain) or centralized pain.
No hip osteoarthritis treatment plan is complete without addressing movement and mechanics. Our physiotherapists and chiropractors are highly skilled in manual therapy – this includes joint mobilizations, manipulations (gentle adjustments), and soft tissue techniques. If your hip is stiff, we use hands-on mobilization to improve your joint play (for example, gently stretching the hip capsule to allow a bit more rotation or flexion). If you have muscle tightness or trigger points (common in the tensor fascia lata or deep rotators with hip OA), we may do myofascial release or targeted massage to loosen those areas. Manual therapy can provide immediate relief by reducing muscle guarding and increasing your range of motion. As supported by clinical guidelines, we use it as an important adjunct to exercise for hip OA. You might notice you can walk or squat a little easier right after a session where we’ve mobilized your hip – that’s the idea, to make movement less painful so you can stay active.
Movement retraining (therapeutic exercise) is the other side of that coin. After we’ve improved your mobility, we want to solidify the gains with targeted exercises. In hip osteoarthritis, a big focus is on strengthening the muscles that support the joint – especially the gluteus medius and maximus (buttock muscles), the thigh muscles, and the core. We often find that patients with hip OA have weakness or poor activation in these areas, which means the hip joint was taking more load than it should. By correcting those imbalances – teaching your glutes to fire properly and your core to stabilize – we reduce abnormal forces on the hip. We’ll also work on stretching or inhibiting muscles that are overly tight, like the hip flexors or adductors, as needed. The exact exercises vary per person, but common ones include bridging exercises, clamshells, gentle squats or step-ups, hip flexor stretches, and balance drills. We ensure you do them with proper form (quality over quantity!). Don’t worry – we won’t overload a painful joint with heavy exercises. It’s about finding the right level of challenge that strengthens you without aggravating the hip. Even simple exercises like leg raises or water-based exercises can be hugely beneficial.
Another aspect of movement retraining is looking at your whole-body alignment and gait. We assess if perhaps your lower back, knees, or feet are contributing to the hip stress. Often, treating hip OA isn’t just about the hip itself, but also the chain of movement. For instance, if your ankle is stiff or your opposite hip has an issue, you might be compensating in a way that overloads the affected hip. Our therapists will check these connections. As one patient noted in a review, “they don’t just treat the main area of pain, they treat secondary problem areas… Because they look at secondary areas, it tells me they really care about making you feel better.”. We truly believe in that whole-body approach.
Putting it all together: A typical Unpain Clinic plan for hip osteoarthritis may involve shockwave + EMTT sessions once a week, manual therapy and guided exercise during those visits, and a customized home exercise program for you to do between sessions. We might also use taping techniques or recommend an unloading aid (like a cane or orthotic) if it helps take pressure off the hip during flare-ups. By combining these therapies, we address pain from multiple angles – reducing inflammation, improving tissue health, correcting biomechanics, and calming the nervous system. This comprehensive approach aims for more than short-term relief; we aim for long-term improvement in function. Our goal is that you not only hurt less but can also get back to the activities you love, whether that’s gardening, cycling, or playing with grandkids.
(Note: All treatments are administered by licensed professionals. We always begin with an Initial Assessment to determine the right mix of therapies for your specific case. If something isn’t appropriate for you – for example, shockwave is generally avoided if you’re on blood thinners or have a bone tumor, etc. – we will find alternative solutions. Your safety and comfort guide every decision.)
To illustrate how these treatments come together, let’s look at a real-life example (name changed for privacy). Meet Nancy, a 47-year-old avid runner from Edmonton who came to us with chronic hip and knee pain. Nancy had been struggling for 5 years with pain on the outside of her hip that radiated into her knee, ultimately forcing her to stop running. She had tried “everything” – physiotherapy, acupuncture, massage, kinesiology taping, and countless stretching routines. Nothing gave lasting relief, and training for her favorite half-marathon seemed out of reach. By the time she visited Unpain Clinic, she could barely run 40 minutes without severe pain. Frustration and disappointment were written all over her face; she feared her running days were over.
