Pain on the outside of the hip that flares when you lie on that side, climb stairs or stand up after sitting is common, and it is often misunderstood. It is frequently gluteal tendinopathy, sometimes called greater trochanteric pain syndrome.
It is often labelled loosely as "bursitis", but the way it is best managed has become clearer. Here is what gluteal tendinopathy is, who tends to get it, what the evidence says helps, and when to see a physio.
- What is gluteal tendinopathy?
- Who tends to get it?
- Why does it hurt to lie on that side?
- What actually helps gluteal tendinopathy?
- What about a cortisone injection?
- When should you see a physio?
- Helping You Perform at Your Best
What is gluteal tendinopathy?
Gluteal tendinopathy is an overload problem of the gluteal tendons where they attach to the bony point on the outside of the hip. It causes pain and tenderness over that area, which can spread down the outside of the thigh, and it often makes lying on that side and weight-bearing tasks sore.
Who tends to get it?
It is common in people around their 40s to 60s, and particularly in women. It can develop with changes in activity or load, and it is one of the more common causes of persistent outside-hip pain.
Why does it hurt to lie on that side?
The gluteal tendons do not like being compressed. Positions that squash them against the bone, such as lying on that side, sitting with crossed legs, or standing with the hip dropped to one side, can aggravate the pain. Understanding this is a big part of settling symptoms.
What actually helps gluteal tendinopathy?
The standout evidence here is the LEAP trial, published in the BMJ in 2018, which included 204 people with gluteal tendinopathy (average age 55). It found that education about load management plus exercise led to greater improvement at both 8 weeks and 52 weeks than a corticosteroid injection or a wait-and-see approach. A typical plan includes:
- Education on which positions and movements compress and aggravate the tendon
- Progressive strengthening for the gluteal muscles and tendons
- Practical changes to sitting, standing and sleeping positions
- A gradual return to the activities you value
Many people improve well with this combination over time.
What about a cortisone injection?
A corticosteroid injection is sometimes used, but in the LEAP trial education plus exercise gave better results than injection at both 8 and 52 weeks. An injection may have a role in some situations, and it is worth discussing the trade-offs with your health professional rather than assuming it is the first or only option.
When should you see a physio?
See a physio if outside-hip pain is disturbing your sleep, limiting walking or stairs, or not settling. It is also worth getting assessed if the pain followed a fall or injury, there is significant weakness, or you are unsure what is causing it, so other causes can be considered.
Helping You Perform at Your Best
Outside-hip pain can be wearing, especially when it disturbs your sleep and limits everyday movement.
At Ace Sports Medicine in Upper Mount Gravatt, our physiotherapists provide personalised care for gluteal tendinopathy and hip pain across Brisbane's southside, with education and a staged exercise plan. Your first appointment includes an assessment and a starter plan.
Need support for outside-hip pain? Book an appointment with the Ace Sports Medicine team today.
