Pain on the outside of the hip
Hip Bursitis and Outer Hip Pain
Does the side of your hip hurt when you lie on it or climb stairs? Here's what is often behind it, and what the research says about easing it.
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What People Call Hip Bursitis
A bursa is a small cushion filled with fluid. One sits over the bony point on the outside of your hip. For years, pain in this spot was called hip bursitis.
Research now points more often to the tendons. In an ultrasound study of 877 people with this pain, about 1 in 5 had a swollen bursa. About half had changes in the gluteal tendons. These are strong cords that join your buttock muscles to that bony point.
Doctors often call this problem greater trochanteric pain syndrome. When a tendon is the main cause, it's called gluteal tendinopathy, which means a sore gluteal tendon. For other kinds of hip pain, see our hip physiotherapy page.
Common Signs
People with this problem often notice pain:
- On the outside of the hip, sometimes spreading down the side of the thigh
- When lying on that side at night
- When climbing stairs or walking
- When standing on one leg
- When sitting with your legs crossed
- After sitting for a long time
It's most common in women aged 40 to 60. In a study of about 3,000 adults aged 50 to 79, about 1 in 4 women had this pain. About 1 in 12 men did.
What the LEAP Trial Found
The LEAP trial was published in the BMJ in 2018. It included 204 people aged 35 to 70. All had pain on the outside of the hip for over 3 months. Each person got one of 3 plans.
| Plan | Felt better at 8 weeks | Felt better at 52 weeks |
|---|---|---|
| Education plus exercise, with 14 physio visits over 8 weeks | 51 of 66 people (77%) | 51 of 65 people (78%) |
| One steroid injection (a cortisone shot) | 38 of 65 people (58%) | 36 of 63 people (57%) |
| Wait and see | 20 of 68 people (29%) | 31 of 60 people (52%) |
Felt better means people rated their hip at least moderately better. The education part taught people how to ease the load on the tendon in daily life. Cortisone is a medicine that calms swelling. At 52 weeks, average pain was about the same in the exercise and injection groups. The authors concluded that the results support education plus exercise for this problem.
Shockwave Therapy: What the Research Says
Shockwave therapy sends quick pulses of pressure through the skin into a sore tendon. A 2024 review pooled 8 trials with 754 people who had this kind of hip pain. The authors found that shockwave gave short-term pain relief.
The same review found that 7 of the 8 trials had a high risk of bias. That means their results may not be accurate. So the research is still weak, and better trials are needed.
At our clinic, shockwave therapy is a $15 add-on within a $95 visit. We use it along with exercise, when it fits your plan.
Easing the Load Day to Day
Some positions press on the sore tendon. Advice from NHS hospitals in the UK suggests these changes.
Sleeping
Try lying on your back with a pillow under your knees. Or lie on your good side with a pillow between your legs.
Sitting
Keep your legs uncrossed, with your knees in line with your hips or a little wider. Choose a higher chair when you can.
Standing
Spread your weight evenly over both feet. Keep your hips level.
Stairs
Use the handrail when you go up or down stairs.
The same advice says to stay active. A strength program that builds slowly can help the tendon handle more load over time.
How We Help
Our clinic is on the ground floor at 1280 Mohawk Rd in Ancaster. There are no stairs at the entrance, and there's free parking by the door. Older adults can read about our physio for seniors.
Free first visitFree
Your first visit is free for new patients: a full assessment and your first treatment. It's never billed to your insurer, and there's no obligation to continue.
Find the source
We check your hip and your lower back, and we watch how you stand and walk. We also look for signs that need a doctor.
Education plus exercise
We show you how to ease the load on the tendon day to day. Then we build a hip strength plan that starts easy and grows over time.
Shockwave, if it fits
Some people add shockwave therapy. It's a $15 add-on within a $95 visit. Follow-up visits are 30 minutes, one on one with a registered physiotherapist.
When to See a Doctor First
Some hip pain needs a doctor's check before physio. Pain deep in the groin often comes from the hip joint itself. Hip osteoarthritis is a common cause, and exercise is a core part of its care. Get a same-day check if you have a fever or a hot, swollen hip.
