Hip bursitis typically resolves within a few weeks to a few months with conservative treatment, and most people never need surgery. The key is reducing inflammation first, then strengthening the muscles around your hip so the problem doesn’t return. Here’s what actually works, step by step.
What’s Happening in Your Hip
Your hip has fluid-filled sacs called bursae that cushion the space between bones and tendons. When one of these sacs becomes inflamed, every step, stair, and attempt to sleep on that side can hurt. The most common type, trochanteric bursitis, causes pain on the outer point of your hip that often radiates down the outside of your thigh. It’s typically worse at night when you lie on the affected side, when you stand up after sitting for a while, and during prolonged walking, stair climbing, or squatting.
A less common form, iliopsoas bursitis, affects a bursa on the inner side of the hip and produces pain in the groin instead. The treatment principles overlap, but knowing where your pain sits helps you and your doctor target the right spot.
First 48 Hours: Calm the Inflammation
Ice is your first move. Apply it to the painful area for 15 to 20 minutes at a time during the first 48 hours to bring swelling down. After that initial window, you can switch to dry or moist heat (a heating pad or warm bath) to loosen the surrounding muscles and ease stiffness.
Rest the hip, but don’t go completely sedentary. The goal is to stop doing whatever aggravated it: running, climbing, prolonged standing, or sleeping directly on that side. A temporary walking cane on the opposite side can take pressure off the hip if walking is painful. If you’re a side sleeper, place a pillow between your knees. Sleeping on your back with a pillow under your knees also helps keep the hips aligned and reduces pressure on the bursa.
Over-the-Counter Pain Relief
Ibuprofen is the most commonly used anti-inflammatory for hip bursitis. A typical dose for mild to moderate pain is 400 mg every four to six hours as needed. It usually starts working within a week, though more stubborn cases can take two weeks or longer before you notice meaningful improvement. Don’t rely on it as a long-term fix. It controls symptoms while you address the underlying problem through movement and strengthening.
Strengthening Exercises That Actually Help
Weak hip muscles, especially the gluteus medius on the outside of your hip, are one of the biggest reasons bursitis develops and recurs. When these muscles can’t stabilize the hip properly, the bursa takes extra friction with every stride. A targeted strengthening program is the single most important thing you can do for lasting relief.
Aim for three sets of each exercise, three times per week. Hold each repetition for about five seconds, and work toward 10 to 15 reps per set.
- Clamshells. Lie on your pain-free side with your knees bent to 90 degrees. Keeping your feet together, slowly raise the top knee toward the ceiling while squeezing your glute. This directly targets the gluteus medius.
- Double-leg bridge. Lie on your back with both knees bent and feet flat on the floor. Slowly raise your hips toward the ceiling and hold. Once this feels comfortable over a few weeks, progress to the single-leg version by holding one knee to your chest while bridging on the other leg.
- Lateral band walks. Place a resistance band around both ankles. Stand with your knees and hips slightly bent and take 6- to 8-inch steps sideways, keeping tension on the band. Repeat in both directions.
- Chair squats. Stand in front of a chair with feet shoulder-width apart. Slowly lower yourself until you feel the chair, then push through your heels to stand. This builds overall leg strength that supports the hip joint.
Start gently. If an exercise sharpens your pain rather than producing a mild, manageable ache, back off and try again in a few days. Progress matters more than intensity early on.
Corticosteroid Injections
If several weeks of rest, ice, anti-inflammatories, and exercise haven’t brought relief, a corticosteroid injection into the bursa is the next common step. The injection delivers a concentrated anti-inflammatory directly to the inflamed tissue and can provide significant pain relief within days. Some people need only one; others may need a second injection a few months later. Injections work best when paired with a strengthening program, because they address symptoms while the exercises address the cause.
Shockwave Therapy for Stubborn Cases
For hip bursitis that hasn’t responded to physical therapy, rest, injections, ice, or painkillers, shockwave therapy is a non-surgical option worth knowing about. The treatment delivers focused pressure waves to the inflamed tissue to stimulate healing. Results aren’t immediate: only about 13% of patients feel better at one month, but that number jumps to 68% by four months and 74% by 15 months. It’s typically reserved for cases that have resisted everything else, and it requires multiple sessions.
When Surgery Becomes an Option
Surgery for hip bursitis is uncommon. It’s considered only when symptoms persist despite months of conservative treatment and continue interfering with everyday activities. The procedure involves either draining excess fluid from the bursa or removing the inflamed bursa entirely. Recovery varies, but for most people, the progression from rest to exercises to injection resolves the problem long before surgery enters the conversation.
Is It Definitely Bursitis?
Hip bursitis and hip arthritis can both make walking and sleeping miserable, but they feel different in ways that matter. Bursitis pain is usually sharp and sits on the outer side of the hip, worsening with direct pressure like lying on it. Arthritis pain tends to settle deep inside the joint or in the groin, comes with noticeable stiffness, and limits your range of motion, especially after you’ve been sitting or resting. Bursitis may hurt during movement, but it doesn’t usually restrict how far your hip can move unless inflammation is severe.
If your pain is deep in the joint, accompanied by grinding or catching sensations, or your hip feels like it’s locking, those are signs pointing toward arthritis or a labral tear rather than bursitis. X-rays or an MRI can confirm the source. In some cases, a diagnostic injection into the joint itself helps pinpoint whether the pain is coming from the bursa or from structures deeper inside the hip.
Typical Recovery Timeline
Most people with hip bursitis see significant improvement within a few weeks of consistent treatment. Full resolution, meaning you can sleep on that side, walk without pain, and exercise normally, often takes a few months. The timeline depends largely on how inflamed the bursa was to begin with, how consistently you do your strengthening exercises, and whether you can avoid the activities that triggered the problem while you heal. Returning too quickly to high-impact activities like running or heavy stair climbing is one of the most common reasons bursitis flares back up.