Outer Hip Pain: Causes and Relief

Overview

Outer hip pain — on the side of the hip, over or just below the bony bump — is one of the most common hip complaints. In most cases the source is the gluteal tendons, not the joint itself.

The old name "trochanteric bursitis" made it sound like a simple inflamed sac, but research shows the tendons of the gluteus medius and minimus are usually the main problem. That matters because tendons respond to progressive loading and education, not rest alone.

What This Symptom Feels Like

Ache or sharp pain on the outside of the hip
Worse when lying on the affected side at night
Worse after walking, climbing stairs or standing on one leg
Tenderness when pressing the bony bump on the side of the hip
Pain that sometimes spreads down the outside of the thigh

Common Causes

Gluteal tendinopathy — the most common local cause of outer-hip pain
Greater trochanteric pain syndrome — the umbrella term that includes gluteal tendon and bursa irritation
Iliotibial (IT) band friction — tightness or irritation along the outer thigh, common in runners, linked to the knee as well
Referred pain from the lower back or sacroiliac joint
Less commonly, hip joint problems such as osteoarthritis — usually felt in the groin rather than the outer hip

Anatomy Usually Involved

Gluteal muscles — the gluteus medius and minimus tendons attach at the outer hip
Hip joint — the joint itself is usually not the main source of outer-hip pain
IT band — runs down the outer thigh from the hip to the knee

Questions to Ask Yourself

Is the pain over the bony bump or lower down the outer thigh?
Is it worse lying on that side, walking, or standing on one leg?
Did it start after increasing walking, running, hiking or stairs?
Is there any groin pain, clicking or catching?
Is it improving with activity adjustment, or getting worse?

When It's Usually Minor

Outer-hip pain that follows an increase in load — more walking, hills, stairs or running — and improves when you adjust that load is the typical pattern for gluteal tendinopathy. It can take weeks or months to fully settle because tendons respond slowly, but it usually improves with consistent strengthening.

When To Seek Medical Care

Pain that is not improving after several weeks of sensible adjustment
Inability to walk comfortably or pain with every step
Sudden severe pain, a pop, or a feeling the hip gives way
Redness, warmth or swelling over the hip, or pain with fever
Numbness or weakness in the leg

Self-Care Options

Reduce the specific loads that flare it up — long walks, hills, stairs — rather than stopping all activity
Sleep with a pillow between your knees if side-lying
Start gentle gluteal strengthening — see the clamshell
Use short-term pain relief if appropriate for you
Progress loading gradually over weeks, guided by how the hip responds

Common Questions

Is outer hip pain bursitis?

The tendon is usually the main source of pain rather than the bursa, which is why "trochanteric bursitis" has been replaced by "greater trochanteric pain syndrome" and gluteal tendinopathy. Treatment targets the tendon with progressive loading.

Can I keep walking with outer hip pain?

Often yes, within comfort. Reducing distance, hills and pace temporarily is reasonable, then build back up gradually. If every step is painful or symptoms are worsening, get it assessed.

How long does outer hip pain take to improve?

Gluteal tendons respond slowly. With consistent load management and strengthening, meaningful improvement often takes several weeks to months rather than days.

Clamshell — targets the gluteus medius
Hip hinge — loads the glutes through the hip
Glute bridge — hip extension strength
Standing hip abduction — gluteus medius strength
Hip thrust — glute strengthening

Piriformis stretch — deep buttock stretch
Hip flexor stretch — front-of-hip stretch

References

Grimaldi A, Fearon A. "Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management." Journal of Orthopaedic & Sports Physical Therapy. 2015. https://pubmed.ncbi.nlm.nih.gov/26381486/
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." BMJ. 2018. https://www.bmj.com/content/361/bmj.k1662

This information is for education only and is not a medical diagnosis. InjuryAtlas does not replace an assessment by a qualified health professional. If you have severe pain, visible deformity, numbness, loss of function, or symptoms that are getting worse, seek medical care promptly.