Outer Hip Pain: Common Causes and When to Get Help
Pain on the outside of your hip can make simple activities surprisingly difficult. Walking through the grocery store, climbing stairs, standing at work, getting out of a chair, or sleeping on your side may become uncomfortable.
Some people notice a dull ache that gradually becomes more persistent. Others experience a sharper pain after increasing their activity, beginning a new exercise program, taking a long trip, or spending more time on their feet.
Outer hip pain is common, but it is not a diagnosis by itself. Several muscles, tendons, cushioning structures, joints, and nerves can contribute to pain in this area. The location of the discomfort provides an important clue, but a complete evaluation is often needed to understand what is causing it.
Many cases of outer hip pain are related to the soft tissues around the hip rather than the ball-and-socket joint itself. These soft tissues include the gluteal muscles and tendons, bursae, and the iliotibial band. Healthcare professionals may use the term greater trochanteric pain syndrome, or GTPS, to describe pain involving these structures. the possible causes of outer hip pain can help you recognize when it is time to have your movement, strength, and daily activities evaluated.
Where Is Outer Hip Pain Felt?
Outer hip pain is usually felt around the bony point on the side of the upper thigh. This area is known as the greater trochanter.
You may feel discomfort directly over this point, slightly behind it, or along the outside of the thigh. In some cases, the pain spreads toward the buttock or farther down the side of the leg.
People often describe the pain as:
- Aching or throbbing
- Sharp with certain movements
- Tender when touched
- Uncomfortable when lying on the affected side
- Worse after walking or standing
- Noticeable when climbing stairs
- Stiff or sore after sitting
The pattern can vary. One person may mainly have pain at night, while another may feel fine while resting but experience discomfort during longer walks.
Pain from greater trochanteric pain syndrome is frequently aggravated by side-lying, stair climbing, prolonged standing, running, or other activities that increase demand on the muscles and tendons around the side of the hip. Pain Is Not Always Hip-Joint Pain
When people say that their hip hurts, they often assume the problem must be inside the hip joint. However, the hip region contains many different structures.
The true hip joint is located deeper in the body. It is formed where the top of the thighbone fits into a socket in the pelvis. Problems within this joint, including hip osteoarthritis, frequently cause pain in the groin, front of the thigh, buttock, or sometimes the knee. directly on the side of the hip is more commonly associated with the surrounding muscles, tendons, bursae, or referred pain from another region. This distinction is helpful, but pain patterns may overlap.
That is why relying on location alone may not identify the source. A licensed healthcare professional will also consider when the pain occurs, what activities make it worse, whether movement is restricted, whether there was an injury, and whether other symptoms are present.
Common Causes of Outer Hip Pain
1. Greater Trochanteric Pain Syndrome
Greater trochanteric pain syndrome is a broad term used for pain involving the tissues around the outside of the hip.
For many years, lateral hip pain was frequently labeled “trochanteric bursitis.” Current understanding recognizes that the gluteal tendons and other nearby tissues may also be involved. GTPS may therefore include gluteal tendinopathy, irritation of a bursa, or a combination of problems. uscles help support the pelvis and control the hip during walking, stair climbing, and standing on one leg. Their tendons attach near the bony point on the outside of the hip.
When the demand placed on these tissues exceeds what they can currently tolerate, pain may develop. This can happen after a sudden increase in activity, repetitive loading, changes in walking, or prolonged pressure on the side of the hip.
Common symptoms may include:
- Tenderness over the side of the hip
- Pain when lying on the affected side
- Pain during longer periods of walking
- Discomfort while climbing stairs
- Pain when standing on one leg
- Symptoms after prolonged standing
- Aching along the outside of the thigh
The pain may begin gradually and become more noticeable over time. Some people do not remember a specific injury.
2. Gluteal Tendon Irritation
The gluteus medius and gluteus minimus muscles attach to the outer hip through strong tendons. These muscles help keep the pelvis level while you walk and provide stability during many daily movements.
A tendon can become painful when it is exposed to more force, repetition, or compression than it is prepared to manage. The issue may develop after a change in exercise intensity, walking distance, terrain, work demands, or recreational activity.
