Pain on the outside of your hip that hurts when you lie on that side, climb stairs or stand on one leg is most often gluteal tendinopathy, sometimes called hip bursitis. It is very common, especially in runners and in women over 40, and it usually responds well to the right exercise and a few simple changes.
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| What it is | Irritation of the gluteal tendons where they attach to the bony point on the side of the hip |
|---|---|
| Who gets it | Runners, walkers, and women around menopause most often |
| Key symptoms | Pain lying on the side, on stairs, standing on one leg, or crossing your legs |
| Main treatment | Education, avoiding compressive positions, progressive glute strengthening |
| Typical improvement | 8 to 12 weeks of consistent exercise; longer-standing cases can take longer |
What causes it?
The gluteus medius and minimus tendons wrap over the bony point on the side of the hip. They do not like being squashed against the bone. Problems tend to start when compression (crossing your legs, hanging on one hip, lying on your side, ITB stretches) combines with a sudden change in load, such as more running, hill walking or a new class.
- A jump in walking, running or hill work
- Standing with your weight shifted onto one hip
- Sitting with legs crossed or in low seats
- Weakness of the hip muscles
- Hormonal changes around menopause, which affect tendon health
Symptoms
- Pain on the outside of the hip, sometimes spreading down the outer thigh
- Pain lying on the sore side, and often on the other side too
- Pain climbing stairs, getting out of the car, or standing on one leg
- Stiffness and pain when you first stand up after sitting
See a doctor promptly if: you have hip or groin pain after a fall, cannot put weight on the leg, have a fever or feel unwell, or have pain that is constant and worse at night.
How is it diagnosed?
Your physiotherapist will usually confirm it from your history and a few simple tests, such as standing on one leg for 30 seconds and pressing on the side of the hip. Scans are not normally needed. We also check your lower back and the hip joint itself, as both can cause pain in a similar area.
Treatment
- Load advice: reducing compressive positions and spikes in activity while keeping you moving
- Isometric exercises to calm pain early on
- Progressive glute strengthening, building to standing and single-leg exercises
- Gradual return to running, walking and stairs
- Shockwave therapy for long-standing cases that are slow to respond
What you can do at home
- Stand with your weight even on both feet, not hanging on one hip
- Avoid crossing your legs and very low chairs
- Sleep with a pillow between your knees
- Stop stretching the outside of the hip
- Break up long walks or runs into shorter ones for a few weeks
Outlook
Most people improve well within 2 to 3 months with education and progressive exercise. Pain can come and go along the way, so steady, consistent progress matters more than doing a lot at once. If you also have back pain, read our guide to sacroiliac joint pain.
Frequently asked questions
Is outer hip pain the same as hip bursitis?
Often, yes. What used to be called trochanteric bursitis is now known to come mainly from the gluteal tendons, so the name gluteal tendinopathy or greater trochanteric pain syndrome is used.
Should I stretch my outer hip?
Avoid strong stretches that pull the leg across the body, such as the classic ITB or glute stretch. They compress the sore tendons and often make pain worse.
Is a steroid injection a good idea?
An injection can ease pain in the short term, but education plus a progressive exercise programme gives better results at one year.
How should I sleep with outer hip pain?
Avoid lying on the sore side. If you sleep on the other side, put a pillow between your knees so the top leg does not drop across.
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References
- Mellor R, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. 2018;361:k1662.
- Grimaldi A, Fearon A. Gluteal tendinopathy: integrating pathomechanics and clinical features in its management. J Orthop Sports Phys Ther. 2015;45(11):910-922.
- Speers CJB, Bhogal GS. Greater trochanteric pain syndrome: a review of diagnosis and management in general practice. Br J Gen Pract. 2017;67(663):479-480.