Hip Osteoarthritis: What Clinicians Should Look for Beyond Hip Pain

Hip osteoarthritis (OA) is often associated with pain and stiffness, but its clinical impact extends beyond the hip joint. As symptoms progress, patients may change how they walk, transfer, climb stairs, or perform everyday activities. For clinicians, recognizing these functional changes can be just as important as identifying the patient's pain.

What Is Hip Osteoarthritis?

Hip osteoarthritis is a degenerative joint condition that can contribute to pain, stiffness, reduced range of motion, and difficulty with movement. However, the severity of symptoms does not always correspond directly with imaging findings. A patient may have radiographic changes with relatively mild symptoms, while another may experience significant functional limitations. This makes the clinical and functional assessment particularly important.

How Hip OA Can Affect Movement

When hip pain or stiffness develops, patients may modify their movement to avoid discomfort.

You may notice changes such as:

• Reduced walking tolerance

• Difficulty with stairs

• Increased use of the upper extremities during sit-to-stand

• Altered gait patterns

• Difficulty getting into or out of a car

• Difficulty putting on socks or shoes

• Reduced participation in physical activity

These changes can gradually affect strength, mobility, confidence, and independence.

Look Beyond the Pain Score

A patient may not describe severe pain but may still demonstrate meaningful functional decline.

Instead of asking only:

“How much does your hip hurt?”

consider asking:

“What can you no longer do because of your hip?”

That question can reveal limitations that a pain rating alone may not capture.

What Should Clinicians Assess?

A hip OA physical therapy evaluation should connect impairments with functional limitations.

Consider assessing:

• Hip range of motion

• Lower-extremity strength

• Gait and movement patterns

• Balance

• Sit-to-stand performance

• Stair negotiation

• Walking tolerance

• Activity limitations

• Patient-specific goals

The goal is to understand how hip OA is affecting the patient's ability to move and participate in daily life.

Why Functional Assessment Matters

Hip osteoarthritis can become a cycle:

Pain or stiffness → movement modification → reduced activity → loss of strength and mobility → greater difficulty with function.

Identifying this cycle early may help clinicians address modifiable factors before functional limitations become more significant. For physical therapists, this is where treatment becomes more than prescribing exercises. The intervention should address the patient's specific movement limitations and functional goals.

How Can Physical Therapy Help With Hip OA?

Physical therapy for hip osteoarthritis may focus on improving strength, mobility, movement strategies, functional capacity, and confidence with activity.

Treatment should be individualized based on the patient's presentation and goals.

For one patient, the priority may be improving walking tolerance. For another, it may be climbing stairs, returning to exercise, or maintaining independence with daily activities.

The goal is not simply to treat the hip.

The goal is to help the patient maintain or regain meaningful function.

Hip Osteoarthritis in Los Angeles: Why This Matters

With a large and growing older-adult population in Los Angeles County, maintaining mobility and independence is an increasingly important part of healthy aging. For clinicians working with older adults, recognizing the functional impact of hip osteoarthritis can help shift care from focusing solely on pain to focusing on what the patient needs and wants to continue doing.

Key Takeaway for Clinicians

Hip OA is more than a finding on imaging or a complaint of hip pain.

When evaluating a patient, consider:

How has their movement changed?

What activities have they stopped doing?

What functional task is becoming difficult?

What does the patient want to return to?

These questions can help create a more patient-centered approach to hip osteoarthritis management and physical therapy.

For patients experiencing persistent hip pain or declining mobility in Los Angeles, a physical therapy evaluation can help identify functional limitations and develop an individualized plan of care.