What Helps With Hip Pain? Treatments That Work

Targeted exercise, anti-inflammatory medication, and in some cases steroid injections or surgery all have evidence behind them for hip pain, but which treatment works best depends heavily on what is causing the pain in the first place. The hip joint sits at a crossroads of tendons, bursae, labral cartilage, and bone, and the list of things that can go wrong there is long. What the research consistently shows is that a structured exercise program belongs at the foundation of nearly every hip pain treatment plan, with medications and procedures layered on top depending on the diagnosis and severity.

Why Pinpointing the Source Matters

Hip pain is not one condition. The differential diagnosis is broad and includes problems inside the joint itself (labral tears, cartilage damage, femoroacetabular impingement, loose bodies), problems in the surrounding soft tissue (bursitis, tendon injuries, snapping hip syndrome), and referred pain from entirely different structures like the sacroiliac joint, piriformis muscle, or pelvic floor.¹ A dull ache deep in the groin usually points to something inside the joint, while pain along the outside of the hip and thigh often signals a tendon or bursa problem. Back-related pain can mimic hip joint pain convincingly enough to fool both patient and clinician.

Getting the diagnosis right is the single most important step, because treatments that work well for one cause may do nothing for another. A strengthening program designed for gluteal tendinopathy, for instance, will not help much if the real culprit is a labral tear causing mechanical catching. Imaging helps sort this out: X-rays catch bone-level changes and impingement morphology, while MRI picks up soft-tissue injuries such as labral tears, cartilage defects, and stress fractures.² When the picture is still unclear, an ultrasound-guided anesthetic injection into the joint can serve as a diagnostic test: if the pain goes away temporarily, the problem is likely inside the joint.³

Exercise and Physical Therapy

For hip osteoarthritis, the most common cause of hip pain in adults over 50, exercise therapy has the most consistent evidence of any non-surgical treatment. A meta-analysis pooling data from multiple trials found that structured exercise, particularly programs that include muscle strengthening, produced a meaningful reduction in pain compared with control groups.⁴ A randomized trial confirmed that an exercise program led to significantly greater pain reduction on a standardized osteoarthritis pain scale compared with both a control group and a sham-exercise placebo group.⁵

The type of exercise matters less than you might expect. Swimming and cycling produced similar improvements in joint pain, stiffness, and physical limitation in adults with osteoarthritis, along with gains in muscle strength and quality of life.⁶ That is good news if you find one activity more comfortable than another: a pool session counts just as much as time on a stationary bike.

One well-known trial threw a curveball at the exercise story, though. When researchers compared a full physical therapy program with sham therapy (hands-on treatment that looked real but was not designed to produce a benefit), both groups improved by a clinically meaningful amount, and the real therapy did not outperform the sham.⁷ That result does not mean physical therapy is useless. It likely means that hands-on manual therapy for the hip does not add much beyond what you get from structured movement, attention, and a therapeutic setting. The broader body of evidence still supports exercise as a first-line treatment. What seems to drive the benefit is the strengthening and loading, not passive joint manipulation.

For gluteal tendinopathy, which causes pain on the outside of the hip and is sometimes called greater trochanteric pain syndrome, exercise-based programs that include progressive loading and patient education are consistently better than a wait-and-see approach for both short- and long-term function.⁸ Exercise also showed a higher treatment success rate than corticosteroid injections for this condition, a finding that matters because steroid shots are still widely offered as a first option.

Anti-Inflammatory Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) remain the most widely used medication for hip pain, especially from osteoarthritis. The choice between a pill and a topical gel or patch is worth thinking about. A systematic review and meta-analysis found that topical and oral NSAIDs are equally effective at reducing pain and improving physical function in osteoarthritis.⁹ Topical formulations carry the advantage of lower systemic absorption, which translates to fewer gastrointestinal side effects and a better overall risk-to-benefit ratio.¹⁰

The practical catch with topical NSAIDs for hip pain specifically is anatomy. The hip joint sits deep beneath layers of muscle and fat, making it harder for a topical gel to reach the joint compared with a knee or hand. Most of the strong evidence for topical NSAID effectiveness comes from knee osteoarthritis studies. If your hip pain is from soft tissue on the outer side of the hip (like bursitis or tendinopathy), a topical formulation can be applied directly over the sore spot and may work well. For deep joint pain, an oral NSAID or a different approach is usually more practical.

Acetaminophen (paracetamol) is sometimes used as a first-line pain reliever because it has fewer gastrointestinal risks, but the evidence for its effectiveness in osteoarthritis pain is weaker than for NSAIDs. It can take the edge off mild pain but rarely produces the same degree of relief for moderate to severe hip symptoms.

