Hip & Thigh

What It Is

Line drawing of the outside of the hip and thigh, showing the glutes and tensor fasciae latae at the hip running into the long band of the IT band down the outer thigh towards the knee. — The glute tendons and the IT band both cross the bony point of the outer hip, which is where this pain usually sits.

Greater trochanteric bursitis, more commonly known as "trochanteric bursitis", is inflammation of a small fluid-filled sac (a bursa) that covers the bony point on the outside of your hip (AAOS, n.d.). Physiotherapists and doctors now often use the name greater trochanteric pain syndrome (GTPS) for this kind of pain on the outside of the hip, because the pain can come from the bursa and/or from the tendons of the buttock (gluteal) muscles that attach to the same bony point (Royal Berkshire NHS Foundation Trust, 2024). Irritation of these tendons is called gluteal tendinopathy, and it is an important cause of this type of hip pain (Mellor et al., 2018).

Bursae are small, jelly-like sacs that contain a small amount of fluid. They are found throughout the body, including around the shoulder, elbow, hip, knee and heel. They act as cushions between bones and the overlying soft tissues, helping to reduce friction as the joints move (AAOS, n.d.).

The bony part on the outside of the hip is known as the greater trochanter. It is an attachment point for muscles that move the hip joint. A bursa lies over the trochanter, and it can become irritated, resulting in what is known as bursitis (AAOS, n.d.).

Trochanteric bursitis can sometimes be difficult to diagnose, and your physiotherapist or doctor will need to rule out the lower back and the hip joint itself as the source of the pain (Royal Berkshire NHS Foundation Trust, 2024). I check your lower back and hip joint as part of my assessment too, and refer you on if I think the pain is coming from somewhere else. Things linked with developing it include (AAOS, n.d.):

Repetitive stress (overuse), such as running, stair climbing, cycling or standing for long periods
An injury to the point of the hip, such as a fall or bump, or lying on one side for a long time
Back problems, such as scoliosis or arthritis in the lower back, that affect the way you walk
A tight iliotibial band (IT band)
One leg being significantly shorter than the other, which affects the way you walk
Rheumatoid arthritis, previous hip surgery, or bone spurs or calcium deposits in the tendons

It is more common in women and in middle-aged or older people (AAOS, n.d.), and gluteal tendinopathy is most common in women over 50 (Mellor et al., 2018).

Patients tend to report pain when lying on the affected side, especially in bed. The pain is felt at the point of the hip and usually spreads down the outside of the thigh (AAOS, n.d.; Royal Berkshire NHS Foundation Trust, 2024). It is often worse at night, when getting up from a chair after sitting for a while, and with long walks, stair climbing or squatting (AAOS, n.d.). Crossing your legs can also make it worse (Royal Berkshire NHS Foundation Trust, 2024).

Trochanteric Bursitis Anatomy

Bursitis is often responsible for pain on the side of the hip, which can make it difficult to lie on that side. The bursa has the job of protecting the other tissues from compression and friction. Too much stress, such as a direct blow, can cause the bursa to become inflamed. The bursa sits between the bony greater trochanter and the soft tissues that pass over it, including the iliotibial band, and a tight IT band can put pressure on the bursa (AAOS, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Greater Trochanteric Bursitis

In most cases this condition does not need surgery and responds well to non-surgical treatment (Royal Berkshire NHS Foundation Trust, 2024). Targeted exercises to strengthen the muscles that support the hip, together with advice on which positions and activities to change, are the main treatment (Royal Berkshire NHS Foundation Trust, 2024), and in a large trial in people with gluteal tendinopathy, education plus exercise worked better than a steroid injection or a "wait and see" approach (Mellor et al., 2018). I can build a tailored exercise programme with you and support it with hands-on work. See the My Approach tab for how I work.

1. Modify Your Activities

Avoid the activities that make your symptoms worse (AAOS, n.d.), but don’t keep the hip completely still: keep mobile and break up long periods of sitting and standing (Royal Berkshire NHS Foundation Trust, 2024). Some positions squeeze the painful tendons and bursa against the bone and are best avoided (Royal Berkshire NHS Foundation Trust, 2024):

Sitting with your legs crossed: try sitting with your legs side by side instead.
Lying on the painful side: try lying on your back or front, or on the other side with pillows between your knees so that the top hip and knee are level.
"Hip hanging" (standing with your weight swayed onto one hip): try standing with your weight evenly on both feet.

2. Ice

Ice or heat can help ease pain (AAOS, n.d.). I use warm or cool applications in the clinic. If you use ice at home, always wrap it in a tea towel so that you do not risk an ice burn.

3. Pain Relief

The American Academy of Orthopaedic Surgeons (AAOS, n.d.) says that nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, may relieve pain and control inflammation, and that they should be used cautiously and for limited periods. (This medicine information comes from the American Academy of Orthopaedic Surgeons (OrthoInfo), not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Corticosteroid injection: a steroid injection into the bursa that may help relieve pain, sometimes so that you can carry on with your exercises (AAOS, n.d.; Royal Berkshire NHS Foundation Trust, 2024). The relief may only be temporary, repeated injections over a long time may damage the surrounding tissues (AAOS, n.d.), and in the trial above education plus exercise gave better results than an injection (Mellor et al., 2018).
Surgery: an operation to remove the bursa, which is rarely needed and only considered if other treatments have not worked (AAOS, n.d.).