During her initial assessment, our team identified that Nancy’s hip pain was due to a combination of gluteal tendinopathy (an overuse injury of the tendons on the side of her hip, common in runners) and early-stage osteoarthritis in the hip joint. Her glute muscles were weak and not firing correctly, causing her IT band and lateral hip area to take excessive strain. We explained our holistic plan: we would use focused shockwave therapy on the injured tendon and hip area to stimulate healing, EMTT to reduce the persistent inflammation, and a series of exercises to strengthen her glutes and core. We also addressed her gait – noticing she had a slight limp – with some neuromodulation techniques to reduce nerve irritation and manual therapy to improve her hip mobility.
Nancy was skeptical at first (after all, nothing had worked so far), but she decided to give shockwave a try – “what did I have to lose?” she said. After one shockwave treatment, she noticed something remarkable: she was able to run longer pain-free than she had in months. This wasn’t a complete cure, but it was the first sign of meaningful improvement in years. Encouraged, she continued with the recommended three sessions of shockwave (along with adjunct therapies). By the end of her treatment course, Nancy reported she was back to training for half-marathons and feeling stronger than ever. Her hip and leg pain had diminished dramatically – she could run over an hour without significant pain, which was a huge win. In her words, “After the full three treatments I am back to training, and I feel stronger than ever.” She also kindly noted that “Uran knows what he is doing and has an impressive understanding of the human body”, and she highly recommended shockwave to others in pain.
Stories like Nancy’s are why we are so passionate about what we do. It’s not about a single treatment or gadget – it’s about finding the right mix of therapies and personalizing them to the patient. In Nancy’s case, shockwave jump-started a healing process in her hip tendons, but it was the combination of that with muscle retraining and time that allowed her to fully regain her running ability. Another patient of ours (we’ll call him John, a 65-year-old with severe hip OA) had a different journey: his relief came gradually over 6 sessions, and the biggest gain for him was going from needing a cane to walk to being able to stroll around the block unaided – something he hadn’t done in over a year. Each patient’s progress is unique, but our aim is always the same: to reduce pain and restore function so you can reclaim your life from chronic hip pain.
(Testimonial excerpts above are real and used with permission. Individual results will vary, and not every case of hip osteoarthritis will respond identically to a given treatment. We share these stories to offer hope, not guarantees.)
While professional treatments can make a big difference, what you do at home is equally important in managing hip osteoarthritis. We empower our patients with at-home strategies to maintain progress and control symptoms. Here are some simple, safe tips and exercises you can do between clinic visits:
Stay Gently Active Every Day: It might sound counterintuitive when you’re in pain, but movement is medicine for osteoarthritis. Aim for low-impact activities that keep your joints moving without pounding them. Great options include walking on flat surfaces, stationary cycling, or swimming/aquatic exercise. Even on days when your hip feels stiff, try to do frequent short bouts of movement (e.g. get up from your chair every 30 minutes and walk around the house or do some gentle hip circles). This helps lubricate the joint and prevents excess stiffness. Studies show that consistent gentle exercise can reduce pain and improve function in hip OA. Listen to your body, though – some discomfort is okay, but sharp pain is a signal to ease off. The goal is motion without commotion (no big flare-ups).
Strengthen the Supporting Muscles: Focus on exercises that strengthen your glutes, thighs, and core, as these muscles take strain off the hip. A few patient-friendly exercises we often recommend:
Glute Bridges: Lie on your back with knees bent, feet on the floor. Gently raise your hips toward the ceiling (squeezing your buttocks) until your body is in a straight line from shoulders to knees. Hold 2 seconds, then lower. This activates your glutes without stressing the hip joint.
Clamshells: Lie on your side with knees bent and feet together. Keeping your feet touching, lift the top knee (open like a clamshell) and slowly lower. This targets the gluteus medius on the side of your hip, crucial for stability.
