How do you treat hip bursitis at home?

Ease off whatever reliably flares it, such as long walks, stair climbing or lying on the sore side, but keep moving within comfortable limits instead of resting completely. Many people sleep better on the other side with a pillow between their knees, and it helps to avoid sitting with your legs crossed. If the pain isn't improving or keeps waking you up, get it assessed so a strengthening program can start.

Should I see a doctor or a physical therapist for hip bursitis?

Either can be a reasonable first stop. With most plans in New York, you can start with a physical therapist without a referral, and if your exam points to something else, such as a fracture, an infection or a problem inside the joint, we'll send you to a physician. See a physician first after a fall, with a fever, or if you can't put weight on the leg.

Is a cortisone shot or physical therapy better for hip bursitis?

They do different jobs. In a 2018 BMJ trial of adults with outer hip pain from gluteal tendinopathy, an education and exercise program run by physical therapists did better than a single corticosteroid injection at eight weeks, and more people in the exercise group still reported improvement a year later. An injection can help calm severe pain, but AAOS advises limiting the number of injections because long-term use may damage surrounding tissues.

How long does a pulled hamstring take to heal?

It depends on how badly it's injured. ChoosePT notes that symptoms of a mild strain may last only a few days, while a more severe injury can last weeks, and returning to sport can take weeks to months. A complete tear may need surgery, so a pop with heavy bruising or real trouble walking deserves a prompt medical look.

Hip Pain Physical Therapy in Buffalo, NY | Lake Erie Physical Therapy

A bursa is a small sac of fluid that acts as a cushion, helping tissues glide over bone. One sits over the bony point on the outside of each hip, and when that spot aches at night, on the stairs or as you stand up from a chair, bursitis usually gets the blame. Often the gluteal tendons that attach at the same point are involved as well, and that shapes what good hip bursitis treatment looks like. This page covers outer hip pain, groin-side bursitis and hamstring strains, and how Lake Erie Physical Therapy in Buffalo approaches each one.

Pinpointing the pain

People say “hip” about pain in the buttock, the groin, the side of the thigh and even the lower back, so the first job is narrowing it down.

On the outside of the hip

The American Academy of Orthopaedic Surgeons (AAOS) describes trochanteric bursitis as pain at the point of the hip that usually extends down the outside of the thigh, sharp at first and later a duller, wider ache. It’s typically worse at night when you lie on that side, when you get up after sitting a while, and with long walks, stairs or squatting.

Researchers often describe the same picture as gluteal tendinopathy or greater trochanteric pain syndrome. The gluteal muscles that steady your pelvis each time you stand on one leg attach at that bony point, and their tendons are often part of the problem. The authors of a 2018 trial in the BMJ note that it affects about one in four women over 50 and often interferes with sleep and daily activity. The takeaway: tendons respond to well-chosen exercise, which is why strengthening sits at the center of care.

In the groin

A second bursa, the iliopsoas bursa, sits on the groin side of the hip, and AAOS notes that when it’s inflamed the pain is felt in the groin. Groin pain also commonly comes from the hip joint itself, including arthritis, which often shows up as stiffness pulling on socks or getting out of the car. Our arthritis page covers that.

From the lower back

The lower back can send pain into the buttock and the side of the hip, and AAOS lists spine problems such as scoliosis and arthritis of the lower spine among the causes of hip bursitis, because they can change the way you walk. That’s why we screen your back with the McKenzie Method (MDT) before settling on a hip diagnosis. If pain runs below the knee with tingling or numbness, see our sciatica page.

Who gets hip bursitis

AAOS says hip bursitis can affect anyone but is more common in women and in middle-aged and older adults. Contributing factors include:

Repetitive stress from running, stair climbing, cycling or long periods of standing
A fall onto the hip, or lying on one side for a long time
A tight IT band, the band of tissue running down the outside of the thigh
A significant difference in leg length
Rheumatoid arthritis, previous hip surgery or a hip implant
Bone spurs or calcium deposits in the nearby tendons

Hip bursitis treatment at Lake Erie Physical Therapy

Trochanteric bursitis treatment usually starts without surgery; AAOS notes that surgery is rarely needed. In the 2018 BMJ trial mentioned above, 204 adults with long-standing outer hip pain from gluteal tendinopathy were assigned to an education and exercise program run by physical therapists, a single corticosteroid injection, or a wait-and-see approach. The exercise group did better than both at eight weeks, and a year later more people in the exercise group still reported improvement than in the injection group.

