Pain in the groin, stiffness after sitting, and an ache that builds after a long walk or a round of golf usually point to osteoarthritis of the hip. The care with the best backing is plain: regular exercise, weight loss if you carry extra weight, a cane when walking hurts, and anti-inflammatory medicine your doctor approves. Laser, magnetic and sound-wave therapies sit outside both major U.S. guidelines, and the hip-specific research on them is thin.
What does hip arthritis feel like, and how is it diagnosed?
Hip osteoarthritis (OA) is wear in the cushioning cartilage of the ball-and-socket joint. The American Academy of Orthopaedic Surgeons (AAOS) says it occurs most often after age 50 and lists pain in the groin (the most common spot) or thigh that can spread to the buttock or knee, stiffness that makes walking or bending hard, pain that flares with vigorous activity, and a limp as it advances. Pain and stiffness are often worse in the morning or after sitting.
Diagnosis starts with your story and an exam. Your doctor checks tenderness, how far the hip moves, and how you walk, and may order X-rays. A 2021 JAMA review names pain when the hip is turned inward as a useful exam finding and notes that a normal X-ray does not rule out OA, so a doctor may start care when the picture fits. If your pain is in the groin, mention it by that name. It is the detail that points to the joint.
Is pain on the outside of the hip arthritis?
Usually not. Mayo Clinic says pain on the inside of the hip or in the groin typically suggests a problem inside the joint, while pain on the outer hip, upper thigh or outer buttock typically comes from muscles, ligaments, tendons or the bursae around it. It can also be referred from the lower back.
| Where it hurts | What it usually points to | Where to read next |
|---|---|---|
| Groin, front of the thigh, sometimes the knee | The hip joint, including arthritis | This guide |
| Outer point of the hip, worse lying on that side | Tendons and bursa outside the joint | Hip bursitis treatment |
| Low back with pain into the buttock or leg | The spine or a pinched nerve | Sciatica treatment |
You can have two of these at once, which is one more reason to get the hip examined before choosing a treatment.
What is the first-line hip arthritis treatment?
The first-line hip arthritis treatment is exercise, weight loss if it applies, mobility aids when walking hurts, and oral anti-inflammatory medicine, with a steroid injection kept for flares. The American College of Rheumatology (ACR) 2026 update says: "In people with knee and hip OA, we strongly recommend exercise." It rates that evidence as moderate certainty. That 2026 text is a summary the ACR board approved on September 8, 2026; the full manuscript is not yet published, so its evidence tables cannot be checked.
| Option for hip OA | ACR 2026 | AAOS 2023 hip guideline |
|---|---|---|
| Exercise | Strongly recommend (moderate certainty) | Physical therapy "could be considered" for mild to moderate OA (Moderate) |
| Weight loss | Strongly recommend if overweight or obese (moderate) | No statement on weight loss for symptoms |
| Cane or other mobility aid | Good-practice statement when walking is limited | No statement |
| Oral NSAIDs | Strongly recommend (moderate) | Should be used when not contraindicated (Strong) |
| Steroid injection | Strongly recommend (low), with ultrasound guidance | "Could be considered" for short-term relief (Moderate) |
| Hyaluronic acid injection | Conditionally recommend against (moderate) | "Should not be considered" (Strong) |
| PRP and stem cell injections | Strongly recommend against | Not addressed |
| Acetaminophen | Conditionally recommend (low) | Consensus option, "may be considered" |
| Opioids | Conditionally recommend against | Consensus: not for nonoperative care |
Sources: ACR 2026 summary; AAOS hip guideline, adopted December 2023. "Conditional" means a fit for some people after a talk about benefits, harms and cost.
Three details change how to read the table.
Hyaluronic acid. The ACR's 2019 guideline strongly recommended against hyaluronic acid injections in hip OA, because the evidence of no benefit was stronger for the hip than for the knee. The 2026 summary lists a conditional recommendation against for knee and hip together. The AAOS's strong statement says it "does not improve function or reduce pain better than placebo." Either way, no guideline supports it for the hip.
