Exercise Offers Minimal Pain Relief for Hip Osteoarthritis, Cochrane Review Finds
Exercise programs provide little to no meaningful reduction in pain for adults with hip osteoarthritis when compared to dummy treatments, though they may yield slight improvements in joint function, according to an updated systematic review published in July 2026 in the Cochrane Database of Systematic Reviews. Researchers evaluated 18 randomized controlled trials involving 1,368 participants aged 53 to 74 to determine how land-based physical activity impacts the joint condition.
Evaluating Exercise Versus Dummy Treatments
The updated review, led by Dr. Melanie Hall and colleagues, examined data up to February 2025 to assess the true efficacy of structured physical activity. When compared directly against dummy treatments across two studies involving 123 participants, exercise demonstrated little to no effect on pain levels. However, participants who engaged in exercise programs scored 7.4 points better on a 0-to-100 joint function scale than those receiving dummy treatments, where a 13-point difference is considered a meaningful clinical change.
Authors noted that participants in most trials were aware of their treatment allocations, and metrics relied heavily on self-reported questionnaires. These methodological factors may potentially inflate the perceived effectiveness of physical interventions. The review updates previous findings published in 2014 by incorporating newer clinical data.
Comparing Exercise With Standard Care and Additional Treatments
When stacked against no treatment, usual care, or limited education across 10 studies comprising 494 adults, exercise probably leads to small improvements. Exercising individuals scored 7.2 points better for pain and 8.8 points better for joint function on a 0-to-100 scale compared to control groups. These margins fall short of established thresholds for noticeable daily differences, which require a 12-point change for pain and a 13-point change for function.
For patients already undergoing other therapies, adding a structured exercise program provides minimal additional benefit. Across seven studies involving 751 adults, combining exercise with another treatment showed little to no effect on pain, joint function, general well-being, or treatment dropout rates. Furthermore, researchers found that exercise probably reduces the risk of unwanted events slightly when combined with other care modalities, while remaining uncertain about adverse event rates when compared solely against dummy treatments or usual care.
Demographics and Study Limitations
The investigated cohorts consisted primarily of women, who made up 63 percent of the total participants. Trials spanned 12 countries, including Australia, Canada, Denmark, Finland, Germany, Ireland, Italy, the Netherlands, New Zealand, Norway, Sweden, and the United States, with intervention durations ranging from two to 52 weeks.
Authors highlighted several limitations affecting the certainty of the evidence. Most trials featured small sample sizes and high outcome variability, leaving researchers moderately confident in some findings and less confident in others. Additionally, because the studies enrolled very few younger adults, the findings may not accurately reflect outcomes for younger populations living with hip osteoarthritis.
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