Gluteal tendinopathy (hip bursitis)
Why does the outside of my hip hurt when I lie on it?
Pain on the outside of the hip, often called hip bursitis. Education and exercise outperform a wait-and-see approach in trials.
What it feels like
Pain over the bony point on the outside of the hip, worse lying on that side at night, climbing stairs, standing on one leg, walking uphill, or sitting with the legs crossed.
What is actually happening
What is often called hip bursitis is usually gluteal tendinopathy: the tendons of the gluteal muscles that attach to the outside of the hip become less tolerant of load, particularly compression from positions that press the tendon against the bone. The nearby bursa can also be irritated.
How it is assessed
Assessment includes tenderness over the outside of the hip, tests that load and compress the gluteal tendons, hip strength and single-leg control, and screening of the low back and hip joint, which can cause similar pain.
How it is treated
In a randomised trial published in the BMJ, education plus a progressive exercise programme produced better results than a corticosteroid injection or a wait-and-see approach at eight weeks, and better results than wait-and-see at one year. Treatment combines education on reducing tendon compression (such as avoiding crossing the legs and hanging on one hip when standing), and progressive strengthening of the hip muscles.
What to do first
Avoid lying on the painful side or put a pillow between your knees when lying on the other side, avoid crossing your legs, stand with your weight even on both feet, and have it assessed if it persists.
Where this is assessed
- Athlete's Care Sports Medicine Centres Yonge & Eglinton · Mon/Wed/Fri · 8:00 AM – 2:00 PM Book at Athlete's Care
- Push Pounds Sports Medicine Downtown Toronto · Tue/Thu · 8:30 AM – 6:30 PM Call Push Pounds to book
- The Runner's Academy St. Clair West · Mon/Wed/Fri · 3:00 PM – 6:30 PM Book at Runner's Academy
References
This page is based on the following clinical practice guidelines and research.