What Is Hip Bursitis?

Hip bursitis, also called trochanteric bursitis, is a common cause of pain on the outside of your hip. It often sits under the broader term Greater Trochanteric Pain Syndrome (GTPS), which includes both bursitis and gluteal tendinopathy.

A bursa is a small fluid-filled sac that cushions tendons where they cross bone. In hip bursitis, the bursa over the bony point of the hip (the greater trochanter) becomes irritated and inflamed. A deeper bursa can also inflame in more stubborn cases.

People often confuse hip bursitis with hip arthritis, lower back pain, or general hip joint pain. A skilled hip physiotherapist can help identify the true source of your pain.

Hip Anatomy and Outer Hip Pain

The outer hip region includes:

• The greater trochanter, the bony bump on the side of your thigh bone.
• The trochanteric bursae, which reduce friction between bone and tendon.
• The gluteal tendons, especially gluteus medius and minimus.
• The iliotibial band, which runs down the outside of the hip and thigh.

Pain in this area may come from one or more of these structures. That is why GTPS often involves both bursitis and tendon irritation.

Causes and Risk Factors for Hip Bursitis

Hip bursitis usually develops from repeated compression and shear over the bursa. Common contributors include:

• Weak gluteal muscles, especially gluteus medius.
• Increased walking, running, stairs, or hill work.
• Running with poor hip and pelvic control.
• Bushwalking or hiking to fatigue.
• Cycling with a high saddle height.
• Side sleeping directly on the painful hip.

Certain factors increase your risk:

• Age between 40 and 60 years.
• Female pelvic shape and wider hips.
• Higher body weight or recent weight gain.
• Previous low back or hip injuries that were not fully rehabilitated.
• Reduced overall strength, balance, or mobility.

Acute cases may follow a fall, a direct knock to the hip, or a bump in sport.

Hip Bursitis Symptoms

Common hip bursitis symptoms include:

• Pain and tenderness over the bony side of the hip.
• Pain that may spread down the outer thigh towards the knee.
• Discomfort when lying on the affected side, especially at night.
• Pain after long periods of sitting, then standing up.
• Pain with walking, stair climbing, hills, or long periods of standing.

Symptoms often feel worse:

• When rolling onto the painful side in bed.
• After long walks, hills, or uneven surfaces.
• When the hip muscles fatigue.

If these symptoms sound familiar, it is worth seeing a Brisbane physiotherapist or your doctor to confirm the diagnosis.

Is It Hip Bursitis or Something Else?

Outer hip pain can also come from:

• Gluteal tendinopathy.
• Hip osteoarthritis.
• Hip flexor pain or groin strain.
• Piriformis-related pain or buttock pain.
• Referred pain from the lower back.

A careful clinical assessment helps distinguish these conditions and guides treatment.

How Is Hip Bursitis Diagnosed?

Diagnosis usually starts with a detailed clinical assessment. Your physiotherapist will:

• Ask about your pain history, daily loads, and sleep positions.
• Examine your hip, pelvis, and lower back.
• Check your walking pattern and single-leg balance.
• Press over the greater trochanter and gluteal tendons.

In many cases, this is enough to diagnose hip bursitis or GTPS. However, ultrasound or MRI may be helpful to:

• Confirm bursitis or tendon irritation.
• Identify partial tears in the gluteal tendons.
• Rule out other hip or lumbar conditions.

Your physiotherapist or doctor will advise if a scan is likely to change your treatment plan.

Do I Need a Scan for Hip Bursitis?

Scans are usually considered when:

• Symptoms are severe or long-standing.
• There is concern about tendon tears.
• You have not improved with a solid trial of physiotherapy.

For many people, a good assessment and structured rehab program are enough.

Best Treatment for Hip Bursitis

Most people with hip bursitis improve with a combination of:

• Load management.
• Exercise-based rehabilitation.
• Targeted pain relief strategies.

Your physiotherapist will build a simple, progressive plan that suits your goals.

1. Load Management

Early on, treatment usually involves:

• Reducing aggravating activities such as hills, stairs, and long walks.
• Modifying how often and how far you walk or run.
• Avoiding lying directly on the painful side.
• Using a pillow between your knees when side sleeping.

These simple changes reduce pressure on the bursa so it can settle while you maintain as much movement as possible.

2. Physiotherapy Treatment

Physiotherapy for hip bursitis commonly includes:

• Education about helpful positions and loads.
• Specific strengthening for the gluteal and deep hip rotator muscles.
• Exercise progressions from supported positions to single-leg tasks.
• Gait and movement retraining to improve hip and pelvic control.
• Hands-on treatment to relieve tight muscles around the hip and lower back.
• Occasional use of kinesiology tape to reduce direct compression over the bursa.

In more persistent cases, your physiotherapist may consider shockwave therapy or other adjunct treatments.

3. Medication and Anti-inflammatory Options

Discuss medication with your doctor. Options may include:

• Short courses of NSAIDs (non-steroidal anti-inflammatory drugs).
• Topical anti-inflammatory gels or creams.
• Natural options such as arnica, if appropriate.

Ice packs can help reduce pain and swelling. Wrap ice in a damp cloth and apply for 10–15 minutes several times per day. Avoid placing ice directly on the skin.

