Initial Treatment for Hip Bursitis
Non-pharmacological Management
- The American College of Rheumatology recommends participating in cardiovascular and/or resistance land-based exercise programs focusing on strengthening the quadriceps and proximal hip girdle muscles 1, 2
- Engage in aquatic exercises which can reduce joint loading while maintaining strength 1, 2
- Start with exercises that are within your capability and gradually build up intensity over several months 3, 4
- Aim for regular, individualized daily exercise regimens that include strengthening exercises for both legs, aerobic activity, and range of motion/stretching exercises 3, 4
- Apply thermal agents (heat or ice) to reduce pain and inflammation 1, 2
- Consider manual therapy in combination with supervised exercise, but not manual therapy alone 1, 2
- Use walking aids (such as a cane used on the opposite side) if needed to reduce pain and improve mobility 1, 3
- Consider appropriate and comfortable footwear to reduce stress on the hip 3, 4
- For overweight patients, implement weight loss strategies including regular self-monitoring of weight, increased physical activity, structured meal planning, and portion control 2, 3, 4
Pharmacological Management
- The American College of Rheumatology recommends acetaminophen as the first-line medication due to its favorable safety profile 1, 2
- Consider intra-bursal corticosteroid injections when oral medications and non-pharmacological approaches fail 1, 2
- Tramadol may be used when acetaminophen and NSAIDs are ineffective or contraindicated 1, 2
Self-Management Strategies
- Participate in self-management education programs that address understanding of the condition, causes and prognosis, activity pacing techniques, and coping strategies 1, 2, 3, 4
- Set both short-term and long-term goals with regular evaluation 3, 4