Mini Squats or Sit-to-Stand: If tolerated, practice standing up from a chair using your hip and thigh muscles (you can use your hands on the chair for support as needed). This functional movement builds strength in quads and glutes. Only bend as far as comfortable – it’s fine if it’s a partial squat.
Core Bracing: Simple core exercises like pelvic tilts or planks (modified on your knees if needed) help support your spine and pelvis, which in turn helps your hip alignment.
Aim to do strength exercises 2-3 times a week. We will typically provide you with a tailored exercise handout or even a PDF of recommended moves (so you won’t have to remember everything). If you’re unsure how to do any exercise, please ask your physiotherapist – proper form is key to avoid strain. Remember: stronger muscles = happier joints.
Improve Hip Mobility (Flexibility): Gentle stretching can ease muscle tightness that aggravates hip pain. Two stretches to consider:
Hip Flexor Stretch: Kneel on one knee (use a cushion) with the other foot in front. Gently shift your weight forward until you feel a stretch in the front of the hip of the kneeling leg. This counters the tightness from sitting and can relieve pressure on the hip joint.
Figure-Four Stretch: Lie on your back and cross one ankle over the opposite knee, forming a “4”. Gently pull the uncrossed leg toward you to feel a stretch in your buttock/outer hip. This targets the piriformis and glutes.
Perform stretches when your muscles are warm (after a short walk or shower is great) and hold each for about 20–30 seconds. Stretch daily if you can. Improved flexibility in the hips and legs can lead to less joint stress and better posture.
Use Heat for Stiffness and Ice for Flares: Many hip OA sufferers find a warm shower or a heating pad in the morning loosens up the joint. Heat therapy increases blood flow and relaxes tight muscles, so it’s perfect for that morning stiffness or pre-exercise warm-up. On the other hand, if your hip is achy and inflamed after a long day, ice therapy for 10-15 minutes can numb the pain and reduce swelling. Use a cloth between ice and skin to protect your skin. Listen to your hip – some people prefer one over the other. (Never apply extreme heat or cold directly for too long.)
Assistive Devices and Supports: Don’t hesitate to use a little help on bad days. For instance, using a cane on the opposite side of a painful hip can reduce the load on the arthritic joint by up to 20-30%. Ensure the cane is adjusted to the right height (your physiotherapist can help with this). Some patients ask about hip braces or supports – unlike knee braces, true “hip braces” are less common, but a trochanteric belt (a strap around the upper thigh/hip) might give a feeling of stability for some people. It’s something we can discuss if you’re interested. Even shock-absorbing shoe insoles can help by reducing the impact on your hips when you walk. These tools don’t cure anything, but they can make daily activities more comfortable, which keeps you moving.
Sleep with Comfort: Hip pain can really disrupt sleep. If you’re a side sleeper and feel hip pain at night, try sleeping with a pillow between your knees. This keeps your hips aligned and takes pressure off the affected side. You can also experiment with different sleeping positions: some people prefer lying on the less painful side with a soft pillow under the bad hip, or on their back with a pillow under the knees. A supportive mattress topper might cushion the joints better. Quality sleep is crucial for pain tolerance, so set yourself up for comfort. And if hip pain is keeping you up, do mention it to us – sometimes a tweak in your treatment plan (like an evening exercise or heat application) can improve nighttime pain.
Mind Your Weight and Diet: As discussed earlier, maintaining a healthy weight will reduce stress on your hip joints. We know weight loss isn’t easy – but even a small reduction can pay dividends in pain relief. Combine portion control with gentle exercise; consider consulting a nutritionist if needed. Also, some people find that certain foods can influence inflammation. There’s no magic “arthritis diet,” but a balanced diet rich in omega-3 fatty acids (fish, flaxseed), antioxidants (fruits and veggies), and low in processed sugars might help overall inflammation levels. Staying hydrated and avoiding excessive alcohol can also keep your joints and muscles in better shape.
