Does PRP Work for Hip Bursitis and Pain on the Outsideof the Hip

Key points

• Greater trochanteric pain syndrome mostly affects middle-aged women. In the largest treatment trial, 167 of 204 participants were women with a mean age of 54.8 years, and imaging studies show true bursitis on its own is rare, with gluteal tendinopathy the usual cause.

• An 80-patient double-blind trial in the American Journal of Sports Medicine found a single ultrasound-guided leukocyte-rich PRP injection gave greater improvement than a single steroid injection at 12 weeks, sustained at 2 years, while the steroid effect peaked at 6 weeks and was gone by 24 weeks.

• A 2025 double-blind trial of 79 patients in the Journal of Bone and Joint Surgery, run in the NHS in Northumbria, found a single ultrasound-guided leukocyte-rich PRP injection no better than saline placebo up to 6 months, and the authors do not support routine use.

• In the 2018 LEAP trial of 204 patients in the BMJ, 77 percent of the education and exercise group were at least moderately better at 8 weeks against 58 percent with a steroid injection and 29 percent with wait and see, with better global improvement still at 1 year.

If you have pain on the outside of the hip that wakes you at night, message us on WhatsApp or email team@thewellnesslondon.com and a doctor will look at your history before recommending anything.

It is usually the tendon, not the bursa

Pain over the bony point on the outside of the hip has been called trochanteric bursitis for decades, and most patients still arrive with that label. Imaging tells a different story. Ultrasound and MRI studies of people with lateral hip pain find the gluteus medius and minimus tendons are the usual source, with primary bursitis on its own rare. The umbrella term is greater trochanteric pain syndrome, and the specific diagnosis in most cases is gluteal tendinopathy, a degenerate and overloaded tendon at its attachment to the bone.

That distinction changes the treatment. A bursa is an inflamed sac, and an anti-inflammatory steroid makes sense for it. A tendinopathy is a failed healing response in a compressed tendon, and the things that help it are reducing compression, loading it progressively, and time. Steroid gives fast relief and then fades, which is exactly what the trials show. The condition is common in women between 40 and 60, and the typical story is pain lying on that side at night, on stairs, and after sitting with the legs crossed, which is the position that compresses the tendon most.

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The trial that says PRP works

The Australian trial published in the American Journal of Sports Medicine screened 228 patients referred with gluteal tendinopathy and enrolled 80 whose diagnosis was confirmed on both examination and imaging, excluding those with full-thickness tears or hip osteoarthritis. They were randomised to a single leukocyte-richPRP injection or a single steroid injection, both delivered into the tendon under ultrasound guidance. At 12weeks the PRP group had a significantly better modified Harris Hip Score, 74.05 against 67.13. Before that point there was no difference.

The 2-year follow up, published in 2019, is the reason the trial matters. Among patients whose symptoms had lasted more than 15 months, the PRP improvement was sustained at 2 years, whereas the steroid improvement peaked at 6 weeks and was not maintained beyond 24 weeks. A 2021 systematic review and meta-analysis pooling this and other trials concluded PRP is more effective than steroid for greater trochanteric pain at around 2 years. For a patient who has already had a steroid injection that faded, that is the case for PRP in a sentence.

Tell us how long your hip has hurt on WhatsApp and a doctor will tell you whether your history matches the patients who did well.

The trial that says it does not

The 2025 HIPPO trial, published in the Journal of Bone and Joint Surgery and run in the NHS in Northumbria, is the most rigorous test of PRP for this condition to date, and it is negative. It randomised 79 patients with refractory greater trochanteric pain, 73 of them women with a mean age of 57, to a single ultrasound-guided 4ml leukocyte-rich PRP injection or 4 ml of saline. Both groups improved from baseline and kept that improvement to 12 months. There was no significant difference between them on the iHOT-12, pain score, modified Harris Hip Score or quality of life at any point. The authors concluded they do not support routine use of PRP for the condition and suggested natural history, the home exercise programme both groups received, and the placebo effect of an injection explained the improvement.

