Hip Replacement or Can Physical Therapy Help My Hip Arthritis?

Hip osteoarthritis (OA) affects 10-25% of adults over the age of 55.  Some common statements I hear is that many patients think that having arthritis automatically means you need a hip replacement and that is often not true. It is important to consider the following:

First, it boils down to diagnosing if a patient has hip arthritis and which signs and symptoms are commonly associated with hip OA.

Secondly, it is important to consider your treatment options. Always know that as a patient you have a right to ask questions about your diagnosis and what treatment options are available.

Lastly, an appointment should be made to meet with a physical therapist that is well versed in manual therapy techniques of the hip. During your physical therapy visits your physical therapist should perform specific high quality manual therapy and exercise to improve pain, function, strength and range of motion.

Common symptoms of hip OA consist of groin pain and front of the hip pain especially with walking, squatting, and twisting on the hip.  The gold standard for diagnosing hip OA is a standard x-ray but there are reliable tests that we can do in the PT clinic to assess the hip with over 90% accuracy.

A study in the Journal of Orthopedic and Sports Physical Therapy looked at 72 patients with x-ray confirmed hip OA and the PT examiners were accurate 91% of the time in diagnosing hip OA if the patient had 4/5 painful hip tests.

Some motions that might hurt a patient with hip OA may include deep squatting, active hip flexion (marching with high knees), and active hip extension (kicking leg behind you).

Physical therapy treatment for hip arthritis can be highly beneficial if the correct treatments are done.  A study in the Journal of Arthritis and Rheumatism in 2004 compared exercise alone verses manual therapy in 109 patients with hip OA.  After a 5 week treatment course (9 visits) 81% of the manual therapy group and 50% of the exercise group had significant improvement in hip function, range if motion, pain, and walking speed.

What that translates to is a high quality physical exam, then evidence based manual therapy to improve pain, stiffness, range of motion, and function.  In some patients, hips do require a replacement but many have a high degree of improvement with the help of a skilled manual physical therapist alone.  Remember” MOTION IS LOTION to arthritic joints, in other words when patients achieve increased movement in the arthritic joint many experience significant pain relief and improvement in function.

At Holland Physical Therapy  we treat every patient individually, utilizing evidence based, hands on, manual therapy techniques.  Exercise is an integral part of treatment for hip pain, however, the hip joint mobility and muscle length must be addressed first to give a complete resolution of symptoms. Call us at 616-355-4284 or visit us at www.Holland-PT.com to get evaluated.


Ford Reinink PT, DPT

Director of Clinical Operations for Holland Physical Therapy


601 Michigan Ave #220, Holland, MI 49423


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