Hip pain and mobility deficits—hip osteoarthritis: revision 2025

This 2025 revision of the hip osteoarthritis guideline, from APTA Orthopedics and the American Academy of Sports Physical Therapy, was published in JOSPT. It updates the 2017 version and covers physical therapy management of hip osteoarthritis.

It recommends manual therapy, including soft tissue work and joint mobilization such as long-axis hip distraction and mobilization with movement, for mild-to-moderate hip osteoarthritis. It also recommends an individualized exercise program, which may include aquatic therapy, along with patient education on activity modification, exercise and joint unloading.

It also recommends functional, gait and balance training with appropriate assistive devices, and support for weight loss in collaboration with other providers. Dry needling of specific hip muscles is supported for short-term gains. Bracing is not a first-line treatment, and therapeutic ultrasound may be added only after explaining the conflicting evidence.