Call 911 or go to the ER now
- Severe hip pain after a fall or injury
- You can't walk or put weight on your leg
- Tingling or loss of feeling in your hip or leg after an injury
See a doctor first
- Hip pain after a fall, if you're an older adult
- Hip pain with a fever, or you feel unwell and shivery
- A hip that is swollen and feels hot
- Deep, strong pain at night that doesn't ease when you change position
- New hip pain with weight loss you can't explain, or if you've had cancer
- Groin pain with a limp
- Severe hip pain that started suddenly, without a fall
Physio is a good place to start
- Pain on the outside of the hip that built up over weeks or months
- Pain lying on that side or climbing stairs
- Pain that changes with how you sit or lie
- Questions about exercise, injections or shockwave
No referral needed in Ontario. If you need a doctor, we'll tell you at your first visit.
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What Patients Say About Our Clinic
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Wonderful experience, … I will come back! Also clinic is clean, fresh & appointments are timely.
I would highly recommend Interlink for physiotherapy sessions. Dhiman is very knowledgeable and patient, taking the time to fully understand what your issues are and making sure he gets a full picture before beginning treatment. He includes you in setting goals and expectations. His treatments are varied and he explains why we would do each exercise. Furthermore, he would provide exercises or stretches to complete at home. Always felt at ease and comfortable to ask any questions or further clarification on anything discussed. …
The space is very clean and the equipment kept in great shape.
All staff are very welcoming and friendly making for a great atmosphere for recovery.
Very thorough assessment. I am very pleased with the attention to details and help recieved from this clinic.
Very clean, welcoming environment.
Friendly and helpful staff.
Would definitely recommend to anyone.
Hip Bursitis FAQs
Is hip bursitis the same as gluteal tendinopathy?
They're often lumped together. In one ultrasound study of people with outer hip pain, about half had gluteal tendon changes. About 1 in 5 had bursitis. Both are in the same spot, so they can feel alike.
How long does outer hip pain last?
It varies. In the LEAP trial, about half of the people in the wait and see group felt better at 52 weeks. In the education plus exercise group, 78% did.
Should I get a cortisone shot?
That's a choice to make with your doctor. In the LEAP trial, more people felt better at 8 weeks after a shot than with wait and see. At 8 and 52 weeks, more people felt better after education plus exercise than after a shot.
How should I sleep with outer hip pain?
Lying on the sore side often hurts. Try lying on your back with a pillow under your knees, or on your good side with a pillow between your legs.
Should I stretch the side of my hip?
NHS hospital advice for this problem says repeated stretching can irritate the tendon. Your physiotherapist can show you which exercises to use.
Does shockwave therapy help hip bursitis?
Some trials found it eased pain in the short term. Most of those trials had a high risk of bias, so the evidence is weak. At our clinic, it's a $15 add-on within a $95 visit.
Do I need a referral to see a physiotherapist?
No. In Ontario you can book with a physiotherapist directly. Some insurance plans want a doctor's note before they pay, so check your plan.
Does OHIP cover physio for hip pain at your clinic?
No. We're a private clinic and don't bill OHIP. If your extended health plan covers physio, we can bill most insurers directly. Your first visit is free for new patients.
Get Your Hip Checked in Ancaster
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The Research on This Page
- Long SS, et al. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis. American Journal of Roentgenology, 2013. Link
- Segal NA, et al. Greater trochanteric pain syndrome: epidemiology and associated factors. Archives of Physical Medicine and Rehabilitation, 2007. Link
- Chamberlain R. Hip pain in adults: evaluation and differential diagnosis. American Family Physician, 2021. Link
- Mellor R, 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. Link
- Rhim HC, et al. Extracorporeal shockwave therapy for greater trochanteric pain syndrome: a systematic review with meta-analysis of randomized clinical trials. JBJS Reviews, 2024. Link
- The Royal Orthopaedic Hospital NHS Foundation Trust. Gluteal tendinopathy. Patient information. Link
- South Tees Hospitals NHS Foundation Trust. Gluteal tendinopathy (GTPS). Patient information. Link
- NHS. Hip pain. NHS website (UK National Health Service), reviewed 2025. Link
- NHS Nottingham and Nottinghamshire Integrated Care Board. MSK services pathway: hip pathology. 2019. Link
This page gives general information. Your physiotherapist or doctor can tell you what fits your situation.
Reviewed by Dhiman Patel, MScPT, registered with the College of Physiotherapists of Ontario. Last reviewed 23 September 2026.