Corticosteroid Injections

A steroid injection directly into the hip joint is one of the more common interventions for hip osteoarthritis pain, and the evidence supports it as a short-term measure. A systematic review and meta-analysis found that intra-articular corticosteroid injections produce significant pain reduction that can persist for up to about 12 weeks.¹¹ A separate review reached a similar conclusion on the 12-week benefit window.¹²

Not everyone responds the same way. In one study tracking 82 patients, roughly a third had continued pain relief beyond the initial weeks, about half experienced an immediate response that faded, and about one in five had no meaningful response at all.¹³ This means steroid injections work well as a bridge, for example to buy time before surgery or to break a pain cycle long enough for physical therapy to gain traction, but they are not a long-term solution. Repeated injections carry risks to the cartilage and surrounding tissues, so most clinicians limit how often they offer them.

Hyaluronic Acid Injections

Hyaluronic acid (HA) injections, sometimes called viscosupplementation, aim to restore some of the joint’s natural lubrication. The evidence here is mixed enough that clinicians genuinely disagree about whether they are worth doing for hip osteoarthritis. A well-conducted randomized trial found that a single HA injection was no more effective than a placebo saline injection at reducing hip pain at three months.¹⁴ A meta-analysis similarly found that while HA can significantly reduce pain compared with pre-treatment levels, it does not clearly outperform saline or other comparator treatments.¹⁵

A newer systematic review adds a nuance: high molecular weight formulations of HA may perform better at the four-to-six-month mark, showing lower pain scores compared with placebo, medium-weight formulations, and controls.¹⁶ So the type of HA product and the follow-up window may explain some of the conflicting results. Still, HA injections are not a treatment where the evidence gives a clear thumbs-up for the hip. If your clinician suggests them, asking about the specific product formulation and what kind of response to realistically expect is a reasonable conversation to have.

Platelet-Rich Plasma

Platelet-rich plasma (PRP) injections have attracted interest as a regenerative option, especially for greater trochanteric pain syndrome (lateral hip pain from gluteal tendinopathy or bursitis). Early results are encouraging but not definitive. A systematic review found PRP to be relatively safe and potentially effective for this condition, though the existing studies are small and the quality of evidence is limited.¹⁷ One randomized trial with two-year follow-up found that a single PRP injection provided benefits lasting up to two years for chronic gluteal tendinopathy, while a corticosteroid injection offered maximum relief for only about six weeks.¹⁸

PRP is not typically covered by insurance for hip conditions, and it can cost several hundred dollars per injection. It is most commonly tried when exercise therapy and steroid injections have not worked. The science is promising enough that it is worth discussing with your doctor if you have chronic lateral hip pain that has not responded to other treatments, but it is too early to call it a standard recommendation.

Dry Needling

Dry needling involves inserting thin needles into trigger points in the muscles around the hip. It is distinct from acupuncture, though the tools look similar. A systematic review of randomized trials found that dry needling reduced hip pain scores within a week and also improved range of motion and muscle force, with no serious side effects reported. The review concluded that dry needling performed better than several comparators, including sham needling, no treatment, corticosteroid injections, and laser therapy.¹⁹

For greater trochanteric pain syndrome specifically, a randomized trial found that dry needling was not inferior to cortisone injection for pain relief and functional improvement.²⁰ A case series looking at chronic lateral hip and thigh pain also showed clinically meaningful improvements in both disability and pain that persisted at long-term follow-up when dry needling was combined with stretching and strengthening.²¹ The evidence base is still relatively small, but dry needling sits in a useful niche for people with muscular trigger points contributing to their hip pain, particularly as a complement to an exercise program.

Using a Cane and Other Simple Adjustments

A walking cane used in the hand opposite to the painful hip is one of the simplest and most underappreciated tools for hip pain. Research on hip biomechanics during walking found that contralateral cane use reduced peak pressure inside the hip joint and decreased the demand on the gluteus medius muscle.²² A more recent study in patients with late-stage hip osteoarthritis measured a roughly 25% reduction in the hip abductor moment and about a 10% reduction in vertical ground reaction force on the arthritic side when using a cane.²³ That is a meaningful load reduction achieved with zero side effects and very little cost.

Many people resist using a cane because of the stigma, especially if they are younger or feel it makes them look “old.” But if you are limping from hip pain, you are already loading the joint abnormally, and a cane can actually let you walk more normally and more comfortably. Some physical therapists recommend a cane specifically during flare-ups rather than as a permanent fixture, which can make it feel more like a temporary tool and less like a lifestyle change.

