Hip Pain Treatment: Non-Surgical Options Matched to the Cause

How is hip pain treated?

Effective hip pain treatment starts with finding the source. The hip joint, the cartilage rim (labrum), the tendons and bursae around the outer hip, and the lower back can all cause pain felt “in the hip”. The NHS guide to hip pain lists common causes and self-care steps. Once the cause is clear, treatment usually moves in steps: self-care and exercise, guided physiotherapy, medicines and injections, then surgery if needed.

What are the common causes of hip pain?

Cause	Where pain is usually felt	Typical first-line care	Possible injection options
Hip osteoarthritis	Groin, front of thigh, stiffness	Exercise, weight management, pain relief	Steroid; PRP or stem cells in mild to moderate cases (evidence limited)
Hip bursitis	Outer hip, worse lying on the side	Activity change, strengthening, physiotherapy	Steroid; PRP studied for tendon-related pain
Gluteal tendinopathy	Outer hip and buttock	Load-management exercise programme	PRP has some trial evidence
Hip labral tear	Groin, clicking or catching	Physiotherapy, activity change	Diagnostic or steroid injection; regenerative options early
Hip impingement (FAI)	Groin pain with deep bending	Physiotherapy, activity change	Diagnostic injection; surgery in selected people
Referred back pain, sciatica	Buttock, back of thigh	Treat the spine	Spine-targeted injections

Pain on the outer hip is often tendon or bursa related, while groin pain points more towards the joint itself. Imaging such as X-ray, ultrasound or MRI helps confirm the diagnosis.

How is the cause of hip pain diagnosed?

A doctor starts with your history: where the pain is, what makes it worse, whether it wakes you at night and whether there was an injury. A physical examination tests hip rotation, strength and tender points over the tendons and bursa. An X-ray shows arthritis and bone shape. An MRI or MR arthrogram shows the labrum, cartilage and tendons in more detail, and ultrasound is useful for tendons and bursae. The spine is checked too, because back problems commonly refer pain to the buttock and hip.

Red flags such as a recent fall with inability to bear weight, fever with a hot swollen joint, unexplained weight loss or a history of cancer need prompt medical care rather than a treatment program. The NHS lists when to get urgent help for hip pain.

Non-surgical hip pain treatment: what works first?

• Exercise therapy and physiotherapy. Strengthening the hip and core muscles is the foundation for arthritis, tendon pain and many labral problems. The NHS explains what physiotherapy involves.
• Weight management. Reducing load helps hip arthritis symptoms.
• Activity changes. Avoiding long periods of sitting cross-legged, lying on the painful side or repeated deep squats can calm tendon and impingement pain.
• Pain relief. Paracetamol or anti-inflammatory medicines, used as advised by a doctor.
• Walking aids. A stick in the opposite hand reduces joint load during flare-ups.

For osteoarthritis, the UK’s NICE guideline recommends exercise and weight management as core treatment before other options.

When are hip injections considered?

Injections are usually considered when pain persists despite several weeks to months of good-quality exercise therapy, or when pain stops a person doing their rehabilitation.

• Steroid injections can give short-term relief for bursitis and arthritis flares. The NHS explains how steroid injections work and their side effects. Repeated steroid injections are generally limited.
• PRP therapy uses your own concentrated platelets. It has been studied in outer hip tendon pain and hip osteoarthritis with mixed results.
• Stem cell therapy uses mesenchymal stromal cells. For the hip, evidence comes mainly from small studies in mild to moderate osteoarthritis.

Hip joint injections should be done under ultrasound or fluoroscopic guidance because the joint lies deep. Compare the two biologic options in stem cells vs PRP, or steroid against cells in stem cells vs cortisone.

Who may be a candidate for regenerative hip treatment?

• Imaging-confirmed mild to moderate hip osteoarthritis, or chronic outer hip tendon pain.
• Pain that continues despite a proper exercise programme and standard care.
• People who want to delay surgery or are not yet surgical candidates.
• People who accept that benefit is uncertain and may be partial or temporary.

Who should NOT have hip injections?

• Severe bone-on-bone arthritis or collapse of the femoral head (avascular necrosis), where hip replacement is usually more effective.
• Suspected fracture, infection or tumour.
• Active infection elsewhere, active cancer, certain blood disorders or uncontrolled diabetes.
• Pregnancy, for cell-based treatments.

Risks of hip injections

Common effects include a pain flare and stiffness for a few days. Steroid injections can raise blood sugar temporarily and, with repeated use, may affect surrounding tissue. Infection after any joint injection is rare but serious. Regenerative injections carry the added risk of paying for a treatment that does not help. Cells are prepared in ISO 9001:2015-certified partner laboratories.

What is recovery like after a hip injection?

Most people walk out the same day. Doctors usually advise relative rest from high-impact activity for a few days, then a gradual return guided by a physiotherapist. Steroid injections tend to act within days. Any benefit from PRP or cell-based injections, if it comes, usually builds gradually over weeks to months. Continuing a strengthening programme matters, because injections work best as part of rehabilitation rather than on their own.

When is surgery the better option?

Hip replacement is one of the most successful operations in medicine for severe arthritis, as the NHS explains in its guide to hip replacement. Hip arthroscopy may be offered for some labral tears or impingement. If your imaging shows severe disease, we will say so honestly and suggest an orthopaedic surgical opinion. Read hip replacement alternatives for a detailed comparison.

Next step: get your hip imaging reviewed

1. Send your hip X-ray, MRI or reports on WhatsApp.
2. A Thai Medical Council-licensed doctor reviews the cause and stage.
3. You get a clear recommendation: conventional care, a regenerative program, or a surgical referral.

See how it works, or read our guides for patients from Australia, the UK and Canada.