Why Does the Outside of the Hip Hurt?

What causes pain on the outside of the hip?

Pain on the outside of the hip is most often greater trochanteric pain syndrome, an irritation of the gluteus medius and minimus tendons and the bursa over the bony point of the hip. It is common in women over 40 and runners. Other causes include gluteal tendon tears, IT band irritation, pinched nerves in the lower back and meralgia paresthetica.

Pain over the bony point on the side of the hip is one of the most common hip complaints in adults, and it rarely involves the hip joint itself. It usually comes from the tendons that attach there. For years it was simply called bursitis, and many patients were given shot after shot. Current care focuses on calming and strengthening the gluteal tendons, which is why so many patients see lasting results without surgery.

Written and medically reviewed by Dr. Stride, MD, board-certified orthopedic surgeon
Last reviewed October 2026

Runner on a park trail holding the outside of his hip

Where it hurts

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How patients describe it

It hurts to lie on that side at nightThe bony point on the side of the hip is tender to touchClimbing stairs or getting out of a chair sends an ache down the side of the thighStanding on one leg to put on pants hurtsCrossing the legs while sitting makes the outer hip throbThe outer thigh burns or feels numb after standing a long time

The most common causes

Gluteal tendinopathy

Women over 40, especially around menopause, and runners who recently added mileage or hills

The gluteus medius and minimus tendons attach to the greater trochanter, the bony point on the side of the hip. Compression and overload can cause these tendons to thicken and become painful, a condition called gluteal tendinopathy. It is the most common driver of what used to be labeled trochanteric bursitis.

The clue: Pain lying on the sore side, and pain within 30 seconds of standing on that leg alone, are the classic clues.

Trochanteric bursitis

Adults with gluteal tendinopathy, a leg length difference or a recent fall on the side of the hip

A bursa is a small fluid sac that reduces friction between tendon and bone. The trochanteric bursa can become inflamed alongside an irritated tendon or after a direct blow. Bursitis on its own is less common than once thought, and the tendon is usually involved too.

The clue: Tenderness right over the bony point after a fall or a long walk, with swelling seen on ultrasound, suggests bursitis.

Gluteus medius or minimus tear

Adults 50 and older with long-standing outer hip pain, more often women

Over time a worn gluteal tendon can partly or fully pull away from the bone. This weakens the muscles that keep the pelvis level when you walk. Tears are sometimes called a rotator cuff tear of the hip.

The clue: A new limp, or the pelvis dropping on the opposite side when you stand on the painful leg, points to a tear.

IT band irritation and external snapping hip

Runners, cyclists and dancers

The iliotibial band is a thick band of tissue running down the outside of the thigh. It can rub or snap over the greater trochanter, irritating the tendon and bursa underneath. Many people feel a visible snap when they walk or swing the leg.

The clue: A snap you can see or feel on the outside of the hip, with soreness in the same spot, suggests the IT band.

Referred pain from the lower back

Adults with arthritis or disc problems in the lumbar spine

Pinched nerves in the lower back, especially at the L4 and L5 levels, can send pain to the outer hip and down the side of the leg. The hip itself may examine normally. Dr. Stride checks the back at every visit for this reason.

The clue: Outer hip pain that travels below the knee with numbness or tingling usually starts in the spine.

Meralgia paresthetica

People who wear tight belts or work belts, pregnant women, and adults with diabetes or recent weight gain

A sensory nerve called the lateral femoral cutaneous nerve can be squeezed where it passes near the front of the pelvis. It causes burning or numbness over the outer thigh. It does not cause weakness.

The clue: A burning, numb patch on the outer thigh with no tenderness at the bony point of the hip is the giveaway.

Get seen right away if

Sudden inability to walk or lift the leg to the side after a fall or a pop
A red, hot, swollen outer hip with fever
Numbness or weakness spreading down the leg, or new trouble controlling the bladder or bowels
Outer hip pain with unexplained weight loss or a history of cancer

What to expect at your first visit

Dr. Stride starts by watching you walk and stand on each leg for 30 seconds, since outer hip pain that appears during single-leg stance is a strong sign of gluteal tendinopathy. He presses on the greater trochanter and the tendon attachments, checks hip strength side to side, and looks for a Trendelenburg sign, where the pelvis drops when the opposite leg lifts. The FABER and FADER tests help sort out tendon pain from joint pain, and a quick check of the lower back, reflexes and skin sensation screens for a pinched nerve or meralgia paresthetica. X-rays rule out arthritis and calcium deposits. In-office ultrasound shows a thickened tendon, a fluid-filled bursa or a tear, and an MRI is ordered when a significant tear is suspected.

