Hip Bursitis

Greater trochanteric bursitis is inflammation of the bursa, a small fluid-filled cushion, that sits over the bony bump on the outer side of the upper thighbone. It is one of the most frequent causes of outer hip pain and can make walking, sleeping, and getting in and out of a car harder. Partial tearing or degeneration of the gluteal tendons often accompanies it, which is why clinicians often use the broader term greater trochanteric pain syndrome. Most people improve well with the right plan.

Common symptoms include:

• Pain over the bony bump on the outer side of the hip
• Pain when lying on that side at night, often the worst trigger
• Pain with climbing stairs, getting out of a car, or walking for a while
• An ache that can radiate down the outer thigh, but rarely below the knee
• Stiffness in the hip for the first several steps after sitting

The hallmark finding is sharp point tenderness directly over the bony bump on the outer hip, where pressing reproduces the pain. X-rays are usually normal for the bursitis itself but help rule out other causes. Ultrasound can image the bursa and guide an injection, and an MRI is reserved for when an associated gluteal tendon tear is suspected or the diagnosis is unclear.

This condition settles down for most people without surgery:

• Activity changes, reducing running and avoiding positions that irritate the bursa, such as lying on the affected side
• Physical therapy to strengthen the side-hip muscles, the most effective long-term treatment
• Anti-inflammatory medication for the acute inflammation
• A corticosteroid injection to create a window for therapy to take hold
• A PRP injection in some cases when other measures have not provided lasting relief

Surgery is rarely needed for the bursitis itself. When a confirmed gluteal tendon tear has not responded to a thorough course of nonsurgical care, surgical repair may be considered.

For a fuller explanation, including anatomy, diagnosis, and the full range of treatment:

• Hip Bursitis — AAOS OrthoInfo