Hip condition
Trochanteric bursitis — the condition most people simply call hip bursitis — is the pain over the bony point on the outer hip, the one that makes lying on that side at night impossible. The name, though, is largely a historical accident. When these hips are imaged or operated on, the bursa is usually not the main culprit: the gluteal tendons attaching at that point are. That distinction is not academic. It is the difference between resting and injecting a hip that will keep hurting, and loading the tendons properly so the pain actually leaves.
Tap any that apply to you — this is guidance, not a diagnosis, but it tells you how quickly to act.
Those signs point beyond a simple tendon problem. A dropping hip or a weak single-leg stand can mean a torn gluteal tendon; heat and fever need urgent assessment; and pain travelling below the knee often comes from the spine rather than the hip. Each changes both the imaging and the plan.
Good news — that reads like the ordinary version. Pain over the bony point, worse lying on it and worse on stairs, is the classic pattern and it responds well once the compression stops and the right strengthening starts. Worth getting the programme built properly rather than guessing at it.
Hip bursitis is usually a tendon problem wearing a bursa’s name, which is why many specialists now call it gluteal tendinopathy. The gluteal tendons wrap over the bony point of the hip on their way to attaching. Anything that presses them against that bone, repeatedly, irritates them — and the postures that do it are ones most people hold for hours without noticing:
Before any exercise programme, the compression has to come off, and these changes often produce the first real improvement within a fortnight. At night, stop lying on the painful side; if you sleep on the other side, put a firm pillow between the knees so the top leg does not fall across the body, and consider a pillow behind you to prevent rolling. Standing, keep your weight evenly on both feet instead of hanging on one hip — easier said than done in a queue, so make it a habit you check. Sitting, uncross the legs, choose a higher seat where you can, and keep the knees apart rather than together. And stop stretching it — the pull-the-knee-across-the-body stretch, foam rolling directly over the bony point, and deep hip stretches all press the tendons harder into the bone. What replaces them is strength work in comfortable positions, which is where the durable improvement comes from.
The trigger tells us what to change first — tap the one that fits:
Night pain is the classic presentation — and the most fixable. Off that side entirely, a firm pillow between the knees, and something behind you to stop rolling over in your sleep. Sleep usually improves before the daytime pain does, which is a good early sign the diagnosis is right.
That points squarely at the gluteal tendons carrying your body weight. Single-leg loading is exactly what they have lost the capacity for — which makes graded strengthening the treatment, not avoidance. Taking stairs one at a time helps in the meantime, but it is a bridge, not a cure.
Crossed legs compress the tendons for as long as you sit like that. Uncross, raise the seat height where you can, keep the knees apart, and set a reminder if you work at a desk. Postural compression is the most underestimated driver of this condition — and the cheapest to fix.
Hip bursitis treatment climbs a ladder, and the large majority of people never leave its first two rungs:
Tap each card to reveal the truth:
It is pain over the bony point on the outer side of the hip, classically blamed on inflammation of the bursa that sits there. Modern imaging and surgical findings have changed the picture: in the large majority of cases the main problem is the gluteal tendons that attach at that point, which have lost capacity and become painful, with the bursa involved secondarily if at all. Many specialists now use the broader term greater trochanteric pain syndrome.
Yes — they describe the same condition. Hip bursitis is the everyday phrase, trochanteric bursitis names the specific bursa involved, and clinicians increasingly prefer greater trochanteric pain syndrome or gluteal tendinopathy because those reflect what is actually going on. Whichever term you arrived with, the pain sits over the bony point on the outside of the hip and the treatment is the same: unload the tendons, then strengthen them.
A deep ache or sharp pain over the bony prominence on the outer hip, often spreading down the outside of the thigh. The giveaway is what provokes it: lying on that side at night, climbing stairs, standing on one leg to dress, sitting with the legs crossed, and standing for long periods with your weight slumped onto one hip. Pain in the groin instead points toward the joint rather than the tendons.
Load management plus progressive strengthening of the gluteal muscles — this outperforms passive treatments over the medium and long term. The first step is removing compression: no lying on the painful side, no crossing the legs, no standing hip-slumped, and no aggressive stretching across the outer hip. A targeted injection can settle a severe flare and create a window for rehabilitation, but on its own it tends not to last.
Usually not, and this is the most common mistake. Stretches that pull the leg across the body press the tendons harder against the bony point — which is precisely the mechanism causing the pain. People often report feeling better briefly during the stretch and worse over the following days. Strength work through comfortable ranges is what these tendons respond to.
With compression removed and a proper strengthening programme, most people improve substantially over six to twelve weeks, though tendons that have been painful for a long time can take longer. Progress is judged over weeks rather than days. Cases that stall despite genuine rehabilitation deserve imaging, because a tear in the gluteal tendon behaves differently and is treated differently.
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