CATEGORY: MOBILITY, BONES & JOINTS
Does exercise really ease an arthritic hip? The most complete answer to date says yes, but not by much. Pooling 18 randomized trials, a new Cochrane review found exercise programs improved hip osteoarthritis pain by about 7 points on a 100-point scale.1 Experts put the smallest improvement a person reliably feels at about 12 points. On average, the gain lands below what most people would notice.
Strength Work, Aerobics and Mind-Body Classes, All Pooled
The review gathered every qualifying randomized trial on the question: 18 of them, covering 1,368 adults with hip osteoarthritis, the slow wearing-down of the cartilage that cushions the hip joint. Nearly two thirds were women, most between 53 and 74. In every trial, a random draw decided who got the exercise program, which keeps the groups honestly comparable. Programs ran from two weeks to a year and leaned on strengthening, aerobic work or gentler mind-body routines. Participants scored their own pain and daily function on 100-point scales, usually right after the program ended. Three comparisons were on offer: a sham treatment, no treatment or usual care, or another therapy given with and without exercise added.
Seven Points of Relief, When Feeling It Takes Twelve
Against no treatment or usual care, pain probably improves by about 7 points and function by about 9, with 12 and 13 points as the usual thresholds for a change someone actually feels. Think of a dimmer switch nudged one notch. The meter moves, but the room doesn’t look brighter. The two trials that used a sham treatment found exercise may make little or no difference to pain, and adding exercise on top of another treatment probably added little or nothing. Quality of life barely moved in any comparison. Two cautions cut in opposite directions. The noticing thresholds come mostly from knee arthritis research, so they may not map neatly onto hips. And since nobody can be blinded to their own workout, self-reported scores tend to flatter exercise, meaning the true effect could be smaller still.
Still the Standard Starting Point
None of this dethrones exercise. The reviewers note it remains recommended as a primary treatment for hip osteoarthritis: it’s cheap, it carries broad health benefits, and these trials showed no clear rise in harms. Their message is about expectations, and the review’s lead author put it plainly: patients should hear that the average benefit may be modest. The picture also fits what the strongest single trial at the severe end of the disease found. In a Danish randomized comparison, hip replacement relieved pain and restored function better than three months of supervised strength training.2 The reviewers close by asking for larger, better-designed trials that recruit people with hip trouble specifically, since several pooled studies mixed hip and knee patients together.
Key Takeaways
- Exercise improved hip osteoarthritis pain by about 7 points out of 100 in pooled randomized trials, and function by about 9, under the 12 to 13 points it typically takes to feel a difference.
- Against sham treatment, or added to another therapy, exercise made little to no measurable difference, and quality of life changed little in any comparison.
- The reviewers didn’t withdraw the standard recommendation of exercise as a first-line treatment; their finding is that its average benefit is smaller than its reputation.
References
- Hall M, Lawford BJ, Hinman RS, et al. Exercise for osteoarthritis of the hip. Cochrane Database of Systematic Reviews. 2026;(7):CD007912. link
- Frydendal T, Christensen R, Mechlenburg I, et al. Total Hip Replacement or Resistance Training for Severe Hip Osteoarthritis. N Engl J Med. 2024;391(17):1610–1620. link