Gluteal tendon pain may be felt directly over the side of the hip. It may worsen during activities that require the muscles to control the pelvis, such as stairs, single-leg standing, or walking on uneven surfaces.
The symptoms may resemble hip bursitis because the gluteal tendons and bursae are located close together. A physical examination can help determine which tissues appear to be contributing to the pain.
3. Hip Bursitis
A bursa is a small, fluid-filled sac that helps reduce friction between tissues. Several bursae are located around the hip.
Trochanteric bursitis involves a bursa near the outer hip. The main symptom is usually pain over the bony point of the hip that can extend along the outside of the thigh. The discomfort may initially feel sharp and later become a more widespread ache. be associated with repeated stress, direct pressure, a fall onto the side of the hip, or irritation from nearby tissues.
Possible symptoms include:
- Localized tenderness
- Pain when pressing on the outer hip
- Pain when lying on that side
- Increased discomfort with movement
- Aching after activity
Although “hip bursitis” is a familiar term, not everyone with outer hip pain has an isolated inflamed bursa. The surrounding tendons and movement patterns should also be considered.
4. A Sudden Increase in Activity
Outer hip pain sometimes begins after a person changes their usual routine.
Examples may include:
- Starting a walking program
- Increasing running distance
- Returning to exercise after a break
- Taking a vacation that involves extensive walking
- Beginning a job that requires more standing
- Adding hills or stairs to a routine
- Increasing sports practices
- Performing repeated yardwork or household projects
This does not necessarily mean the activity was harmful. It may simply mean the tissues were asked to handle more work than they were accustomed to.
The body generally responds well to gradually increased activity. Problems are more likely when the amount, frequency, or intensity changes faster than the body can adapt.
A physical therapist can help identify the demands that may have contributed to the pain and develop an appropriate plan for returning to activity.
5. Muscle Weakness or Reduced Movement Control
Strength and coordination throughout the trunk, pelvis, hip, knee, and ankle all affect how force travels through the body.
If certain muscles are not contributing effectively, other tissues may have to work harder during walking, stairs, or exercise. This may increase stress around the outer hip.
Weakness does not always mean someone is generally inactive. Even strong or athletic individuals can have differences in how muscles coordinate during a particular task.
A licensed physical therapist may evaluate:
- Hip and leg strength
- Balance
- Walking mechanics
- Pelvic control
- Range of motion
- Stair movement
- Ability to stand on one leg
- Movement during work or recreational tasks
This information helps the therapist understand the whole movement pattern rather than focusing only on the painful spot.
6. Direct Pressure or Trauma
A fall onto the side of the hip can irritate the tissues around the greater trochanter. Pain may also occur after bumping the hip against an object or repeatedly placing pressure on the area.
Sleeping on a firm surface or remaining on one side for long periods may aggravate an already sensitive hip. This is one reason outer hip pain often becomes particularly noticeable at night.
Traumatic pain should be evaluated carefully, especially when the person cannot comfortably bear weight or when pain is severe.
7. Referred Pain From the Lower Back
Pain felt at the hip does not always begin there.
The lower back contains joints, muscles, and nerves that may refer symptoms into the buttock, hip, or leg. Some people with referred pain have little or no noticeable back discomfort.
Signs that another region may be contributing include:
- Pain extending below the knee
- Numbness or tingling
- Burning sensations
- Symptoms that change with spinal position
- Weakness in the leg
- Pain involving the lower back and hip together
Not every person with these symptoms has a serious condition. However, they are important details to discuss during an evaluation.
A physical therapist can examine both the hip and nearby regions to determine how movement in one area may be affecting another.
8. Hip Osteoarthritis
Hip osteoarthritis typically causes deep discomfort in the groin or front of the hip, but pain patterns differ from person to person. Some individuals feel pain in the buttock, thigh, knee, or outer hip.
Other common features include stiffness after sitting or resting, reduced hip movement, and increasing difficulty with daily activities. Hip osteoarthritis often develops gradually, although symptoms may occasionally appear more suddenly. itis and outer-hip soft-tissue pain can occur at the same time, an evaluation may be needed to determine how much each issue is affecting movement.