Weight management is another lifestyle factor worth mentioning, though the relationship with hip pain is less straightforward than you might assume. While obesity contributes to osteoarthritis onset and progression generally, and weight loss can improve joint function and pain in OA overall,²⁴ the hip may not respond to weight loss as dramatically as the knee does. Studies of patients after bariatric surgery found that hip pain did not improve as much as pain in other weight-bearing joints, possibly because the positioning of the femoral head inside the socket is less affected by body weight than the mechanics of the knee.²⁵ Weight loss is still worthwhile for overall health and joint protection, but if hip pain is your primary complaint, do not expect dramatic relief from dropping weight alone.

When Surgery Becomes the Best Option

Surgery enters the conversation when conservative treatments have been given a fair trial and the pain is still significantly limiting daily life. The two most relevant surgical paths for hip pain are hip arthroscopy (for younger patients with structural problems like impingement or labral tears) and total hip replacement (for advanced osteoarthritis).

For femoroacetabular impingement, a condition where abnormal bone shape causes the femoral head to grind against the acetabular rim, hip arthroscopy has shown advantages over physical therapy in randomized trials. One multicenter trial found that arthroscopic surgery produced a 10-point improvement in a hip function score compared with a personalized physiotherapy program at eight months.²⁶ A meta-analysis of randomized trials similarly favored surgery for patient-reported hip outcomes.²⁷ That said, the advantage of arthroscopy is not universal. A trial in patients over 40 with labral tears found that a supervised physical therapy program actually produced superior pain and function scores compared with physical therapy alone or a crossover group, and arthroscopy did not outperform supervised therapy in this older population.²⁸ Age and the extent of existing cartilage damage influence how much benefit arthroscopy can provide.

Total hip replacement is one of the most successful operations in modern medicine. Pain and walking scores roughly double after the procedure, satisfaction is high, and the vast majority of patients maintain independent living at long-term follow-up.²⁹ But it is not a guaranteed fix for everyone. A systematic review estimated that roughly 9 to 20% of patients report an unfavorable long-term pain outcome after hip replacement.³⁰ A more recent update estimated roughly 14% of patients still experiencing some long-term pain at six and twelve months, although the confidence in those numbers was limited by study quality.³¹ For patients with end-stage arthritis who are struggling to walk, sleep, or maintain their independence, those are still very favorable odds. But it is worth knowing going in that a small but real fraction of people do not get full relief.

The Role of the Hip’s Evolutionary Design

Part of the reason hip pain is so common has to do with how the joint evolved. The human hip was shaped by the transition to permanent upright walking, producing a deep ball-and-socket joint with a spherical femoral head (sometimes called “coxa rotunda”) that allows a wide range of motion while remaining inherently stable.³² That spherical shape is present in our closest primate relatives and in most modern humans. But high-impact sports during adolescence, when the growth plates are still open, can trigger the formation of a bony bump on the front of the femoral neck, known as a cam deformity. This extra bone makes the femoral head aspherical and creates the kind of impingement that damages cartilage over time. The morphology of cam deformity resembles the naturally aspherical hips of four-legged animals, just oriented differently because we load our hips in extension rather than deep flexion.

This evolutionary quirk explains a frustrating clinical pattern: a young, active person who played aggressive sports as a teenager may develop hip pain in their twenties or thirties from a structural problem that was set in motion years earlier. Recognizing this connection has shifted how sports medicine doctors think about hip impingement. It is not a random misfortune but a predictable biomechanical consequence of loading patterns during growth, and understanding that helps explain why some treatments (like arthroscopy to reshape the bone) can address the root cause in a way that stretching alone cannot.

Digital Programs and Pain Education

An emerging category of hip pain treatment involves app-based programs that combine exercise prescription with cognitive behavioral therapy (CBT) techniques and education about pain science. These programs deliver educational content through a smartphone app, targeting concepts like fear of movement, activity pacing, and self-management alongside guided exercises.³³ The idea is that chronic hip pain often involves more than just a damaged structure: how you think about and respond to pain shapes how disabling it becomes. Addressing the psychological component alongside the physical one can improve outcomes, particularly for people who have been dealing with hip pain for months or years and have started avoiding activities out of fear that movement will cause further damage.

These programs are still relatively new, and the evidence base is growing rather than mature. They are not a replacement for a proper diagnosis and hands-on care when needed. But for someone with chronic hip pain who does not have access to regular physical therapy or who wants additional support between clinic visits, a well-designed digital program can fill a real gap. The key ingredients seem to be consistent exercise, gradual progression, and an understanding that hurt does not always equal harm.