Hip Bursitis (Greater Trochanteric Pain Syndrome): What's Going On and What Helps
You roll onto your side at night and the outside of your hip lights up. Stairs, getting out of the car, or standing on one leg to put on a shoe bring the same sore spot. Many people hear "hip bursitis" and assume a cushion in the hip is simply inflamed. The picture is more nuanced, and it matters for what helps.
What is greater trochanteric pain syndrome?
Greater trochanteric pain syndrome (GTPS) is a common cause of pain on the outer side of the hip [3]. For many years it was believed to be trochanteric bursitis, and treatment aimed at the bursa. More recently, problems with the gluteal tendons, called gluteal tendinopathy, or small tears in them, have been proposed as a common cause [3]. Tendinopathy of the gluteus medius and gluteus minimus tendons is now recognized as a primary local source of outer hip pain [2].
It mostly shows up in mid-life, in people who exercise and people who do not, and affects women more often than men [2]. Compression of the tendons and the hip drifting inward across the body are thought to be key factors [2]. That is a working theory, not a settled fact.
What does it feel like?
The NHS describes bursitis as pain that may spread to the upper leg and feel worse when moving or lying on your side [5]. Gluteal tendinopathy interferes with sleep when lying on that side, and with weight-bearing tasks [2]. The NHS advises against diagnosing hip pain yourself, because several problems can look alike [5]. Some of those look-alikes start in the low back, so our post on low back pain is a good one to read as well.
Red flags that need urgent care
Outer hip pain is usually not an emergency, but a few signs should not wait. The NHS says to call 911 or go to the emergency room if you have [5]:
Severe hip pain after a fall or injury
Trouble walking or putting weight on the leg
Tingling or loss of feeling in your hip or leg after an injury
Ask for an urgent appointment the same day for severe hip pain that started suddenly without a fall, a swollen and hot hip, skin color change around the hip, or hip pain with a high temperature or feeling unwell [5].
See a doctor if hip pain is stopping normal activities, affecting your sleep, getting worse, or not improved after about 2 weeks of home care [5].
What can you do at home?
Keep moving, but do not overdo it. The NHS suggests avoiding heavy carrying and low chairs, and wearing comfortable shoes with a soft sole [5].
Use an ice pack wrapped in a towel for up to 20 minutes every 2 to 3 hours if it helps [5].
Go easy on compression. Because compression and inward hip position are thought to stress the tendon [2], many people find it helps to avoid crossing their legs, standing with weight dropped onto one hip, and lying on the sore side. A pillow between the knees can help. This is a practical inference, not a proven rule.
How does physical therapy help?
Here is what the research looks like. In an Australian trial, 204 adults aged 35 to 70 with outer hip pain for over 3 months and MRI-confirmed gluteal tendinopathy received an education and exercise program (14 sessions over 8 weeks), a single corticosteroid injection, or a wait-and-see approach [1].
At 8 weeks, about 77% of the education and exercise group reported a successful outcome, compared with about 58% after injection and 29% with wait and see [1]. At 52 weeks, about 78% of the exercise group reported success, compared with about 57% after injection and 52% with wait and see. Pain scores were similar for exercise and injection, and both were lower than with wait and see [1]. The wait-and-see group improved over a year too, so time matters, but fewer people in that group reported success.
A 2025 systematic review was more cautious. It found moderate-strength evidence that exercise and education has a medium effect on pain and function in the short term, with smaller effects later, and said it can be cautiously recommended as the core approach [4]. Reviews also note there is no defined treatment protocol for GTPS [3] and a thin evidence base for any treatment, so the authors favor managing tendon load through exercise and education [2].
In plain terms, we work out what is loading the outer hip too much, then build your capacity back up gradually. Tendons respond slowly, so we plan in weeks, not days.
When should you get seen?
Come in if your hip pain is disturbing your sleep, limiting your walking, or has not improved after about 2 weeks of home care [5]. If it started after a fall, or any warning sign above applies, get urgent care first.
How can Hybrid Physical Therapy help?
We spend the first visit working out what is driving your hip pain, not just where it hurts. You work one-on-one with a Doctor of Physical Therapy every session, and we build the plan around what you want to get back to, whether that is a full night of sleep or a long walk.
This post is general education and does not replace an exam. If the outside of your hip has bothered you for a couple of weeks, come in and let us take a look.
Let Hybrid Physical Therapy be the ones to optimize your performance.
References:
Mellor R, Bennell K, Grimaldi A, 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. doi:10.1136/bmj.k1662. PubMed (PMID 29720374)
Grimaldi A, Mellor R, Hodges P, et al. Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management. Sports Med. 2015;45(8):1107-19. doi:10.1007/s40279-015-0336-5. PubMed (PMID 25969366)
Reid D. The management of greater trochanteric pain syndrome: A systematic literature review. J Orthop. 2016;13(1):15-28. doi:10.1016/j.jor.2015.12.006. PubMed (PMID 26955229)
Bremer T, Nicklen P, Fearon A, et al. The efficacy of gluteal tendinopathy treatments: A systematic review. Clin Rehabil. 2025;39(5):600-617. doi:10.1177/02692155251327298. PubMed (PMID 40223303)
NHS. Hip pain in adults. Page last reviewed 20 November 2025. Source page
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