Introduction
Greater trochanteric bursitis, often simply called hip bursitis, is one of the most common causes of pain on the outer side of the hip. Millions of people experience it each year, but it’s often misunderstood or misdiagnosed. Because the pain can interfere with walking, exercising, sleeping, and even simple daily activities, understanding this condition is essential for proper care and long-term recovery.
In this comprehensive guide, we’ll explore everything you need to know about greater trochanteric bursitis—what it is, why it happens, how to recognize it, and the best treatment options available today. Whether you’re a patient looking for answers, a caregiver trying to help, or simply someone curious about hip pain, this article will give you the tools to better understand the condition and move toward relief.
What Is Greater Trochanteric Bursitis?
The hip joint is surrounded by several small, fluid-filled sacs called bursae. These bursae act like cushions, reducing friction between bones, tendons, and muscles. The greater trochanter is the bony prominence on the side of the thigh bone (femur). When the bursa overlying this area becomes irritated or inflamed, the result is greater trochanteric bursitis.
This inflammation causes pain that typically feels sharp, burning, or aching along the outer hip, sometimes radiating down the outside of the thigh. While often labeled simply as “hip bursitis,” GTB is specifically localized to the greater trochanter region.
Anatomy of the Hip and Bursa
Understanding GTB starts with knowing the structures involved:
Femur (thigh bone): The greater trochanter is the large bump on its outer side.
Gluteal muscles: Particularly the gluteus medius and minimus, which stabilize the hip during walking.
Iliotibial band (IT band): A long tendon running down the outside of the thigh that can rub against the bursa.
Trochanteric bursa: A fluid-filled sac between the greater trochanter and overlying tissues.
When repetitive stress, direct trauma, or muscle imbalance occurs, this bursa can swell, leading to pain and tenderness.
Common Causes of Greater Trochanteric Bursitis
Several factors can trigger or worsen GTB:
1. Overuse and Repetitive Stress
Activities like running, cycling, climbing stairs, or even prolonged walking can irritate the bursa due to repetitive friction from the IT band or surrounding muscles.
2. Trauma or Injury
A direct fall onto the hip, bumping the side of the hip against a hard surface, or sudden twisting motions may inflame the bursa.
3. Muscle Weakness or Imbalance
Weak gluteal muscles or tight hip flexors/IT band create abnormal forces across the hip joint, putting stress on the trochanteric bursa.
4. Arthritis and Hip Joint Problems
Conditions like osteoarthritis or rheumatoid arthritis can alter joint mechanics, increasing irritation in the bursa.
5. Postural and Biomechanical Issues
Leg length differences, flat feet, or abnormal walking/running gait patterns can cause repetitive strain on the outer hip.
6. Previous Surgery
Hip replacements or other orthopedic surgeries may change hip alignment or muscle activation, raising the risk of bursitis.
7. Other Risk Factors
Age (more common in middle-aged and older adults)
Female sex (due to wider pelvis and biomechanics)
Obesity (increased stress on hip structures)
Symptoms of Greater Trochanteric Bursitis
The hallmark sign of GTB is lateral hip pain, but it can present in several ways:
Pain on the outside of the hip, worse with pressure (like lying on that side).
Pain radiating down the outer thigh to the knee.
Tenderness when pressing over the greater trochanter.
Increased discomfort with prolonged standing, walking, or climbing stairs.
Sharp pain with sudden movements, but dull aching pain at rest.
Night pain that makes it difficult to sleep on the affected side.
Symptoms often worsen with activity and improve with rest, but untreated bursitis may become chronic and disabling.
Diagnosis of Greater Trochanteric Bursitis
A proper diagnosis is crucial to rule out other causes of hip pain, such as arthritis, sciatica, or tendon tears.
Clinical Evaluation
A healthcare provider will:
Take a detailed history of symptoms and activities.
Palpate the outer hip to check for tenderness.
Assess hip range of motion and strength.
Observe gait and posture.
Imaging Studies
X-rays help rule out fractures or arthritis.
Ultrasound can detect fluid in the bursa.
MRI provides detailed imaging of bursae, tendons, and surrounding tissues if needed.
Treatment Options for Greater Trochanteric Bursitis
The good news is that GTB often responds well to conservative treatment.
1. Rest and Activity Modification
Avoid aggravating activities like prolonged standing, running on hard surfaces, or side sleeping on the painful hip.
2. Ice and Heat Therapy
Ice packs reduce inflammation and numb pain.