“Bring your outside X-rays and MRI. I’ll go through them with you, but how your hip moves on the exam table tells me just as much as the pictures.”
Dr. Stride, MD

The hip-spine connection

Could it start in your back?

Pain on the outside of the hip is usually tendon or bursa trouble, and a stiff lower back can add to it. Both are checked at the first visit.

Is it your hip or your back? →

Treatment options, from simplest to most involved

Step 1
Less compression, more smart loading
Avoiding the positions that squeeze the tendon, such as lying on the sore side, crossing the legs and standing with weight shifted onto one hip, often eases night pain within a couple of weeks.
Hip Activity & Weight Plan →
Step 2
Tendon-focused physical therapy
Progressive strengthening of the gluteal muscles is the most reliable long-term treatment for gluteal tendinopathy. Most patients need 8 to 12 weeks of consistent work.
Hip Physical Therapy →
Step 3
Cortisone injection
An ultrasound-guided cortisone injection near the bursa can quiet a painful flare and help you sleep, so that therapy can progress. Relief is often good for a few weeks to a few months. Repeated shots are avoided because they can weaken the tendon.
Trochanteric Bursa Injection →
Step 4
PRP for stubborn tendinopathy
For tendon pain that keeps returning after good rehab, platelet-rich plasma (PRP) is a reasonable option. Some studies suggest longer-lasting relief than cortisone for gluteal tendinopathy, though it is usually an out-of-pocket cost.
PRP Hip Injection →
Step 5
Gluteal tendon repair
When the gluteus medius or minimus has torn away from the bone and causes weakness and a limp, Dr. Stride can reattach it, often through small incisions with an endoscope.
Gluteus Medius Tendon Repair →

What you can do at home now

Sleep on your back or on the good side with a pillow between your knees
Put a soft mattress topper on a firm mattress to reduce pressure on the hip
Sit with your knees level or lower than your hips and avoid crossing your legs
Stand with weight even on both feet instead of hanging on one hip
Take stairs one at a time and use the handrail during flares
Avoid IT band stretches that pull the leg across the body, which squeeze the tendon

Frequently asked questions

Is trochanteric bursitis the same as gluteal tendinopathy?

They overlap but are not the same. Most outer hip pain once labeled bursitis is now known to come mainly from the gluteal tendons, and the bursa may or may not be inflamed. The umbrella term is greater trochanteric pain syndrome.

Why does outer hip pain get worse at night?

Lying on the sore side presses the tendon against bone, and lying on the other side lets the top leg drop across the body, which compresses the tendon too. A pillow between the knees keeps the hips level and usually helps. Night pain typically eases as the tendon gets stronger.

How many cortisone shots are safe for hip bursitis?

Our team generally limits cortisone for outer hip pain to a few injections spaced at least 3 months apart. Repeated injections can weaken the gluteal tendons over time. If pain keeps coming back, strengthening, PRP or an MRI to check for a tear are better next steps.

Can a torn gluteus medius heal on its own?

A partial tear can often become comfortable with physical therapy, even though the tendon does not fully reattach. A full-thickness tear with weakness and a limp usually does better with surgical repair. An MRI shows which type of tear is present.

Is it safe to keep walking with outer hip pain?

In most cases yes, walking on flat ground at a comfortable pace is fine and helps the tendon stay healthy. Steep hills, long stair climbs and walking on a slanted shoulder of the road tend to flare it. Back off if you start limping.

Treatments for outside of hip

Injections

Trochanteric Bursa Injection

A trochanteric bursa injection places cortisone and numbing medicine over the bony point on the outside of the hip to calm hip bursitis and gluteal tendon pain.

Gluteus Medius Tendon Repair

Gluteus medius tendon repair is a surgery that reattaches the torn hip abductor tendons to the outside of the hip bone, done endoscopically or through a small open incision.