Clinical Practice Guidlines for Hip Pain and Mobility

Hip pain can make everyday activities walking, sitting, exercising feel frustrating and limiting. The good news? The latest 2025 Clinical Practice Guidelines (CPG) published in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT) give us even clearer direction on what actually works to reduce pain and improve mobility.

At our clinic, we base our care on the most current research so here’s what this update means for you.

This guideline focuses on hip osteoarthritis (OA) a common condition where joint changes lead to pain in the groin, thigh, or buttock, stiffness (especially in the morning or after sitting), reduced mobility and difficulty with daily tasks. The 2025 update builds on previous guidelines (2009, 2017) but focuses specifically on new evidence for physical therapy treatment.

The strongest message from the 2025 CPG. Exercise and hands-on therapy is the BEST outcome. 

The guidelines emphasize individualized exercise programs as the foundation of treatment. This includes strength training (especially glutes and hip stabilizers), mobility and flexibility work, aerobic conditioning and functional training (sit-to-stand, walking, stairs).

New in 2025: Aquatic therapy is now specifically included as an effective option.

Manual Therapy or hands-on treatment remains a key component. This may include joint mobilizations, hip distraction techniques and soft tissue work. New research continues to support that manual therapy improves mobility, reduces pain, enhances function. The update emphasizes tailoring techniques based on joint irritability and patient tolerance.

A major update in 2025 is that Dry needling is now supported by strong evidence. It can help with pain reduction, muscle tightness, range of motion, short-term functional improvements. This is a big shift as there was no recommendation for dry needling in 2017.

The guidelines stress treating the whole person, not just the joint. That means addressing walking mechanics, balance deficits and movement patterns. This is especially important for preventing falls, improving confidence with movement and returning to daily activities.

Patient education is also very important and not optional. Key topics include activity modification (not avoidance!), weight management (if applicable) and long-term exercise habits. The goal: empower you to manage your condition long-term, not just temporarily relieve symptoms.

So if you’re dealing with hip pain or arthritis, resting alone is not the answer! The right guided movement plan is key.

The 2025 CPG reinforces what we see every day in the clinic. Targeted physical therapy works. With the right plan, you don’t have to just “live with” hip pain! You can move better, feel stronger, and get back to doing what you enjoy.

Nicole Perna PT, DPT 

Evolve Physical Therapy