Severe hip arthritis: what non-surgical care can and can't do

If you've been told you have severe hip arthritis, one of the first questions is usually: do I need a replacement?

Sometimes the answer is yes. Often there's a lot to try first. Here's what UK guidance says.

How common is it?

Hip osteoarthritis is common. Arthritis UK estimates that around 3.2 million people in the UK have it. Many people are managed without surgery. The NHS says surgery is only needed "in a small number of cases where other treatments haven't been effective or where your daily life is seriously affected".

What's happening in the joint

In osteoarthritis, the cartilage lining the joint thins and the bone and tissue around it change. Cartilage has very limited ability to repair itself, so structural changes don't usually reverse.

But structure isn't the whole story. How much a hip hurts, and how well it works, can change a great deal — which is why non-surgical care matters.

What the guidance recommends

NICE, which sets clinical guidance for the NHS in England, says the core treatments for osteoarthritis are:

• Therapeutic exercise, tailored to you — for example local muscle strengthening and general aerobic fitness.
• Weight management, if appropriate.
• Information and support to help you manage the condition.

Pain medicines are meant to be used alongside exercise, not instead of it, at the lowest effective dose for the shortest time. Anti-inflammatory tablets (NSAIDs) can affect the stomach lining, which is why doctors often prescribe a stomach-protecting medicine with them.

What the guidance advises against

NICE advises against offering glucosamine, acupuncture or dry needling, TENS and similar electrotherapy, and hyaluronan injections for osteoarthritis, because the evidence of benefit isn't strong enough.

When surgery is considered

NICE says joint replacement should be considered when symptoms are substantially affecting quality of life and non-surgical treatment hasn't worked or isn't suitable.

If it comes to that, the UK National Joint Registry has some reassuring data: about 96 in every 100 hip replacements had not needed further (revision) surgery ten years on. That measures how long the implant lasts, not how satisfied people are — but it's a useful figure.

The honest position

There's no supplement that reverses hip arthritis, and no supplement replaces exercise, weight management or a good physiotherapist. If your hip is affecting your sleep and daily life, talk to your GP about every option, including surgery.

Sources

NICE guideline NG226: Osteoarthritis in over 16s: diagnosis and management (2022).

NHS: Osteoarthritis — treatment (reviewed March 2023).

Arthritis UK: The State of Musculoskeletal Health (2025).

National Joint Registry: 22nd Annual Report (2025).

Also worth reading: The best exercise for hip arthritis and Diet, weight and supplements for hip arthritis.

This article is for general information only and does not replace medical advice. If you have hip arthritis, speak to your GP or a physiotherapist about a plan that's right for you.

About LYVA: LYVA Flex is a food supplement for healthy movement that we are developing. It is not a treatment for arthritis, and this article is not about LYVA Flex. Read how we approach the evidence.

— William Tyler-Street, Founder