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10 9 8 7 6 5 4 3 2 1 The real traeatment of the patology is divided in non surgical and surgical approach. The non surgical is important to delay the progression and the need of surgery. While consistent evidence supports the efficacy of these strategies in the management of knee OA [], the evidence in hip OA is far more variable Weight loss is recommended for people with hip OA who are overweight/obese; however unlike knee OA, there is a paucity of clinical trial evidence for weight loss in hip OA .A cohort study reported that a combined dietary and exercise weight loss program improved functional symptoms and reduced pain Ideally the treatment of OA of the hip is an individualized and multidisciplinary process taking into account the physiological and physical fitness of the patient as well as their home environment and functional aspirations. The objectives are to control the pain and improve function while empowering the patient to play a major part in their own recovery. This involves enabling the patient to understand the pathological process affecting them via dissemination of information in the doctors’ offices, the internet and local chapters of arthritis foundations, thus empowering them to be involved in their own care. Physiotherapy for hip OA usually includes physiotherapist led exercise therapies in conjunction with manual therapy. An exercise program that does not involve high impact activities usually is advocated and is associated with pain reduction. Aquatic exercises also improve function. Exercises that strengthen and stretch the muscles around the hip can support the hip joint and ease hip strain. No particular activity type has been shown to produce superior results, and thus it is recommended that exercise programs be personalized to reflect the unique needs of each patient. This aspect of treatment includes mainly analgesic drugs and has long been the mainstay of treatment for patients with O A. The World Health Organisation ‘analgesic ladder’ is a widely accepted approach to treating pain and consists of three levels of pain control. The simplest of these is paracetamol which has been shown to significantly decrease pain and increase function in patients. The next step up the analgesic ladder involves the use of Non Steroidal Anti-inflammatory Drugs. These are used commonly in conjunction with paracetamol. Though they are considered to be quite safe, several important side effects have been noted including Gastritis, gastric ulcers, renal and hepatic toxicity, notably in older patients and those taking them for a prolonged period of time. Opioid containing analgesics such as codeine phosphate can be used for acute exacerbations of pain as necessary but regular use is discouraged in the elderly population due to troublesome side effects such as constipation, dizziness and increased risk of falling.