Hip bursitis pain typically responds well to a combination of rest, anti-inflammatory medication, targeted exercises, and simple changes to how you sleep and move. Most people improve significantly within six to eight weeks of consistent conservative treatment, and many never need anything beyond home care. The key is reducing irritation to the inflamed bursa while gradually strengthening the muscles that stabilize your hip.
What’s Happening in Your Hip
A bursa is a small, fluid-filled sac that cushions areas where bones, tendons, and muscles slide against each other. Your hip has several of them, but two cause the most trouble. The trochanteric bursa sits on the bony point on the outside of your upper thigh, and it’s by far the more common site of hip bursitis. The iliopsoas bursa sits on the inner, groin side of the hip and produces deeper pain closer to the front.
The bursa becomes inflamed when something repeatedly compresses or irritates it. Running, stair climbing, cycling, standing for long stretches, or even lying on one side for too long can all trigger it. A direct fall onto the hip or a sudden bump can do it too. Once the bursa is inflamed, everyday movements keep aggravating it, which is why the pain tends to linger unless you actively change what’s irritating it.
Worth knowing: what many people call “hip bursitis” sometimes turns out to be damage to the tendons of the gluteal muscles that attach near the same spot. True bursitis produces tenderness right over the bony prominence on the outside of the hip. Tendon problems tend to cause pain slightly more toward the front of the hip bone, along with noticeable weakness when you try to move your leg sideways against resistance. The distinction matters because tendon damage can require a different rehab approach. If your pain doesn’t improve after several weeks of home treatment, imaging with ultrasound can sort out what’s going on.
Reducing Pain and Inflammation
Over-the-counter anti-inflammatory medications like ibuprofen and naproxen are the first line for calming the swollen bursa. They work best when taken consistently for a few weeks rather than sporadically, because the goal is to reduce the underlying inflammation, not just mask pain in the moment. If you’re still relying on them after a month, that’s a sign to check in with a doctor about next steps.
Ice is a useful complement, especially after activity. Apply a cold pack wrapped in a thin towel to the outside of your hip for 15 to 20 minutes at a time. This is most effective in the first week or two when inflammation is at its peak. You can ice several times a day as needed.
The most important thing you can do early on is identify and temporarily stop whatever activity triggered the flare. If it was running, switch to swimming or another low-impact option. If standing at work is the culprit, find ways to alternate between sitting and standing throughout the day. Complete bed rest isn’t necessary or helpful, but continuing the aggravating activity will keep the cycle going.
Exercises That Build Hip Stability
Strengthening the muscles around your hip is the most effective long-term strategy for relieving bursitis pain and preventing it from returning. Weak gluteal muscles force the bursa to absorb more friction and pressure than it should. The exercises below come from clinical guidelines for trochanteric hip pain and can be done at home with no equipment.
Bridging
Lie on your back with your knees bent and feet flat on the floor, arms at your sides. Push your hips toward the ceiling using your glutes, hold for a few seconds, then slowly lower back down. This targets the deep hip stabilizers without putting lateral pressure on the bursa.
Side-Lying Leg Lift With Pillow
Lie on your unaffected side with a pillow between your knees. Gently raise the top leg toward the ceiling, hold briefly, and lower it. The pillow prevents your legs from pressing together and irritating the bursa, while the lift strengthens the outer hip muscles that are often weak in people with bursitis.
Step Ups
Stand at the bottom of a staircase. Step up leading with your affected leg, keeping that foot on the step, then slowly step the other leg up and back down. This builds functional strength for the exact movement pattern (stairs) that often triggers bursitis pain.
Start with whatever number of repetitions you can manage comfortably. Doing small amounts throughout the day works better than one big session. As the exercises get easier, add one or two repetitions every few days. Once you can do more, break them into sets of about eight repetitions, done fewer times per day. This gradual progression builds strength without re-inflaming the bursa. Expect to continue the exercise program for at least six to eight weeks before seeing lasting improvement.
Sleeping With Less Pain
Nighttime is often the worst for hip bursitis. Lying on the affected side puts your full body weight directly on the inflamed bursa, and even lying on the opposite side can let the top leg drop, pulling on the hip.
Two positions help the most. Sleeping on your back with a pillow under your knees keeps your hips in a neutral, aligned position and takes pressure off the outer hip entirely. If you’re a side sleeper, lie on your unaffected side and place a firm pillow between your knees. This prevents the top leg from falling inward and stretching the structures over the bursa. A body pillow works well for maintaining this position throughout the night. Some people also find that a mattress topper adds enough cushion to reduce the pressure that wakes them up.
How Weight Affects Hip Pressure
Every pound of body weight translates to roughly six pounds of force on the hips during movement. That means losing even five pounds removes about 30 pounds of pressure from the bursa with every step. For people who are carrying extra weight, this is one of the highest-impact changes available. It won’t resolve the inflammation on its own, but it meaningfully reduces the mechanical load that caused the problem and makes other treatments more effective.
Cortisone Injections
When home treatment isn’t enough, a cortisone injection directly into the inflamed bursa is the next step most doctors offer. The injection delivers a potent anti-inflammatory right to the source of the problem. Pain relief can last several months to a full year, and some people get permanent relief from a single shot. The injection itself takes a few minutes and is often guided by ultrasound to ensure accuracy.
Cortisone injections work well for breaking the cycle of inflammation, but they don’t address the underlying weakness or movement patterns that caused the bursitis. That’s why they’re most effective when combined with a strengthening program. Without rehab, the pain tends to return once the injection wears off.
Shockwave Therapy for Stubborn Cases
For bursitis that hasn’t responded to standard treatment, extracorporeal shockwave therapy (ESWT) is a non-invasive option with growing evidence behind it. The treatment uses focused sound wave pulses directed at the inflamed area. A study of 103 patients with persistent hip bursitis or tendon damage found that three weekly shockwave sessions, combined with a home exercise program, produced significant pain reduction by two months and continued improvement in hip function and quality of life out to six months. The treatment is typically done in an outpatient setting and doesn’t require anesthesia.
When Surgery Becomes an Option
Surgery for hip bursitis is uncommon and reserved for the small percentage of people whose pain persists despite months of conservative treatment, injections, and physical therapy. The procedure, called a bursectomy, involves removing the inflamed bursa entirely. It can be done through small incisions using a camera (arthroscopically), which means a shorter recovery than open surgery. Published outcomes show good results for both open and arthroscopic approaches, but most orthopedic surgeons view this as a last resort after all other options have been fully explored.
The bursa does not grow back in its original form after removal, but the body forms scar tissue in the area that serves a similar cushioning function over time. Most people who reach this point have been dealing with symptoms for six months or longer.