Pain Management Aids: Over-the-counter pain creams (topical NSAIDs like diclofenac gel, or rubs with menthol/capsaicin) can provide temporary relief for some folks. They’re available in Canada without prescription and can be applied to the hip area (follow instructions, of course). These creams don’t penetrate super deep into the hip joint, but they can ease superficial pain or muscle soreness around the hip. Always test a small area first to ensure you don’t get skin irritation. If oral pain medications are needed, use them judiciously and under guidance – for example, Tylenol (acetaminophen) or an NSAID can be used for flare-ups, but they’re not meant for daily long-term use without a doctor’s supervision due to potential side effects.
Lastly, stay optimistic and engaged in your care. Hip osteoarthritis is a long-term condition, but many people manage it successfully and continue doing what they love with the right strategies. Keep a journal of what helps or worsens your pain – this can reveal patterns (for example, if sitting too long triggers pain, you’ll know to break up your sitting time). Celebrate small victories, like walking an extra block or needing fewer painkillers than last month. And always communicate with your therapist or doctor about your progress. We’re here to adjust your plan as you improve or as your life circumstances change.
(Reminder: The above tips are general and may not all apply to you. Always get personalized advice – we provide home exercise programs tailored to each patient’s condition and fitness level. If an exercise hurts or you’re unsure of proper form, hold off and consult your physiotherapist to avoid injury.)
Hip osteoarthritis is usually caused by a combination of age-related wear and tear and other factors that increase stress on the joint. As we get older, the cartilage that cushions the hip can wear down and lose its ability to repair itself. This natural aging process is often compounded by factors like obesity (excess weight), which puts more load on the hip with every step, and previous injuries or trauma to the hip. For instance, a bad fall or sports injury in your younger years can alter how the joint functions and lead to earlier degeneration (this is called post-traumatic arthritis). Genetics and developmental conditions (like hip dysplasia, where the hip socket is abnormally shallow) also play a role – they can make someone more prone to developing OA. In essence, anything that changes the normal mechanics of the hip or accelerates cartilage breakdown (including poor posture or chronic muscle imbalances) can contribute. It’s rarely one single cause; rather, hip OA tends to emerge from a “perfect storm” of wear, strain, and time. The good news is that while we can’t turn back the clock on cartilage loss, we can address many contributing factors (like muscle weakness or weight) to slow progression and reduce pain.
Osteoarthritis is often described in four stages (Stage I through IV) based on severity, though you won’t necessarily hear these terms unless you’re looking at an X-ray report or talking to an orthopedist:
Stage I (Early/Mild): Minor wear-and-tear in the cartilage. You might have few symptoms or very mild pain and stiffness that comes and goes. X-rays may still look normal or show tiny bone spurs. Many people at this stage don’t even realize they have OA – they might just feel a little stiff in the morning.
Stage II (Mild to Moderate): More noticeable bone spur formation and some cartilage thinning. People often start feeling intermittent pain after long activities, and some stiffness. You might get a “grating” sensation in the joint or reduced flexibility (e.g. difficulty spreading your legs or rotating the hip fully). This is often when people first consult a doctor or physio.
Stage III (Moderate to Severe): Significant cartilage erosion in areas, the space in the joint narrows on X-ray, and spurs are more obvious. Pain becomes more frequent and can be moderate. You’ll likely feel stiffness, crunching or locking, and pain may limit your daily activities. At this stage, over-the-counter pain meds and conservative treatments are typically recommended to manage symptoms.
Stage IV (Severe): This is advanced OA – the cartilage is mostly gone in some parts of the joint, leading to bone-on-bone contact. X-rays show very little joint space and lots of large bone spurs. Pain can be severe and chronic, often even at rest. Joint deformity can occur, and everyday tasks (walking, putting on shoes) may be very difficult. This is the stage where joint replacement surgery is often considered to restore mobility and relieve pain, because the joint damage is extensive.