4. Corticosteroid Injections

For some people, a corticosteroid injection into the bursa can help settle a severe flare. The injection is usually performed under ultrasound guidance. The local anaesthetic provides short-term relief and the steroid gradually reduces inflammation.

Injections may provide relief for a few months but do not correct muscle weakness or poor movement patterns. A full rehabilitation plan remains essential. Your doctor will advise how often injections are safe and appropriate.

Phased Rehabilitation for Hip Bursitis

Your physiotherapist will tailor your program, but a typical approach includes three phases.

Phase I – Settle Pain and Protect the Hip

• Active rest and load reduction (no complete bed rest).
• Changes to walking distance, stairs, and hills.
• Sleep position adjustments and pillow support.
• Ice therapy, taping, and other pain-relief strategies.
• Gentle isometric (static) hip strengthening in safe positions.

Phase II – Restore Hip Strength and Control

• Progressive strengthening for the gluteals and deep hip rotators.
• Improving hip range of motion and muscle length.
• Balance and single-leg stability exercises.
• Gait retraining and step control.
• A gradual walking or running progression, if appropriate.

Many patients follow a structured hip core stabilisation approach used at PhysioWorks to rebuild control and confidence.

Phase III – Return to Sport and Full Function

• Sport-specific drills, such as hills, stairs, or uneven surfaces.
• Higher-level strength and power exercises.
• Endurance work for walking, running, hiking, or sport.
• A prevention plan to reduce future flare-ups.

Surgery (bursectomy or related procedures) is rarely required and usually reserved for long-standing cases that have not responded to high-quality conservative care.

How Long Does Hip Bursitis Take to Heal?

Recovery time varies from person to person. Many acute hip bursitis cases improve within 6–12 weeks with good physiotherapy and load management. More chronic cases can take several months.

Factors that may slow recovery include:

• Delays in seeking treatment.
• Persistent overload (for example, continuing long, hilly walks).
• Significant gluteal weakness or tendon involvement.
• Co-existing conditions such as hip arthritis or lower back issues.

The best outcomes usually come from combining targeted exercise, load changes, and consistent self-management strategies.

Can You Prevent Hip Bursitis?

You can reduce your risk of future hip bursitis flare-ups by:

• Keeping your hip and gluteal muscles strong.
• Building walking or running loads gradually.
• Varying surfaces and avoiding excessive cambered ground.
• Using a pillow between your knees when side sleeping.
• Maintaining a healthy body weight where possible.

Your physiotherapist can design a simple home program to maintain your gains and keep your hips moving well.

When Should You See a Physiotherapist?

Book a physiotherapy assessment if:

• Your outer hip pain has lasted more than two weeks.
• Night pain stops you sleeping comfortably.
• Walking, stairs, or running are becoming harder.
• Your symptoms keep returning despite rest.

Early treatment usually leads to a faster, smoother recovery.

What To Do Now

Hip bursitis can make simple daily tasks feel much harder. The good news is that most people improve with a clear plan and the right guidance.

A PhysioWorks physiotherapist can:

• Assess your hip and identify your main pain drivers.
• Set up a staged rehabilitation program.
• Guide you on safe activity levels and prevention strategies.

Booking early helps protect your hip and reduces the risk of chronic pain.

Hip Bursitis FAQs

Is walking good for hip bursitis?

Gentle walking is usually fine, especially if pain stays mild. You may need to shorten distances or avoid hills early on. Your physiotherapist can help set safe limits and guide gradual progressions.

What is the fastest way to heal hip bursitis?

The quickest improvement usually comes from reducing painful loads, starting targeted hip strengthening, and using pain-relief strategies. Follow your home program and use ice or medication as advised by your doctor or physiotherapist.

Will hip bursitis go away on its own?

Some mild cases settle with rest and simple changes. Many people, however, find symptoms return when they increase activity. Rehabilitation offers better long-term results because it improves hip strength and movement control.

What causes hip bursitis to flare up?

Common triggers include long walks, hills, stairs, lying on the painful side, increases in training volume, and fatigue-related loss of hip control. Direct pressure over the outer hip can also provoke symptoms.

Is hip bursitis a type of arthritis?

No. Hip bursitis affects soft tissues outside the joint, while arthritis affects the joint surfaces. Some people may have both, so a thorough assessment is important. You can read more about joint conditions here: Hip Arthritis.

Related Articles

1. Greater Trochanteric Pain Syndrome (GTPS)
2. Gluteal Tendinopathy
3. Hip Pain Overview
4. Bursitis
5. Hip Flexor: Iliopsoas Groin Pain
6. Piriformis Syndrome
7. Hip Replacement Information

References

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2. Pianka MA, Serino J, DeFroda SF, Bodendorfer BM. Greater trochanteric pain syndrome: evaluation and management of a wide spectrum of pathology. SAGE Open Medicine. 2021;9:20503121211022582.
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3. Wang Y, Wang K, Qin Y, et al. The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research. 2022;17:283.
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4. Notarnicola A, Ladisa G, Moretti L, et al. Shock waves and therapeutic exercise in greater trochanteric pain syndrome: a prospective randomized clinical trial with cross-over. Journal of Orthopaedic Surgery and Research. 2023;18:414.
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5. Patricio Cordeiro TT, Rocha EAB, Scattone Silva R. Effects of exercise-based interventions on gluteal tendinopathy: systematic review with meta-analysis. Scientific Reports. 2024;14:3343.
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