Most cases of hip bursitis improve with consistent home care over six to ten weeks. The condition involves inflammation of a fluid-filled sac on the outside of your hip, where it cushions the movement of tendons and a thick band of tissue sliding over the bony prominence at the top of your thighbone. The good news: physical therapy exercises and basic self-care are considered the first-line treatment, even by clinical guidelines. Here’s how to manage it effectively at home.
What’s Actually Happening in Your Hip
The pain you feel on the outer side of your hip comes from a bursa, a small cushioning sac that sits between bone and the soft tissues that glide over it. Repetitive friction, often from activities like running, climbing stairs, or simply walking with an altered gait, creates microtrauma where your gluteal tendons attach to the bone. That microtrauma triggers inflammation, and the bursa fills with fluid and becomes painful.
This means treatment isn’t just about calming the inflammation. It’s also about reducing the repetitive stress that caused it in the first place, which is why activity changes and strengthening exercises matter as much as ice and pain relievers.
Ice, Heat, and Pain Relief
In the first three days of a flare-up, ice is your best tool. Apply an ice pack wrapped in a thin towel for 10 to 15 minutes at a time, up to twice per hour. After those initial 72 hours, you can switch to heat or alternate between heat and ice, depending on which feels better. Heat works well before stretching because it loosens the surrounding muscles.
Over-the-counter anti-inflammatory medications like ibuprofen or naproxen can reduce both pain and swelling. Naproxen is specifically indicated for bursitis relief and can be taken every 12 hours. These medications work best when used consistently for a short period rather than sporadically. Avoid relying on them for more than 10 to 14 consecutive days without checking in with a pharmacist or doctor, as prolonged use raises the risk of stomach and kidney problems.
Exercises That Reduce Hip Pressure
Current evidence supports home exercise as the single most important treatment for hip bursitis. The goal is to strengthen the gluteal muscles that stabilize your hip and stretch the tight band of tissue (the IT band) that runs along the outside of your thigh. Start slowly, and back off any exercise that increases your pain.
Hip External Rotator Stretch
Lie on your back with both knees bent and feet flat on the floor. Place the ankle of your painful leg on the opposite thigh, near the knee. Use the opposite hand to gently pull that knee across your body toward the far shoulder. Hold for 15 to 30 seconds, and repeat two to four times. This stretch targets the deep muscles behind the hip joint that often tighten up when the bursa is inflamed.
IT Band Stretch
Stand a few inches from a wall with your painful hip closest to the wall. Cross your unaffected leg in front of the other and lean your hip gently toward the wall until you feel a stretch along the outer thigh. Hold for 15 to 30 seconds. The IT band is a major contributor to friction over the bursa, so keeping it flexible directly reduces irritation.
Gluteal Strengthening
Side-lying leg raises and clamshell exercises build strength in the gluteus medius, the muscle most responsible for stabilizing your pelvis when you walk. Weakness in this muscle forces surrounding structures to compensate, increasing friction on the bursa. Aim for two to three sets of 10 to 15 repetitions, performed daily or every other day. Progress gradually. These exercises often feel easy at first but can provoke soreness if you do too much too soon.
Activities to Avoid During Recovery
Hip bursitis is usually an overuse injury, so the most important change you can make is temporarily stopping the movements that aggravate it. Stair climbing, running, and cycling are the most common culprits because they all involve repetitive hip flexion under load. You don’t need to stop moving entirely. Walking on flat ground, swimming, and water aerobics are typically well tolerated and keep you active without compressing the bursa.
Pay attention to everyday habits too. Standing with your weight shifted onto one hip, sitting cross-legged, and lying directly on the painful side all increase pressure on the inflamed area. Small adjustments throughout the day add up.
How to Sleep With Less Pain
Nighttime pain is one of the most frustrating parts of hip bursitis, especially if you’re a side sleeper. If you sleep on your non-painful side, place one or two pillows between your knees. The key is keeping your top leg from dropping forward and across your body, which stretches the IT band over the bursa. Some people do better placing pillows in front of their body and resting the top leg on them for full support.
If side-lying is uncomfortable in any position, try placing a line of pillows lengthwise down the bed and lying partly on them, angled between your side and your back. This takes pressure off the outer hip while still feeling stable enough to fall asleep. Experiment with positions, because what works varies from person to person.
Check Your Footwear
A leg length difference as small as half a centimeter can alter your gait enough to overload one hip. Research shows that orthotic insoles improve pelvic symmetry during walking and significantly reduce pain in people with even mild leg length differences. You don’t necessarily need custom orthotics. A simple heel lift from a pharmacy, placed inside the shoe on the shorter side, can correct the imbalance. Worn-out or unsupportive shoes also contribute to poor alignment, so replacing old sneakers is a low-cost intervention worth trying.
What Recovery Looks Like
With consistent home care, most people see meaningful improvement within six to ten weeks. The first sign of progress is usually less pain at night, followed by reduced tenderness when pressing on the outer hip. Full recovery can take longer if you’ve had symptoms for months before starting treatment, but steady improvement week over week is a good sign you’re on the right track.
If your pain hasn’t improved after several weeks of consistent stretching, strengthening, icing, and activity modification, a doctor can offer options like corticosteroid injections to break the pain cycle and let you engage more fully in rehab. Injections provide short-term relief but offer little long-term benefit when used alone, so they work best as a bridge to exercise-based recovery.
Seek immediate medical attention if the skin over your hip becomes red, swollen, or warm to the touch, or if you develop a fever. These are signs of a possible infection in the bursa, which is rare but requires prompt treatment. Sudden inability to move the hip or severe, disabling pain also warrants a same-day visit.