It’s important to remember that these stages are a spectrum. People don’t always fit neatly into one stage or progress predictably from one to the next. Moreover, symptom severity doesn’t always match X-ray severity – some folks with “bone-on-bone” X-rays have manageable pain, while others with moderate changes experience a lot of discomfort. Regardless of stage, early intervention is key. The earlier we implement joint-friendly habits and treatments, the better we can slow progression. Even in later stages, therapies like exercise, shockwave, etc., can help with pain and function, potentially delaying the need for surgery.
Squats – when done with proper form and within a safe range – can actually be beneficial for hip osteoarthritis, but there’s a big caveat: they must be appropriate for your strength level and stage of arthritis. Squatting is a natural movement that strengthens the glutes, thighs, and core, which are crucial for supporting the hip. Gentle or shallow squats (for example, squatting to sit down in a chair and getting back up) are generally good, as they help maintain leg strength and hip mobility. In fact, targeted strengthening is recommended for hip OA. However, problems arise if you do squats with poor form or excessive load. Deep squats (where your hips drop below knee level) or weighted squats (holding heavy weights) could put a lot of pressure on an arthritic hip and worsen pain, especially in later stages of OA. So, if you have hip OA, the rule of thumb is:
Yes to mini-squats or sit-to-stands as tolerated – these keep you functional.
Be cautious with heavy or deep squats – these might aggravate the joint.
If you’re unsure, work with a physiotherapist. They can teach you squat modifications, like using a chair or railing for support or limiting the depth. As you build strength, you might increase your range gradually. Also pay attention to pain: a little muscle soreness is okay, but sharp joint pain means stop. Listen to your hip. Done right, squatting-type exercises can help you by strengthening the very muscles that offload the hip. But done recklessly, they can be harmful. We tailor squat exercises to each patient’s ability – for some, that might mean just a partial bend of the knees initially. Over time, many patients actually improve their squat ability as their pain decreases and strength improves, which is a win for overall mobility.
Hip pain can definitely make sleep tricky. Here are a few tips to improve night-time comfort:
Use Pillows for Positioning: If you sleep on your side, place a soft pillow between your knees. This keeps your hips, pelvis, and spine in better alignment and prevents your top leg from pulling on your painful hip. Some people even hug a pillow in front to keep their posture optimal. If you’re a back-sleeper, placing a pillow under your knees can ease the pull on your lower back and hips.
Mattress Considerations: A mattress that’s too hard can press on tender joints, while one that’s too soft may not support your body correctly. Aim for medium-firm with a cushioned top. Memory foam toppers can help distribute your weight and reduce pressure on the hips. Essentially, you want to avoid pressure points on the hip – it might mean experimenting with cushioning.
Heat Before Bed: Consider using a warm compress or hot shower before bedtime to relax the muscles around your hip. Warmth can reduce joint stiffness and pain, potentially helping you fall asleep more comfortably.
Night-time Routine: Sometimes hip pain is aggravated by inflammation at the end of the day. Doing some gentle stretches in the evening (like the hip flexor stretch or a few yoga poses such as child’s pose) and then icing the hip for 10 minutes can calm things down. Also, try to avoid vigorous activity an hour or two before bed if that tends to trigger pain.
Medication Timing: If you take pain relievers or anti-inflammatories, timing them so they’re most effective during the night can help. For example, taking Tylenol or an NSAID an hour before bed (if your doctor approves) might reduce pain through the first half of the night. Always follow medical advice on this.
Sleeping Position: Sometimes the side that’s less painful is obvious (you probably avoid lying on the bad hip). But also consider sleeping on your back if you can; back-sleeping evenly distributes weight (just prop your knees with a pillow as mentioned). If you must lie on the painful side occasionally, do so for short periods and ensure plenty of cushioning under that hip (a folded blanket or specialized hip pillow).