9. Changes in Walking or Lower-Extremity Function
Pain, stiffness, weakness, or an old injury elsewhere in the body may change the way someone walks.
For example, a person recovering from a knee, ankle, or foot problem may spend more time shifting weight to the opposite side. A person with limited mobility may also take shorter steps or lean during walking.
These adjustments can be useful in the short term, but they may increase demand on the outer hip when they continue.
The goal of an evaluation is not simply to label the painful tissue. It is to determine why that area may be receiving extra stress.
Why Does My Hip Hurt When I Lie on My Side?
Pain while lying on the affected side is one of the most common complaints associated with lateral hip pain.
Side-lying places direct pressure on the tissues around the greater trochanter. If the area is already sensitive, that compression may increase symptoms.
Some people also feel pain while lying on the opposite side. In that position, the top leg may move inward and place tension or compression on the outer-hip tissues.
Nighttime pain can interfere with sleep and make the hip feel more sensitive the following day. However, pain at night does not automatically identify one specific condition.
Persistent nighttime pain, especially when it is severe, worsening, or unrelated to position, should be discussed with a healthcare professional.
Why Does My Outer Hip Hurt When I Walk?
Walking requires repeated control from the muscles around the hip.
Each time you step onto one leg, the muscles on that side help support the pelvis. If the tissues are irritated, weak, fatigued, or not accustomed to the walking distance, symptoms may develop.
Pain may become more noticeable when:
- Walking farther than usual
- Moving quickly
- Walking uphill
- Using uneven ground
- Carrying objects
- Taking longer strides
- Returning to activity after inactivity
The solution is not always to stop walking completely. Avoiding all movement can lead to additional weakness and reduced confidence.
Instead, the appropriate level of activity should be based on the person’s symptoms, health, goals, and physical examination. A physical therapist can help determine how activity may be adjusted and gradually progressed.
When Should You Seek Help for Outer Hip Pain?
Consider scheduling an evaluation when the pain:
- Has continued for more than several days without improvement
- Keeps returning
- Interferes with sleep
- Limits walking, stairs, work, or exercise
- Causes you to limp or change how you move
- Began after a change in activity and is not settling
- Is associated with increasing stiffness
- Prevents you from participating in activities you enjoy
- Is becoming more frequent or intense
Early evaluation may help identify contributing factors before the problem begins to limit more of your daily life.
You do not need to wait until the pain becomes severe before asking for help.
When Does Hip Pain Require Prompt Medical Attention?
Some symptoms require more urgent medical assessment.
Seek prompt care if you have:
- Severe hip pain after a fall or injury
- An inability to stand or bear weight
- A visibly deformed leg or hip
- A hot, swollen, or significantly red joint
- Hip pain with fever, chills, or feeling acutely unwell
- Sudden loss of strength
- Significant numbness
- Loss of bladder or bowel control
- Unexplained severe pain that does not change with position
- Rapidly worsening symptoms
A hot, swollen hip accompanied by fever or feeling unwell may indicate a joint infection and should be evaluated urgently. unsure whether symptoms are urgent, contact an appropriate medical professional for guidance.
How Is Outer Hip Pain Evaluated?
An evaluation should look beyond the location of the pain.
Your healthcare professional may ask:
- When did the pain begin?
- Was there an injury?
- What activities make it better or worse?
- Does it disturb your sleep?
- Where exactly do you feel it?
- Does the pain travel down your leg?
- Have you experienced numbness or tingling?
- Has your activity level recently changed?
- Are you having difficulty walking or using stairs?
- Do you have other health conditions that may affect the hip?
A physical therapist may then assess how your hip, lower back, pelvis, knee, and ankle move together.
The evaluation may include range of motion, strength, balance, walking, posture, and functional movements. The therapist may also observe an activity that is especially difficult for you.
Not every person requires imaging. A healthcare provider determines whether an X-ray, MRI, ultrasound, or other test is appropriate based on the examination and medical history.
How Can Physical Therapy Help Outer Hip Pain?
Physical therapy focuses on helping you move more comfortably and confidently.
At Hohman Rehab, a licensed therapist performs an evaluation and creates a personalized care plan based on your symptoms, movement, health history, and goals.
