Hip Bursitis

Trochanteric bursitis is the traditional name for pain over the bony prominence on the outer hip, where a bursa cushions the gluteal tendons as they wrap the greater trochanter. Modern imaging has refined the story: in many patients the deeper problem is gluteal tendinopathy - irritated hip-stabilizing tendons - with the bursa inflamed as a bystander. The distinction matters because tendons respond to graded loading, not just rest.

The pattern is distinctive: pain lying on the affected side at night, pain on stairs and single-leg tasks, and tenderness you can point to with one finger on the outer hip bone. It is most common in women in mid-life, and everyday compression positions feed it - sitting with legs crossed, standing with the hip slung sideways, sleeping without a pillow between the knees.

Importantly, this is not hip-joint arthritis: joint disease hurts in the groin, stiffens rotation, and behaves differently on examination - which is why the first job is deciding which hip problem you have.

• Pain on the outer hip (lateral hip pain) that may radiate down the thigh
• Tenderness when pressing on the affected area
• Pain that worsens with activities like walking, climbing stairs, or lying on the affected side
• Swelling or warmth over the bursa
• Stiffness in the hip, especially in the morning
• Pain that may be sharp initially but becomes a dull ache
• Difficulty sleeping on the affected side

Several factors increase the risk of developing hip bursitis:

• Repetitive activities that stress the hip, such as running, cycling, or climbing stairs
• Direct trauma or injury to the hip
• Muscle imbalances or weakness in the hip stabilizers
• Leg length discrepancies that alter hip biomechanics
• Underlying conditions like hip arthritis or hip impingement
• Previous hip surgery or injury
• Certain occupations or activities that involve repetitive hip motion
• Age-related changes in muscle strength and flexibility

Diagnosis is anatomical: tenderness directly over the greater trochanter, pain reproduced by resisted hip abduction or 30 seconds of single-leg standing, and a story of night pain on that side. The examination deliberately checks the neighbors too - the groin and rotation for the joint itself, the lumbar spine and buttock for referred pain - because outer-hip pain has several imposters.

X-rays screen the joint; ultrasound is the most useful test here, showing the gluteal tendons and bursa directly and guiding any injection. We offer a complimentary MRI review when imaging already exists or tendon tears are suspected.

Non-Surgical Treatment Options

The core of treatment is load management with decompression: avoid crossing the legs, stop hanging on one hip when standing, sleep with a pillow between the knees, and pause direct-pressure aggravators while progressively strengthening the gluteal muscles - graded loading is what tendons respond to. Anti-inflammatories help flares.

Injection or Interventional Care

An ultrasound-guided corticosteroid injection can settle a stubborn flare and confirm the diagnosis, used selectively - repeated steroid around already-irritated tendons is used with care, which is exactly why guidance and dosing judgment matter here.

Surgical Treatment Options

Surgery is uncommon and reserved for persistent cases with a structural driver - a significant gluteal tendon tear needing repair, or thickened tissue requiring release - after a genuine trial of loading-based care.

Hip bursitis pain is typically localized to the outer hip and is often described as a sharp, burning pain that worsens with pressure or specific movements. The pain may be constant or intermittent, depending on activity level.

Lying on the affected side often exacerbates the pain, making sleep difficult. The pain typically improves with rest and worsens with activities that stress the hip, such as walking, running, or climbing stairs. Our comprehensive treatment approach addresses both the inflammation and any underlying causes, providing lasting relief.

Several strategies can help prevent hip bursitis from developing or recurring:

• Avoiding repetitive activities that stress the hip without proper conditioning
• Maintaining strong hip stabilizers through regular exercise
• Using proper technique and equipment during physical activities
• Addressing muscle imbalances through targeted exercise
• Gradual progression in activity intensity to avoid overuse
• Proper warm-up and stretching before activities
• Addressing underlying conditions like leg length discrepancies or arthritis
• Seeking early treatment if symptoms develop to prevent chronic inflammation

If outer hip pain is affecting your daily activities or sleep, schedule a consultation with Mountain Spine & Orthopedics today. Benefit from expert evaluation and personalized treatment to resolve your hip bursitis. Same-day and next-day appointments are often available.