Hip Bursitis (Greater Trochanteric)

The greater trochanter is the bony prominence on the outer side of your upper femur. A bursa — a small fluid-filled cushioning sac — lies over it, allowing the iliotibial band and gluteal tendons to glide without friction. When that bursa becomes inflamed (bursitis), every step that loads the outer hip causes pain.

This is the most common cause of pain on the outer side of the hip. It's more common in middle-aged women and in runners. Weak side-hip muscles, a leg-length difference, and a tight iliotibial (IT) band all contribute. Doctors increasingly use the broader term greater trochanteric pain syndrome because partial tearing of the gluteal tendons (the muscles you'd land on if you fell sideways) frequently sits alongside the bursitis or mimics it.

The hallmark complaint is pain on the outer side of your hip, right over the bony bump you can feel when you press your hand against your upper thigh (the greater trochanter). Lying on that side at night is often the worst trigger — it wakes you up or keeps you from falling asleep. Climbing stairs, getting out of a car, and long walks all flare the pain.

The ache can radiate down the outer thigh toward the knee, but it rarely travels below the knee — if it does, the source is more likely your spine than the bursa. You may also notice stiffness in the hip for the first several steps after sitting. The condition is more common in middle-aged women, runners, and anyone with a wider pelvis or a leg-length difference.

The hallmark is sharp point tenderness right over the bony bump on the outer hip — pressing on it reproduces the pain. Symptoms typically get worse lying on that side at night, climbing stairs, and after walking. X-rays are usually normal but rule out other bone problems. Ultrasound or MRI can confirm the bursitis and pick up any associated gluteal tendon tear.

1. Corticosteroid injection

   An corticosteroid injection into the bursa, guided in real time by ultrasound — gives rapid, significant pain relief and lets you do the physical therapy that keeps it from coming back.

2. PRP injection

   A PRP (platelet-rich plasma) injection — concentrated growth factors taken from your own blood — placed into the bursa or into an associated tendon tear. Reasonable to try when cortisone has only given short-term relief.

Surgery is rarely needed for bursitis itself. When a confirmed gluteal tendon tear (partial or full) hasn't responded to non-operative care, surgical repair may be considered.

External patient-education references and related OSI pages for additional background:

• Britannica — Bursitis
• Britannica — Hip (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language