How can both trials be right. The Australian trial compared PRP with steroid, which fades, and found PRP held.The UK trial compared PRP with saline, which does not fade, and found no difference. Read together they suggest PRP may not be doing much beyond what a needle, a home exercise programme and time do on their own, and that its advantage over steroid at 2 years may be as much steroid’s failure as PRP’s success. That is an uncomfortable reading for a PRP clinic to publish, which is why we publish it.

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What actually has the strongest evidence

The LEAP trial in the BMJ in 2018 randomised 204 people with gluteal tendinopathy to 14 sessions of education on load management plus exercise over 8 weeks, a single ultrasound-guided steroid injection, or wait and see. At 8 weeks, 77 percent of the education and exercise group reported being at least moderately better, against 58 percent with steroid and 29 percent with wait and see. Education and exercise also beatsteroid on function, quality of life and pain frequency at 8 weeks. At 52 weeks it still led on global improvement, with no difference in pain intensity, and both active groups remained ahead of wait and see.

That is the strongest evidence for anything in this condition, and it is not an injection. A patient who has not done a structured load management and strengthening programme has not yet had first-line treatment, and any injection, steroid or PRP, should be offered after it or alongside it rather than instead of it. Where PRP has a defensible place is the patient who has done the programme properly, has had a steroid injection that faded, has a confirmed tendinopathy without a full tear, and wants to try one more thing before a surgical opinion.

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A load management checklist you can start today

These are the principles the LEAP education programme was built on. They cost nothing and they are the first treatment, whichever clinic you see.

• Stop sitting with the legs crossed, and avoid sitting in low chairs with the knees higher than the hips. Both compress the tendon against the bone.

• Sleep on the other side with a pillow between the knees, or on your back. Lying on the painful side compresses the tendon for hours.

• Do not hang on one hip when standing. Keep weight even through both feet.

• Stop stretching the outside of the hip. The iliotibial band and gluteal stretches that feel productive compress the tendon further.

• Reduce hills, stairs and long walks temporarily rather than pushing through, then build back gradually.

• Start isometric holds for the hip abductors, lying on the good side with the top leg held slightly lifted, and progress to standing strengthening over 8 to 12 weeks, ideally with a physiotherapist.

• Give it 8 weeks. That is the point at which the LEAP trial measured its clearest result.

Our doctors put it this way. For outer hip pain, the tendon needs unloading and strengthening before it needs a needle. PRP is a reasonable third step, and anyone offering it as the first has not read the trials.

Message us on WhatsApp with how long the hip has hurt, what you have already tried, and any imaging, and a doctor will give you a straight answer.

What PRP does not do for the hip

PRP does not repair a full-thickness gluteal tendon tear, which is a surgical problem. It does not treat hip osteoarthritis coming from the joint itself, which is a different diagnosis with different evidence. In the one placebo-controlled trial it did no better than saline at 6 months, and its advantage over steroid appears only after the steroid has faded. PRP is not routinely commissioned by the NHS for this condition and private medical insurance rarely covers it. Because the gluteal tendons sit deep under muscle and close to the sciatic nerve, an unguided injection here is both less accurate and less safe, and should be declined whatever it costs.

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What hip PRP costs in London

Specialist central London clinics commonly charge from around £780 to £900 or more per image guided tendon or joint PRP injection including assessment, with a course of 2 to 3 taking a plan past £2,000, though both hip trials used a single injection. Image guided steroid injections in central London are commonly quoted between £250 and £475. Outside central London PRP is advertised from around £250 to £500, often without ultrasound guidance, which for a tendon this deep is the difference between treating it and missing it.

The reframing that matters is that the best-evidenced treatment for this condition is a physiotherapy programme, and a clinic that sells an £800 injection before it has asked whether you have done one is selling the wrong product first.

Care at The London PRP Clinic by The Wellness is doctor-led and priced below flagship central London rates, with your exact figure confirmed at the free suitability review once a doctor knows whether a single guided injection is the right next step for your tendon.