How I can help (see the My Approach tab)

A tailored hip-strengthening programme
Advice on positions and activities that take pressure off the hip
Hands-on work for the low back, buttock and thigh

Tips

Avoid activities that place undue stress on your hips (AAOS, n.d.).
Avoid sleeping on the side that hurts, if possible. If you lie on the other side, put pillows between your knees (Royal Berkshire NHS Foundation Trust, 2024).
Avoid over-hard mattresses, or look for a soft mattress topper that may offer some give and reduce pressure on the hip.
Avoid sitting with your legs crossed (Royal Berkshire NHS Foundation Trust, 2024).
If you are overweight, losing weight can help to take the pressure off the hips and may improve pain and function (AAOS, n.d.; Royal Berkshire NHS Foundation Trust, 2024).
If one leg is shorter than the other, a properly fitting shoe insert may help (AAOS, n.d.). I can help you work out whether one would help and how to get it, and point you to a chiropodist or podiatrist if you need a custom orthotic.
Maintain the strength and flexibility of your hip muscles (AAOS, n.d.).
If you are a sportsperson, especially a runner or cyclist, make sure you use proper technique and a good bike set-up. Ask a coach for advice.
Take care with running, climbing stairs, standing for long periods and cycling (AAOS, n.d.).
Be patient: this condition takes time to settle, and keeping up with your exercises is important (Royal Berkshire NHS Foundation Trust, 2024).

Treatment

My Approach

Pain on the outside of the hip usually comes from the buttock tendons where they attach to the bony point of the hip, often with the bursa there irritated too. These tendons don't like being squashed, so my aim is to take the pressure off first, then build strength so your hip copes with walking, stairs and your usual activities.

I start by assessing how your lower back and hip move, your hip strength, and how you stand and walk, since pain here can also come from the back or the hip joint. Work on the buttock and hip is only when it's clinically relevant, with your informed consent and a signed consent form.

Taking the Pressure Off

Changing the positions that squeeze the tendons, such as crossed legs, hanging on one hip or lying on the sore side
No pressing into the sore spot: I work the low back, buttock and thigh around it, easing trigger points that refer into the hip, with gentle joint mobilisation
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Gentle, pain-free holds, such as pressing your legs out against a belt without moving

Building Strength

Myofascial work and frictions for tight tissue around the area
Bridges, mini-squats, side-stepping and step-ups, keeping the knee from collapsing inward, then gym-based strength work when you're ready
Retraining the deeper buttock muscles so the muscle at the front and outside of the hip stops doing too much
No stretches that pull the leg across your body, because they squeeze the tendons against the bone

Exercise shouldn't cause pain over the hip: if it does, we reduce the range, speed or effort. Shorter, softer strides when walking help too. If I suspect an infection in the bursa, or it isn't improving, I'll send you to your family doctor or nurse practitioner to discuss other options.

What to Expect

Typical Course

Typical course: Most people come in once or twice a week at first, then weekly, then less often as they manage more on their own, with a reassessment at about 4 to 6 weeks. This condition takes time to settle: expect steady improvement over about 6 to 12 weeks of consistent exercise, and longer if the pain has been there a long time.

What I Focus On

Offloading Compression

Gentle Isometrics

Progressive Glute Strength

Posture & Gait

Soft-Tissue Release

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Hip bursitis. OrthoInfo. Available at: https://www.orthoinfo.org/en/diseases--conditions/hip-bursitis/ (Accessed: 7 October 2026).
Mellor, R., Bennell, K., Grimaldi, A. et al. (2018) '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, 361, k1662. doi: 10.1136/bmj.k1662
Royal Berkshire NHS Foundation Trust (2024) Greater trochanteric pain syndrome (GTPS). Available at: https://www.royalberkshire.nhs.uk/media/g5mfdnrr/greater-trochanteric-pain-syndrome_nov24.pdf (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooGreater Trochanteric Bursitis

What It Is

Trochanteric Bursitis Anatomy

Self-Care & Treatment

How to Treat Greater Trochanteric Bursitis

1. Modify Your Activities

2. Ice

3. Pain Relief

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Taking the Pressure Off

Building Strength

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooGreater Trochanteric Bursitis

What It Is

Trochanteric Bursitis Anatomy

Self-Care & Treatment

How to Treat Greater Trochanteric Bursitis

1. Modify Your Activities

2. Ice

3. Pain Relief

Treatments you may want to discuss with your family doctor or nurse practitioner

Tips

My Approach

Taking the Pressure Off

Building Strength

Typical Course

References

Related Conditions

Iliotibial Band Friction Syndrome

Hip Osteoarthritis

Piriformis Syndrome

Hyperlordosis

Gluteus Medius Tendinopathy

Book a session