Short answer: pain on the outside of the hip that is sore to lie on is often called hip bursitis. The bursa and the gluteal tendons beside it are usually both irritated, and the label matters less than what is loading them. What usually helps is working out what aggravates it, adjusting those things, and building the hip’s capacity step by step, not weeks of rest or stretching.
What it is
The bony point on the outside of your hip is the greater trochanter. The tendons of your gluteus medius and minimus muscles attach there, and a small fluid-filled sac, the bursa, sits between the tendons and the bone. Pain over this spot is grouped under the name greater trochanteric pain syndrome. It is most common from your 40s or 50s, and more common in women.
It often looks like this:
- A sore spot on the outside of the hip, sometimes spreading down the outer thigh
- Pain lying on that side at night, sometimes waking you
- Pain on stairs, hills, getting out of a chair or standing on one leg
- Pain after sitting with your legs crossed
Bursitis, tendon pain, or both?
Bursitis means an inflamed bursa. Gluteal tendinopathy means an irritated tendon. On the outside of the hip they sit side by side, and both are commonly involved, which is why the names get used loosely. I don’t try to pick one from the outside, and a scan can’t settle it either. Changes on scans of this area are common in people with no hip pain, so I don’t plan treatment from the picture alone.
What I look for is what the area is being asked to do. Usually it is a mix of two things: a spike in load that the hip hasn’t built up to, such as more walking, running or stairs, and positions that press the tendons against the bone, such as standing with your weight hanging on one hip, or lying on the sore side.
What usually helps
The best evidence is for education plus progressive exercise. In the LEAP trial (BMJ, 2018, 204 people with gluteal tendinopathy), a physio-led program of education and exercise over eight weeks gave better results at eight weeks than a single corticosteroid injection or wait and see. At a year, it was still better than injection for overall improvement, though pain scores were similar between the two.
In practice that means two parts.
Modify what irritates it. I don’t hand out a list of strict no-nos. There is no magic rule about crossing your legs or standing on one leg. It is usually pretty basic: notice what flares it, such as stairs, a long walk, a low couch or a particular sleeping position, and change those for a while. A pillow between the knees at night helps some people.
Build capacity. I lean towards gentle holds (isometric work) to settle it, then build strength through the hips and thighs in steps. As a rough guide, discomfort that hangs around three to four out of ten without escalating is generally acceptable while you do it. If it climbs or is much worse the next day, that is a sign to back off. The right dose depends on you, which is why it is set after an assessment.
Aggressive stretching and digging a foam roller into the sore spot can irritate it further. A day or two of easing off during a flare is reasonable. Weeks of rest tends to leave the area less able to cope.
A corticosteroid injection is best discussed with your doctor, ideally a sports physician or a GP who sees a lot of this. It is not something I provide.
What I do and don’t use
I use hands-on work, mostly massage and joint mobilisation, where it helps, alongside the loading. I don’t use dry needling, ultrasound or shockwave, and I explain why in my dry needling post. Personally, I’m not a fan of shockwave. That is my choice for my practice, not a claim about every clinician.
How long does it take?
Tendons adapt slowly. As a rough guide, I usually see people for at least six visits, and sometimes ten to twelve for longer-standing or more stubborn cases. It depends on how long you’ve had it, how irritable it is and what you need your hip to do, so it can’t be known before an assessment. I plan for a finish line: once it is under control and you know how to manage it, I discharge you rather than book maintenance.
Hip bursitis, or something else?
Pain on the outside of the hip can come from other places:
- The hip joint. Deeper, often in the groin, stiff first thing, hard with socks and shoes. See knee and hip osteoarthritis.
- The lower back. Pain in the buttock or outer hip that may travel down the leg. See sciatica.
- Deep in the buttock. Often blamed on the piriformis. See piriformis syndrome and SI joint pain.
- The front of the hip or inner thigh. See hip flexor pain and groin strain.
- A pinch in the joint with deep squatting or clicking. See labral tears.
The tests are different for each, which is why it is worth getting it sorted instead of stretching for months.
When to get it checked
See a doctor promptly for a hot, red, swollen hip, or hip pain with a fever or feeling unwell. Go to hospital after a fall or knock if you can’t put weight on the leg. Constant pain at night that doesn’t change with position, unexplained weight loss, or a past cancer diagnosis should also be checked by a doctor. Numbness around the groin, leg weakness that is getting worse, or changes to bladder or bowel control need emergency care.
Otherwise, get it assessed if it hasn’t improved after a few weeks, or keeps coming back.
What the first appointment involves
I see people at Shop 8 / 19 Ways Road, Hampstead Gardens. The initial appointment is $150 (45 minutes), HICAPS is on site, and no referral is needed for private appointments. I take a history first: where it hurts, what you do, what changed. Then I test how the hip moves and handles load, including standing on one leg, and check your lower back and pelvis. You leave knowing what I think is going on, what I am not sure of yet, and what the first few weeks look like. You usually don’t need a scan first. If I think you need imaging or a doctor, I’ll say so.
Fees and claiming are on the services and FAQ pages.
Common questions
Is hip bursitis the same as gluteal tendinopathy? No. One is the bursa and the other is the tendon, and they are often irritated together. I don’t try to separate them. What matters is what loads the area and how it copes.
Should I stretch it or use a foam roller? Usually not as the main plan. Both can irritate it. Gentle strengthening that you can build on tends to work better.
Can I keep walking or running? Often yes, at a level that doesn’t leave it worse the next day. Cutting back, not stopping, is usually the first step.
Do I need a scan? Usually not at the start. Changes on scans are common in people with no pain, so I assess how the hip moves and loads.
Where this comes from
- Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy (Mellor et al., BMJ, 2018), the LEAP randomised trial.
I treat hip and groin pain at my clinic in Hampstead Gardens, Adelaide. For the wider picture, see hip and groin physio.