Ask about the cost for your hip on WhatsApp and we will explain what the review covers.

The free suitability review

Every enquiry here starts with a free, doctor-led suitability review rather than a booking. A GMC-registered doctor assesses you and gives one of two answers. Either you are approved for treatment, with a clear plan and realistic expectations that reflect both trials above, or you are not approved, with an honest explanation of what would serve you better, whether that is a load management programme, a steroid injection, imaging to exclude a tear, or a surgical opinion.

We decline a meaningful share of the people who enquire. For this condition, that share is higher than most, because the first-line treatment is not something we inject.

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Why people choose The London PRP Clinic by The Wellness

• An 87 percent patient success rate across treatments.

• More than 187 five star reviews.

• Every treatment performed by a GMC-registered doctor.

• 100 supervised treatments completed by every clinician before they treat a patient here unsupervised.

• A 32 percent average density increase reported in our hair restoration programme.
  
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Frequently asked questions

Does PRP work for hip bursitis

The two best trials disagree. An 80-patient trial found a single ultrasound-guided PRP injection beat steroid, sustained at 2 years. A 79-patient UK trial in 2025 found PRP no better than saline at 6 months. Most hip bursitis is actually gluteal tendinopathy, and education plus exercise has the strongest evidence of all.

Is PRP better than a steroid injection for greater trochanteric pain

At 2 years, yes, in the one trial that compared them, because the steroid effect peaked at 6 weeks and was gone by 24 weeks while PRP held. Whether PRP beats doing nothing is less clear, since a 2025 placebo-controlled trial found no difference from saline.

What is the best treatment for gluteal tendinopathy

Education on load management plus a progressive strengthening programme. In the 204-patient LEAP trial, 77percent were at least moderately better at 8 weeks, against 58 percent with a steroid injection and 29 percent with wait and see, and the advantage in global improvement persisted at 1 year.

How many PRP injections do you need for hip tendinopathy

Both major trials used a single ultrasound-guided injection into the tendon. There is no evidence that a course of 2 or 3 does better, and a clinic proposing one for this condition should be asked what supports it.

Why does my hip hurt at night lying on my side

Lying on the painful side compresses the gluteal tendons between the bone and the mattress for hours, which is the position that aggravates gluteal tendinopathy most. Sleeping on the other side with a pillow between the knees is one of the first changes the LEAP programme recommends.

Is hip PRP available on the NHS

PRP is not routinely commissioned by the NHS for greater trochanteric pain or other tendon conditions, and the 2025 NHS trial concluded against routine use. Steroid injections and physiotherapy are available on the NHS. Almost all PRP is self-pay.

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References

• BMJ, 2018. Mellor et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy, the LEAP trial.https://pubmed.ncbi.nlm.nih.gov/30385462/

• American Journal of Sports Medicine, 2018. Fitzpatrick et al. The effectiveness of platelet-rich plasma injections in gluteal tendinopathy, a randomised double-blind controlled trial comparing a single PRP injection with a single corticosteroid injection. https://pubmed.ncbi.nlm.nih.gov/29293361/

• American Journal of Sports Medicine, 2019. Fitzpatrick et al. Leucocyte-rich platelet-rich plasma treatment of gluteus medius and minimus tendinopathy, a double-blind randomised controlled trial with 2-year follow-up. https://pubmed.ncbi.nlm.nih.gov/30840831/

• Journal of Bone and Joint Surgery, 2025. Atchia et al. Efficacy of platelet-rich plasma versus placebo for the treatment of greater trochanteric pain syndrome, a double-blinded randomised controlled trial, the HIPPO trial. https://pubmed.ncbi.nlm.nih.gov/39804899/

• British Medical Bulletin, 2021. Platelet-rich plasma versus steroids injections for greater trochanter painsyndrome, a systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/34405857/

• Central London clinic price lists for image guided PRP and steroid injections, accessed September 2026.

This article is for general information and does not replace a medical assessment. Speak to one of our doctors before deciding whether PRP is right for your hip.