Exercise has two evidence stories. A Cochrane review updated in July 2026 now describes "very low to low certainty evidence that exercise may result in a slight improvement in pain and function," of questionable clinical importance, and downgraded its certainty from the 2014 version. A 2025 review of seven hip-only trials found low-quality evidence of no significant short-term difference between mixed exercise and no intervention for pain. Meanwhile a 2023 network meta-analysis of 152 knee and hip trials found exercise relieved pain about as well as oral NSAIDs and paracetamol, with a better safety profile. Exercise stays first-line because it is low risk and helps the whole body, but expect modest gains, not a cure.
What "exercise" means. AAOS says your doctor or a physical therapist can build an individualized program to increase range of motion and flexibility and strengthen the hip and leg muscles. It also suggests moving from high-impact activity such as jogging or tennis to swimming or cycling, easing off stairs when they aggravate the joint, and using a cane, crutches or a walker if walking is hard. The ACR adds that people who are limited in function or held back from exercise by pain should be referred to physical therapy.
Do laser, PEMF, shockwave and red light help hip arthritis?
The research for hip OA specifically is small. Neither ACR 2026 nor the AAOS hip guideline lists laser, PEMF, shockwave or red light as a treatment. We searched PubMed on November 6, 2026 for each of them in hip OA and found this:
| Therapy | Best hip-specific evidence found | How to read it |
|---|---|---|
| Laser | One 2026 randomized trial, 57 people | Laser was added to hyaluronic acid and physiotherapy; small gains in walking and quality of life |
| Shockwave | One 2022 pilot trial, 148 people | Both types did better than sham; one trial, 8 weeks of follow-up |
| PEMF | No randomized trial found; one 2019 study of 30 men | No sham group; cannot show the treatment caused the change |
| Red light | None found | Evidence comes from other joints and devices |
Laser. In the 2026 trial, both groups got hyaluronic acid injections and physiotherapy, and one also got real laser while the other got a sham. Both improved on the Harris Hip Score, and the laser group did better only on the six-minute walk test and, at six months, a quality-of-life score. The authors wrote that more evidence is needed. Because every participant also received hyaluronic acid, which both guidelines advise against, it is a weak guide to laser alone. The knee has more trials, with mixed results; see our knee osteoarthritis guide and laser therapy guide.
Shockwave. A 2022 pilot trial of 148 people randomized them to focused shockwave, radial shockwave or sham. Pain and WOMAC scores fell from baseline at four and eight weeks in both real-treatment groups, both did better than sham, and focused did better than radial. The authors said it was the first study of shockwave in hip OA. We found no second trial confirming it.
PEMF. A 2019 study gave 30 men with hip OA one of two magnetic-field treatments and saw less pain afterward, with no untreated comparison group. That cannot separate the therapy from time, expectation or other care. Our PEMF guide explains how sessions work.
Red light. We found no hip OA trial of red light, in a bed or on a handheld device. Our red light guide covers the wider research.
One practical point: the hip sits deep under thick muscle. When a provider says a light or laser device helps the hip, ask what they expect it to reach and what the studies they rely on measured.
When is hip replacement the next step?
Replacement is considered when nonsurgical care has not been enough and the hip limits daily life. AAOS lists pain that limits everyday activities such as walking or bending, and inadequate relief from anti-inflammatory drugs, physical therapy or walking supports. Recommendations rest on pain and disability, not age, and most people who have the surgery are 50 to 80. AAOS lists unlimited walking, swimming, golf, driving, hiking, biking and dancing as realistic afterward, and puts serious complications such as joint infection under 2% of patients.
If you are weighing it, our hip replacement recovery timeline shows what the months after surgery look like.
Questions to bring to the surgeon:
- Do my X-ray findings match where it hurts?
- What have I not yet tried at full effort, such as a supervised exercise program or a cane?
- Is a steroid injection reasonable for me, and with ultrasound guidance?
- If I wait, what would change your advice?