Heat therapy helps relax tight muscles once the acute inflammation settles.
3. Medications
NSAIDs (ibuprofen, naproxen) can reduce pain and swelling.
In severe cases, a corticosteroid injection into the bursa may provide fast relief.
4. Physical Therapy
One of the most effective treatments, PT addresses both pain and root causes:
Stretching: IT band, hip flexors, and piriformis.
Strengthening: Gluteus medius, gluteus maximus, and core muscles.
Manual therapy: Soft tissue release, mobilization, and modalities like ultrasound.
Gait training: Correcting walking or running mechanics.
Posture correction: Addressing spinal or pelvic alignment issues.
5. Assistive Devices
Temporary use of a cane or crutch may reduce stress on the hip during flare-ups.
6. 830Laser (Cold Laser) Therapy
Cold laser therapy, also known as 830Laser, is a safe, non-invasive treatment option that uses low-level light to reduce inflammation, speed up tissue repair, and decrease pain. Many patients with chronic bursitis find that cold laser therapy provides lasting relief when combined with physical therapy.
7. Surgery
Rarely required, but surgical bursectomy (removal of the inflamed bursa) may be considered in persistent, severe cases.
Exercises for Greater Trochanteric Bursitis
Targeted exercises help restore balance, strength, and mobility:
Clamshells: Strengthen the gluteus medius.
Bridges: Build core and glute strength.
Side-lying leg lifts: Target hip abductors.
Hip stretches: IT band stretch, figure-four stretch.
Foam rolling: Gentle IT band and glute release.
Always perform exercises under the guidance of a licensed physical therapist to avoid overloading the hip.
Preventing Greater Trochanteric Bursitis
Prevention strategies are key, especially for those at higher risk:
Warm up before physical activity.
Cross-train to avoid repetitive stress.
Strengthen hip and core muscles.
Maintain a healthy weight.
Wear supportive footwear.
Avoid sitting or standing for long periods without breaks.
Use proper form during exercise and daily activities.
Living With Greater Trochanteric Bursitis
GTB can be frustrating, but with proper care, most people recover fully. Some patients experience recurring flare-ups, but lifestyle adjustments, therapy, and self-care strategies often keep symptoms manageable.
For chronic cases, ongoing physical therapy, regular exercise, and attention to posture and body mechanics help reduce pain and improve quality of life.
When to See a Doctor
Seek medical attention if:
Pain is severe or worsening.
Pain radiates into the groin or lower back.
You experience weakness, numbness, or tingling.
Symptoms do not improve after several weeks of conservative care.
FAQs About Greater Trochanteric Bursitis
Is greater trochanteric bursitis the same as hip bursitis?
Yes, but specifically it refers to bursitis affecting the outer hip (greater trochanter), not other hip bursae.
How long does recovery take?
With proper treatment, many patients improve in 6–12 weeks, though chronic cases may take longer.
Can GTB heal on its own?
Mild cases may improve with rest and home care, but professional treatment is often needed for lasting relief.
Is walking good for trochanteric bursitis?
Walking in moderation can help maintain mobility, but long or intense walks may worsen symptoms. Listen to your body and adjust as needed.
What sleeping position is best?
Avoid lying directly on the painful hip. Sleeping on the opposite side with a pillow between the knees can reduce strain.
Can physical therapy cure it?
For many patients, physical therapy resolves symptoms completely by addressing underlying biomechanical issues.
Does surgery cure GTB?
Surgery is rarely needed, but in stubborn cases, removal of the inflamed bursa can eliminate symptoms.
Conclusion
Greater trochanteric bursitis is a common yet treatable cause of outer hip pain. By understanding its causes, recognizing symptoms early, and pursuing the right treatment—especially physical therapy and advanced options like cold laser therapy—most people can regain pain-free movement and prevent future flare-ups.
If you’re struggling with persistent hip pain, don’t wait. Early evaluation and treatment can make all the difference in your recovery.
Hohman Rehab Locations
We proudly serve Central Florida with three convenient locations:
Clermont Office
236 Mohawk Road
Clermont, FL 34715
📞 855-404-6908
Ocoee Office
11095 W Colonial Drive
Ocoee, FL 34761
📞 855-404-6908
Apopka Office
125 S. Park Ave.
Apopka, FL 32703
📞 407-410-3200
Written By:
Dr. Katie Hohman, PT, DPT, CLT
Physical Therapist, Certified Lymphedema Therapist, Founder
