Hip bursitis typically improves within a few weeks to a few months with rest and basic home treatment. The condition involves inflammation of the fluid-filled sac (bursa) on the outer point of the hip, and most people recover without surgery or advanced procedures. Treatment follows a clear progression: start with simple self-care measures, add targeted exercises, and escalate to injections or other therapies only if pain persists.
Rest, Ice, and Pain Relief
The first step is reducing the irritation that’s keeping the bursa inflamed. That means avoiding the activities that triggered the pain, whether it’s running, prolonged standing, or sleeping on your affected side. You don’t need complete bed rest, but you do need to stop aggravating the area.
Apply ice to the outer hip for 15 to 20 minutes at a time during the first 48 hours after symptoms flare. Over-the-counter anti-inflammatory medications like ibuprofen or naproxen can help reduce both pain and swelling. These can be taken for several weeks if needed, though using them at the lowest effective dose is the safest approach. If walking is painful, a cane held in the opposite hand takes significant pressure off the affected hip.
Exercises That Target the Right Muscles
Once the initial flare calms down, strengthening the muscles around the hip is the most important thing you can do to prevent the problem from coming back. Weak hip stabilizer muscles are a major contributor to trochanteric bursitis, and targeted exercises address the root cause rather than just the symptoms. You can start these at home, though a physical therapist can tailor a program to your specific situation.
Three exercises form the foundation of most hip bursitis rehab programs:
- Bridging: Lie on your back with knees bent and feet flat. Push your hips toward the ceiling using your arms for support, hold a few seconds, then lower slowly. This strengthens your glutes without putting direct pressure on the outer hip.
- Side-lying leg lift with a pillow: Lie on your unaffected side with a pillow between your knees. Gently raise your top leg toward the ceiling, keeping it in line with your body (not drifting forward), hold briefly, then lower. This isolates the muscles on the outer hip that stabilize the joint.
- Step-ups: Stand at the bottom of a staircase. Step up leading with your affected leg, keep that leg on the step, and slowly step up and down with the opposite leg. This builds functional strength in a movement pattern you use every day.
Start with low repetitions and increase gradually. Pain during these exercises should stay mild. If an exercise causes a sharp increase in symptoms, scale it back or wait a few more days before trying again.
How to Sleep With Hip Bursitis
Nighttime pain is one of the most frustrating parts of hip bursitis. Lying directly on the inflamed bursa can wake you repeatedly or prevent sleep altogether. Sleeping on your back with a pillow under your knees, or on your unaffected side with a pillow between your knees, helps keep the hips aligned and reduces pressure on the outer hip. If you tend to roll onto the painful side during the night, placing a body pillow behind you can act as a physical barrier.
Injection Options
If several weeks of rest, anti-inflammatory medication, and exercise haven’t brought meaningful relief, injections are the next step your doctor will likely discuss. There are two main options, and they work very differently.
Corticosteroid (cortisone) injections work by shutting down the inflammatory cells in the area, which stops them from activating pain signals. Relief can last anywhere from a few weeks to six months, sometimes up to a year. You typically need to wait at least three months between injections, because repeated steroid use can weaken surrounding tissue. This is especially relevant at the hip. Some specialists avoid cortisone for trochanteric bursitis entirely because steroids can weaken the tendon on the outside of the hip. Damaging that tendon creates a much bigger problem, comparable to a rotator cuff tear in the shoulder.
Platelet-rich plasma (PRP) injections take the opposite approach. Instead of suppressing inflammation, PRP uses concentrated healing factors from your own blood to stimulate tissue repair. Symptom relief from PRP tends to last six months to a year. Some hip specialists now prefer PRP over cortisone for trochanteric bursitis specifically because it avoids the tendon-weakening risk. PRP is generally not covered by insurance, so cost is a factor.
Shockwave Therapy
For chronic cases that haven’t responded to other conservative treatments, focused shockwave therapy is a non-invasive option worth knowing about. The treatment delivers targeted energy pulses to the affected area, promoting healing and reducing pain. A systematic review of randomized controlled trials found that shockwave therapy provides meaningful improvement in both pain and function over the short and medium term. Sessions are typically done in an outpatient setting over several weeks. Long-term data is still limited, so it’s not yet clear how lasting the benefits are, but for people trying to avoid surgery it represents a reasonable intermediate step.
When Surgery Becomes an Option
Surgery for hip bursitis is uncommon. It’s reserved for the small subset of patients whose symptoms persist despite exhausting all conservative treatments, including rest, physical therapy, medications, and injections over many months. The procedure, called a trochanteric bursectomy, removes the inflamed bursa and can be performed through small incisions using a camera (endoscopic approach). Some surgeons also release a tight band of tissue on the outer thigh if it’s contributing to the problem. Recovery from this type of surgery takes several weeks, with a gradual return to normal activities.
Signs the Problem May Be Something Else
Most hip bursitis is caused by overuse, repetitive pressure, or muscle imbalance. But in rare cases, a bursa can become infected. If you develop a high temperature, chills, or notice the skin over the hip becoming red, warm, or increasingly swollen, those are red flags. Infected bursitis requires antibiotics and sometimes fluid drainage. Your doctor can draw a small sample of fluid from the bursa to test for infection or other conditions like gout.
Pain on the outer hip can also come from other sources, including referred pain from the lower back, hip arthritis, or a tear in the tendons that attach to the outer hip bone. If your symptoms don’t follow the typical bursitis pattern (pain with lying on the side, tenderness at the hip bone, pain going up stairs), it’s worth getting a proper evaluation to make sure you’re treating the right problem.
Realistic Recovery Timeline
With consistent conservative treatment, most people see significant improvement within a few weeks. Full resolution can take a few months, especially if the bursitis has been present for a long time before treatment started. The people who recover fastest are generally those who commit to the strengthening exercises rather than relying solely on rest and medication. Rest calms the inflammation, but strong hip muscles prevent it from returning. Recurrence is common in people who go back to their previous activity level without addressing the underlying muscle weakness or movement patterns that caused the problem in the first place.