Pain on the outside of the hip is often blamed on “bursitis”, but many cases are better described as greater trochanteric pain syndrome, or GTPS. This can involve the gluteal tendons, the bursa and the way the hip is being loaded.

One classic symptom is pain lying on the affected side. Some people also feel pain walking uphill, climbing stairs, standing on one leg, or sitting with the legs crossed.

Why it happens

The gluteal tendons help stabilise the pelvis when you stand, walk and climb stairs. They can become painful when the load exceeds what they tolerate. Compression over the outside of the hip can also aggravate symptoms.

That is why side-lying, crossing legs and hanging on one hip while standing can be provocative.

What else can mimic it?

Pain from the lumbar spine, hip joint osteoarthritis and referred pain can overlap. A careful examination helps distinguish pain on the outside of the hip from groin-dominant hip joint pain or nerve-related symptoms.

First steps that often help

Reducing compressive positions is often useful. That may mean sleeping with a pillow between the knees, avoiding prolonged side-lying on the painful side, and not standing with the hip dropped out to one side.

Strengthening is usually central, but it needs to be introduced carefully. Too much single-leg loading too early can flare symptoms.

Where injections fit

Cortisone injections may settle pain for some people, especially when sleep is badly affected, but they are not a complete long-term solution. Other options may be considered depending on the diagnosis and previous response.

You can read more on our greater trochanteric pain syndrome page.

The bottom line

Side-lying hip pain is often treatable, but it needs the right diagnosis and a load plan that respects the gluteal tendons.