Every person is different – some of our patients find huge relief with a body pillow, others swear by an electric blanket’s warmth. It might take some trial and error. Importantly, if your sleep is very disrupted, let your doctor know. Persistent insomnia can worsen pain sensitivity and fatigue. They may suggest short-term sleep aids or additional pain control methods for night-time. With a combination of the above strategies, many people with hip OA can improve their sleep quality, which in turn helps them feel better overall.
Currently, there is no outright cure for osteoarthritis, and it’s generally not reversible in the sense of regrowing the lost cartilage back to its original state. Osteoarthritis is a chronic degenerative condition – once cartilage is worn down, the body doesn’t fully rebuild that cartilage on its own (at least not the same smooth, frictionless type of cartilage). That said, “no cure” does not mean “no hope.” Far from it. While we might not be able to undo the structural changes, we can significantly manage and reduce the symptoms and improve joint function. Many patients are able to live active, fulfilling lives with osteoarthritis by using the strategies we’ve discussed: exercise, weight management, physical therapy, medications, and advanced treatments like shockwave. Pain can often be decreased to minimal levels, and stiffness can be managed, essentially putting the condition into a controllable state. There is also exciting research ongoing in fields like cartilage regeneration, stem cell therapy, and PRP (platelet-rich plasma) injections – some early studies show potential for slowing the progression of arthritis or even helping the cartilage a tiny bit. But these are still being investigated and are not guaranteed fixes. The most definitive “reversal” of severe hip OA in a sense is a total hip replacement surgery, where the damaged joint surfaces are replaced with artificial parts. That, of course, is a last-resort option for when conservative measures no longer provide relief and quality of life is seriously impacted. The bottom line is: while we can’t yet make your hip joint like new again, we can usually help you feel and move a lot better despite the arthritis. Many patients effectively “forget” about their hip OA for long stretches because they are nearly symptom-free after good management – and that’s our aim. Always be wary of any product or clinic claiming to cure osteoarthritis; instead, look for evidence-based treatments (like the ones we use) that can control it. With the right approach, hip osteoarthritis can be a well-managed condition for most people.
Hip replacement is a big decision, and it usually comes into play only when conservative treatments (physiotherapy, medications, injections, etc.) are no longer giving you adequate relief. Here are some signs that it might be time to discuss surgery with an orthopedic surgeon:
Severe, Unrelenting Pain: If you have constant hip pain that significantly limits your daily activities (for example, you’re in pain even at rest or at night, and it’s not relieved by any reasonable treatment), that’s a major factor. When pain is so intense that it interferes with basic things like walking across the house or sleeping, surgery might be considered.
Loss of Function/Mobility: Perhaps you can no longer put on your shoes, go up stairs, or walk any meaningful distance because of your hip. If you’re becoming increasingly housebound or needing a cane/walker and that’s not reversible with therapy, it indicates advanced disease.
X-ray/Stage: If imaging shows end-stage arthritis (essentially bone-on-bone, Stage IV changes) and this correlates with your symptoms, surgeons may recommend considering a replacement. However, they’ll weigh this alongside your symptom severity – it’s not based on X-ray alone.
Failure of Conservative Management: This is key. We generally want to see that you’ve tried non-surgical approaches. Have you done dedicated physio and exercise? Tried appropriate medications and maybe injections (like corticosteroid or viscosupplementation)? If yes, and you’re still in significant pain, then you’ve “earned” the next step, so to speak.
Impact on Life Quality: Ultimately, it comes down to your quality of life. If hip OA is preventing you from living your life and doing things you enjoy, and nothing else is helping enough, replacement becomes a reasonable consideration. People often say “I’m just tired of the pain and limitations.”