- What would I be able to do on the golf course six months after surgery?
Where do studio services fit?
Studio services sit beside first-line care, never in place of it. The evidence above points to a possible role for laser and shockwave in the hip, based on one small trial each, a weaker case for PEMF, and none we could verify for red light. OutRecover's service pages describe what each does, and its research summaries are on the orthopedic and joint health page.
If you want to try them as an add-on, two packages match this goal. OutRelief lists shoulder, hip and knee pain and arthritis pain and stiffness among who it is for, and combines PEMF, Class IV laser and red light with an IV and molecular hydrogen, which this guide did not review. OutMove is a shorter program for stiff, achy joints with the same three services. Shockwave is sold by the session.
Before you book, check:
- The provider asks where the pain is and whether a doctor has examined your hip.
- Nobody promises that a session will rebuild cartilage or let you skip surgery.
- You can stop if you see no change against the goal you set, such as playing nine holes.
- You keep your exercise plan going alongside.
If a replacement is planned, clear anything new with your surgeon first.
Your next step
See your primary care doctor or an orthopedic surgeon if no one has examined your hip or taken an X-ray, and tell them the pain is in your groin if it is. Ask for a physical therapy referral, start walking, swimming or cycling this week, and decide with your doctor about anti-inflammatory medicine and whether a steroid injection fits. Add laser or shockwave only as an extra you can stop, judged against a goal you set first.
Sources
- American College of Rheumatology. 2026 Update of the ACR Recommendations for the Management of Osteoarthritis of the Knee, Hip, and Hand (summary). ACR, approved September 8, 2026. https://assets.contentstack.io/v3/assets/bltee37abb6b278ab2c/bltb3d12c34020da842/oa-guideline-summary-2026.pdf
- Kolasinski SL, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care & Research, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC11488261/
- American Academy of Orthopaedic Surgeons. Management of Osteoarthritis of the Hip, Evidence-Based Clinical Practice Guideline. AAOS, adopted December 1, 2023. https://www.aaos.org/globalassets/quality-and-practice-resources/osteoarthritis-of-the-hip/oah-cpg.pdf
- American Academy of Orthopaedic Surgeons. Osteoarthritis of the Hip. OrthoInfo. https://www.orthoinfo.org/bodypart/hip-thigh/osteoarthritis-of-the-hip
- American Academy of Orthopaedic Surgeons. Total Hip Replacement. OrthoInfo. https://www.orthoinfo.org/treatment/total-hip-replacement
- Katz JN, Arant KR, Loeser RF. Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC8225295/
- Mayo Clinic. Hip pain: causes and definition. Mayo Clinic. https://www.mayoclinic.org/symptoms/hip-pain/basics/causes/sym-20050684
- Hall M, et al. Exercise for osteoarthritis of the hip (update). Cochrane Database of Systematic Reviews, July 2026. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007912.pub3/information
- Is physical exercise effective in improving pain, functional mobility and quality of life in individuals with hip osteoarthritis? A systematic review with meta-analysis. Journal of Bodywork and Movement Therapies, 2025. https://pubmed.ncbi.nlm.nih.gov/39663077/
- Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 2023. https://pubmed.ncbi.nlm.nih.gov/36593092/
- de Sire A, et al. Combined ultrasound-guided hyaluronic acid injections, high-power laser therapy and physiotherapy improve hip function in osteoarthritis: a randomized controlled trial. Journal of Experimental Orthopaedics, 2026. https://pubmed.ncbi.nlm.nih.gov/42255387/
- The short-term efficacy of large-focused and controlled-unfocused (radial) extracorporeal shock wave therapies in the treatment of hip osteoarthritis. Journal of Personalized Medicine, 2022. https://pubmed.ncbi.nlm.nih.gov/36675709/
- Evaluation of beta-endorphin concentration, mood, and pain intensity in men with idiopathic hip osteoarthritis treated with variable magnetic field. Medicine (Baltimore), 2019. https://pubmed.ncbi.nlm.nih.gov/31348243/