Depending on the findings, physical therapy may focus on:
- Improving hip and leg strength
- Restoring comfortable movement
- Improving balance and pelvic control
- Addressing walking or stair mechanics
- Helping irritated tissues tolerate activity
- Adjusting activities that repeatedly aggravate symptoms
- Gradually returning to work, recreation, or exercise
- Teaching strategies to reduce recurrence
- Examining whether the lower back or another area is contributing
Physical therapists can help people with hip bursitis reduce pain and irritation, address related weakness, and return to everyday activities. ingle program that is appropriate for everyone with outer hip pain. The best plan depends on what is causing the symptoms and how the problem affects your life.
Should You Rest an Aching Hip?
A short reduction in aggravating activity may help calm a flare-up, but complete and prolonged rest is usually not the long-term answer for most mechanical hip problems.
The hip and surrounding tissues need appropriate movement and loading to remain strong. The challenge is finding the right amount.
Doing too much too quickly may increase symptoms. Doing too little for too long may reduce strength and activity tolerance.
A licensed physical therapist can help you find a reasonable balance based on your individual condition. This may include temporarily modifying certain activities while maintaining other comfortable forms of movement.
Can Outer Hip Pain Improve Without Surgery?
Many causes of outer hip pain are initially managed without surgery.
Conservative care may include education, activity modification, progressive rehabilitation, and coordination with a medical provider when additional care is needed. Reviews of greater trochanteric pain syndrome describe nonoperative management as the primary approach for most patients. not always be immediate. Tendons and other soft tissues often need time to adapt.
Consistency, an appropriate plan, and gradual progression are important. A temporary flare does not necessarily mean that the condition is worsening or that recovery is impossible.
Frequently Asked Questions About Outer Hip Pain
Is outer hip pain the same as hip bursitis?
Not always. Hip bursitis can cause pain on the outside of the hip, but the gluteal tendons and other tissues may also contribute. Greater trochanteric pain syndrome is a broader term that includes several potential sources of lateral hip pain.
Why is the side of my hip tender to touch?
The tendons, bursae, and other soft tissues near the greater trochanter can become sensitive. Direct pressure may reproduce the pain, but an examination is needed to determine which tissues are involved.
Can hip arthritis cause outer hip pain?
It can, although hip arthritis more commonly causes pain in the groin or front of the hip along with stiffness and reduced movement. Some people experience discomfort in the buttock, thigh, knee, or outer hip.
Why does my hip pain travel down the side of my leg?
Outer-hip soft-tissue pain can spread along the outside of the thigh. Pain that travels farther, especially with numbness, tingling, burning, or weakness, may involve a nerve or another region and should be evaluated.
Should I continue exercising with outer hip pain?
The answer depends on the cause, severity, and type of activity. Some movement may be helpful, while certain activities may need temporary modification. A licensed physical therapist can help determine an appropriate plan.
How long does outer hip pain last?
Recovery time varies. It depends on the tissues involved, how long symptoms have been present, overall health, activity demands, and consistency with the care plan. Persistent or worsening symptoms should be evaluated.
Take the Next Step Toward Moving More Comfortably
Outer hip pain can make walking, sleeping, working, and exercising more difficult, but you do not have to keep guessing about the cause.
A personalized physical therapy evaluation can help identify movement limitations, weakness, activity changes, and other factors that may be contributing to your symptoms.
At Hohman Rehab & Sports Therapy, our licensed therapists provide personalized, one-on-one care and create a plan based on your needs and goals. We focus on helping you understand the cause of your limitations, improve movement, and return to the activities that matter to you.
To schedule an evaluation, visit www.hohmanrehab.com or contact the location nearest you:
Clermont
236 Mohawk Rd., Clermont, FL 34715
(352) 404-6908
Ocoee
11095 W. Colonial Dr., Ocoee, FL 34761
(407) 347-8936
Apopka
125 S. Park Ave., Apopka, FL 32703
(407) 410-3200
Let our team help you on your path to wellness.
This article is for general educational purposes and is not intended to diagnose a condition or replace individualized medical advice.
Written By:
Dr. Katie Hohman, PT, DPT, CLT
Physical Therapist, Certified Lymphedema Therapist, Founder