Your plan follows the same logic:

A one-on-one evaluation of where it hurts and what sets it off, hip strength and single-leg balance side to side, how you walk and step up, and your lower back.
Load education about everyday positions that commonly aggravate outer hip pain, like lying on the sore side, sitting with your legs crossed or standing with your weight sunk into one hip.
Progressive strengthening. AAOS lists exercises to improve hip strength and flexibility as part of treatment. We start with what your hip tolerates today and build toward single-leg and stair work.
Hands-on care when it helps you move, and pain-relieving modalities when indicated.
A short home program that changes as you get stronger.

Progress with tendon pain is usually gradual, so rather than predicting a number of visits, we track what matters to you, like how far you can walk and whether you’re sleeping through the night.

Physical therapy for a hamstring strain or tear

Pain where you sit, or along the back of the thigh after a sprint or a slip, usually points to the hamstrings. ChoosePT, the American Physical Therapy Association’s patient site, notes that hamstring injuries are common with high-speed running, jumping and kicking, and most frequent in football, soccer, rugby and track. The typical story is a sudden, sharp pain in the back of the thigh or buttock, sometimes with a pop, then bruising within hours or days.

Early protection, not stretching. ChoosePT advises against stretching an injured hamstring at first and warns that continuing to walk or exercise on it can make the injury worse.
Strength, measured side to side. ChoosePT calls strengthening an essential part of rehab. We compare legs and raise the load on purpose, adding blood flow restriction (BFR) training when heavier lifting isn’t tolerated yet and a safety screening allows it.
A graded return to running, from jogging to faster running and sport drills, each step earned by how the leg handled the last. See sports physical therapy for how we approach return to play.
Prevention built in. ChoosePT notes that after tearing a hamstring, a person is more than three times as likely to injure it again, so warm-ups and strength work stay in your routine.

ChoosePT notes that most hamstring strains are managed successfully with physical therapy. A suspected severe (grade 3) tear is likely to be referred to an orthopedic physician for imaging, though, and a complete rupture may need surgery.

See a doctor first if

Physical therapy does not replace a medical diagnosis. Get medical care before starting therapy if:

Your hip hurts after a fall or other injury and you can’t put weight on the leg, or the leg looks shortened or turned out (go to an emergency department)
You have a fever or chills, or the hip is hot, red and swollen
Hip or groin pain came on suddenly and you take long-term steroids or have sickle cell disease
Several joints hurt or swell at the same time
Pain wakes you at night no matter how you lie, or comes with unexplained weight loss or a history of cancer
You have new numbness or weakness in the leg, or any change in bladder or bowel control (emergency)
You felt a pop at the back of the thigh or near the sit bone and have heavy bruising or can’t walk normally
A child or young teen has hip or knee pain or a new limp

Getting started

With most plans, New York lets you see a physical therapist without a referral for up to 10 visits or 30 days, whichever comes first, though some plans still require a referral to pay. Medicare doesn’t require one to start; your physician certifies the plan of care. Two exceptions: No-Fault requires a referral if a car accident caused your pain, and a Workers’ Compensation claim requires one for a work injury. If your hip is heading toward surgery, our hip replacement rehab page covers recovery.

If your hip is costing you sleep or cutting your walks short, call our Buffalo clinic at (716) 332-4838 or request an appointment. Wear shorts so we can see how your hip and knee move.

Sources

Written by the Lake Erie Physical Therapy clinical team. This page is general information, not a diagnosis; your physical therapist will assess your situation in person.

Physical Therapy for Hip Pain and Bursitis