Most hip pain improves with a combination of targeted exercises, the right pain relief strategy, and simple changes to how you move and sleep. The best treatment depends on what’s causing the pain, but the majority of cases respond well to nonsurgical approaches. Here’s what works, when to escalate, and how to get relief faster.
Identifying What’s Behind Your Hip Pain
The two most common causes of hip pain in adults are osteoarthritis and greater trochanteric pain syndrome, which includes conditions like bursitis and tendon problems on the outer hip. They feel different and respond to different strategies, so it helps to know which one you’re dealing with.
Osteoarthritis tends to develop gradually in older adults. The pain typically shows up deep in the groin or front of the hip and gets worse after sitting or walking for long periods. You may notice stiffness when you first stand up, and your range of motion shrinks over time. Greater trochanteric pain syndrome is more common in middle-aged women and people carrying extra weight. The hallmark is tenderness on the bony point of your outer hip, pain when lying on that side at night, and discomfort that flares with activity or prolonged sitting. There’s usually no specific injury that started it.
Less common causes include labral tears (often felt as a catching sensation), stress fractures, and referred pain from the lower back. If your pain came on suddenly after a fall, you can’t bear weight, the hip feels hot or swollen, or you have a fever alongside hip pain, that warrants emergency care rather than home treatment.
Over-the-Counter Pain Relief That Actually Works
Not all painkillers perform equally for hip pain. A large network analysis published in The BMJ compared dozens of medications head-to-head for osteoarthritis of the hip and knee. Anti-inflammatory drugs (NSAIDs) were clear winners. Prescription-strength oral diclofenac produced about a 14-point improvement on a 100-point pain scale, roughly 1.5 times the threshold for a meaningful difference. Acetaminophen (Tylenol), by contrast, produced only a 4-point improvement, the weakest effect of any treatment studied.
For over-the-counter options, ibuprofen and naproxen are the most accessible NSAIDs and a reasonable starting point. Topical anti-inflammatory gels applied directly to the skin had a 92% probability of producing clinically meaningful pain relief with a better safety profile than oral versions, since less of the drug enters your bloodstream. Topical options are particularly useful if you have stomach sensitivity or are concerned about the cardiovascular risks of oral NSAIDs over time.
Opioid painkillers performed poorly in the same analysis. Regardless of the type or dose, none reached the threshold for clinically meaningful pain relief, and 83% of opioid treatments carried an increased risk of side effects that caused patients to stop taking them. They are not a good long-term strategy for hip pain.
Exercises That Build Hip Stability
Strengthening the muscles around your hip is one of the most effective treatments available, particularly for outer hip pain and early-to-moderate arthritis. The key muscle group is the gluteus medius, which runs along the side of your pelvis and stabilizes your hip with every step. When it’s weak, other structures compensate and become irritated. The American Academy of Orthopaedic Surgeons recommends these exercises as part of a hip conditioning program:
Clamshells: Lie on your side with hips slightly bent and knees bent to about 90 degrees. Keep your feet stacked together and slowly lift your top knee as high as you can without your pelvis rolling backward. Hold for 5 seconds, then lower over a count of 5. Do 10 to 15 reps per side, daily.
Side-lying hip abduction: Lie on your side with your bottom leg bent for support. Straighten your top leg and slowly raise it to about 45 degrees, keeping the knee straight but not locked. Hold 5 seconds, then lower. Start with 8 reps and progress to 12. Do this 2 to 3 days per week, and add 1-pound ankle weights as it gets easier.
Reverse clamshells: Same starting position as the clamshell, but this time keep your knees together and rotate your top foot upward toward the ceiling. Lower slowly over 5 seconds. Do 10 to 15 reps per side, daily. This targets slightly different stabilizers on the inner and outer hip.
For range of motion, the knee-to-chest stretch is a good foundation. Lie on your back, bend one knee, and gently pull your shin toward your chest. Hold for 30 seconds, relax for 30 seconds, then switch sides. Pull both knees in together, and repeat the entire sequence 4 times. A standing IT band stretch (crossing one leg behind the other and leaning away from the affected side) also helps loosen the tight band of tissue that runs from hip to knee.
Sleep Adjustments for Nighttime Pain
Hip pain that wakes you up or prevents you from falling asleep is one of the most frustrating symptoms, especially with bursitis. Two positions help: sleeping on your back with a pillow under your knees, or sleeping on your unaffected side with a pillow between your knees. Both positions keep your hips aligned and reduce the pressure on irritated structures. A firm, full-length body pillow works better than a standard pillow for side sleepers because it prevents your top leg from dropping forward and twisting the hip through the night.
Injection Options and What to Expect
When exercises and medication aren’t enough, injections offer a middle step before considering surgery. Cortisone (corticosteroid) injections are the most reliable option for quick relief. They reduce inflammation directly inside the joint or bursa and typically provide relief lasting anywhere from a few weeks to six months. If you’re considering a hip replacement down the road, plan to wait at least three months after your last cortisone shot before surgery, as steroids can increase infection risk.
Platelet-rich plasma (PRP) injections use concentrated growth factors from your own blood to stimulate tissue repair. Relief tends to take longer to kick in but may last six months to a year. PRP has supporting evidence for both hip arthritis and torn tendons, though results are less predictable than cortisone and the procedure is rarely covered by insurance.
Hyaluronic acid injections, sometimes called viscosupplementation, aim to restore the lubricating fluid inside an arthritic joint. They’re recommended for moderate osteoarthritis rather than acute flare-ups. Because the hip joint sits deep beneath muscle, these injections require ultrasound guidance for accurate placement. Results vary. Hyaluronic acid works best as part of a broader treatment plan rather than a standalone fix, and expectations for pain relief should be realistic. For some patients, it serves as a useful bridge to delay joint replacement.
When Hip Replacement Becomes the Right Call
Total hip replacement is reserved for people who have tried conservative treatments, including physical therapy, medications, and injections, and still experience persistent pain that limits daily activities like walking, climbing stairs, or getting dressed. Significant joint deformity or loss of motion can also qualify someone for surgery, even if pain is manageable, when the resulting disability is substantial enough.
The outcomes are strong. In patients under 50, a population that puts the most demand on artificial joints, 98% of hip replacements were still functioning at an average follow-up of 14 years. Modern implant materials wear down at a rate of about 0.024 millimeters per year, well below the 0.1 mm threshold where complications begin. Functional scores improved by an average of nearly 44 points on the standard 100-point hip assessment. For younger and older patients alike, hip replacement is one of the most successful elective surgeries in medicine, with the vast majority of people returning to pain-free walking and active lives.
Putting a Treatment Plan Together
Start with the basics: daily hip-strengthening exercises, a topical or oral anti-inflammatory, and sleep position adjustments. Give this approach four to six weeks. If pain persists, physical therapy with a structured program adds hands-on guidance and progression that home exercises alone may miss. Cortisone injections can be layered in for pain that interferes with your ability to exercise or sleep. If six months of consistent effort doesn’t produce meaningful improvement and imaging confirms joint damage, that’s a reasonable point to discuss surgical options with an orthopedic specialist.