Modern hip replacements are very successful for appropriate candidates, and people often get dramatically improved pain and function. But it is major surgery with its own risks and rehab process, so it’s not to be taken lightly. Age can be a factor – if you’re younger, doctors might want to delay because replacements last about 15-20 years and revision surgeries are more complicated. That being said, if you’re suffering at 50, you don’t necessarily have to wait until 70; it’s a personal decision about benefits vs. drawbacks. We at Unpain Clinic work closely with orthopedic specialists, and if we feel – after working with you – that you’re not achieving the relief you deserve, we will refer you to discuss surgical options. Our goal is to help you avoid surgery if possible by using all the effective non-surgical methods available. Many patients are able to postpone or never need a hip replacement because their pain becomes manageable. But if the time comes that you do need one, we’ll support you through the prehab and rehab to ensure the best outcome. Always remember: choosing surgery is a personal decision, made after thorough discussions with your doctors, and you should feel confident that you’ve tried all other reasonable avenues first.
Hip osteoarthritis can truly be a life-altering condition – when every step or bend brings pain, it’s easy to feel discouraged. But we hope this article has shown you that there is a path forward. By understanding the condition’s root causes and what the latest research says, you’ve taken the first step in fighting back against hip OA. Effective management is usually not one single thing, but a combination of approaches: from strengthening exercises and weight management to cutting-edge treatments like shockwave therapy that can jump-start healing when progress stalls. At Unpain Clinic, we’ve seen firsthand that even when patients have “tried everything and felt nothing” elsewhere, a whole-body, personalized approach can make a world of difference.
Hip osteoarthritis doesn’t have to mean giving up. With the right care, many people get back to moving freely – whether it’s walking the dog, enjoying a yoga class, or playing with their grandchildren – with little to no pain. Remember, it’s about progress, not perfection: even small improvements in pain and mobility can significantly boost your quality of life. Our team is here to guide you through every stage, with warmth, empathy, and expertise. We’ll celebrate your victories (like that extra block you walked, or that first good night’s sleep in ages) and troubleshoot any setbacks.
Don’t let hip pain write the end of your story. Instead, let’s turn the page to a new chapter of understanding your body and healing. If you’re ready to address not just where it hurts but why it hurts – to fix the root causes and not just chase symptoms – we invite you to take the next step with us. Recovery is a journey, and you don’t have to walk it alone.
Ready to find real relief from hip osteoarthritis? Keep reading for how to get started with a comprehensive initial assessment at Unpain Clinic – the first step toward getting you back to a life without pain dictating your every move.
Book Your Initial Assessment NowAt Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.
✅ What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance
🕑 Important Details
60 minutes, assessment only
No treatment in this visit
👩⚕️ Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
🔜 What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.
🌟 Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care
🎯 Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
1. Teirlinck, C. H. et al. (2023). Effect of exercise therapy in patients with hip osteoarthritis: A systematic review and cumulative meta-analysis. Osteoarthritis and Cartilage Open, 5(1):100338pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov.
2. Salis, Z. et al. (2025). Loss of body weight is dose-dependently associated with reductions in symptoms of hip osteoarthritis. Int J Obesity, 49:147–153nature.comnature.com.
3. Şah, V. et al. (2023). The Short-Term Efficacy of Large-Focused and Radial Extracorporeal Shock Wave Therapies in the Treatment of Hip Osteoarthritis. J. Pers. Med., 13(1):48pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov.
4. Berisha, U. (Host) (2021, August 6). From prehab to rehab: the ‘hip’ new way patients are crushing their joint replacement surgeries (Unpain Clinic Podcast Episode #5)unpainclinic.comunpainclinic.com.
5. Unpain Clinic – Hip Pain Relief: The Hidden Connection Between Your Hips & Body (Podcast/Blog Article)unpainclinic.comunpainclinic.com.
Reviews Archive – Unpain Clinic. Patient Testimonial – Nancy T., Hip & Leg Painunpainclinic.com.
6. Unpain Clinic (2025). Why Shockwave Therapy Is Becoming a Go-To Option for Persistent Hip Painunpainclinic.comunpainclinic.com.
7. Unpain Clinic (n.d.). Shockwave Therapy Edmonton | Focal vs Radial for Heel Pain (Webpage – EMTT & Neuromodulation explained)unpainclinic.comunpainclinic.com.
