What does hip bursitis feel like?

The pain sits on the bony point on the side of the hip. Press it and you find the spot. Lying on that side at night is the classic complaint, and many people end up hugging a pillow between the knees. Stairs, getting out of a low car seat and standing on one leg to pull on pants all hurt. Pain may spread down the outside of the thigh, but it stops above the knee.

Pain deep in the groin is more likely the hip joint. Pain in the buttock that runs down the back of the leg is more likely the spine. Our hip pain page sorts those out, and sciatica covers the nerve.

Why do doctors now call it gluteal tendinopathy?

For years everyone blamed the bursa, a small fluid sac on the side of the hip. Ultrasound changed that. In most painful hips the bursa is only part of the story. The main problem is the tendon of the gluteus medius and minimus, the muscles that hold your pelvis level when you stand on one leg. Those tendons wrap over the bony point of the hip, and when they are squeezed against it too often they fray.

The full name is greater trochanteric pain syndrome. It matters because a treatment aimed only at the bursa misses the tendon underneath it.

Who gets hip bursitis, and why does it hang on?

It is most common in women over forty, and it clusters with low back pain and knee pain. Standing all shift on concrete, crossing the legs, hanging on one hip while you wait in line, and long drives across the bridge with one hip hiked all compress the tendon. A weak gluteus medius lets the pelvis drop with each step, which squeezes the tendon harder. Blood sugar and the hormone shifts after menopause make tendons stiffer and slower to repair. We look at all of it.

How do we confirm hip bursitis?

Pressing the bony point on the side of the hip brings back the pain. So does standing on the sore leg for half a minute, or turning the knee in against resistance while you lie on your back. Ultrasound shows whether the gluteal tendon is thick, frayed or torn, and whether the bursa is swollen. When a tendon is torn through, an MRI helps plan the next step.

We also check the lower back and the hip joint at the same visit. Back problems and outer hip pain show up together often enough that missing one sends you home with half a plan.

What can I do about hip bursitis tonight?

Put a pillow between your knees and sleep on the other side or on your back. Do not sit with your legs crossed. Stand with your weight even on both feet instead of hanging on one hip. Take stairs one step at a time, leading up with the good leg. Keep walking on flat ground. These steps do not heal the tendon, but they stop the daily squeeze that keeps it from healing.

Why did my hip bursitis shot stop working?

A steroid shot into the bursa calms pain for a while. A 2025 review of the best trials for this condition found steroid had a small, short-term effect on pain. It does not rebuild a frayed tendon. The pain returns, the next shot does less, and the cycle repeats.

Does PRP work for hip bursitis?

A 2026 review of randomized trials looked at PRP for problems around the outside of the hip. In the gluteal tendon trials, PRP beat the comparison treatment in three of five, and the pooled hip function score favored PRP. Every trial reported improvement after PRP. The 2025 review above also found PRP beat steroid for short-term hip function.

In a double-blind trial of 80 patients whose outer hip pain had lasted more than a year, a single PRP injection into the tendon under ultrasound beat a single cortisone shot at 12 weeks. Platelet preparations are not interchangeable, and the white-cell content and dose differ widely between them. We prepare a concentrated, leukocyte-poor product and place it into the damaged part of the tendon under ultrasound.

What rehab makes it last?

The injection starts the repair. The rehab decides whether the tendon stays healed. The first job is to stop squeezing it: no crossed legs, no hanging on one hip, a pillow between the knees at night. The second is to load it the right way, starting with gentle holds that tighten the side hip muscles without pressing the tendon against the bone, then building to step-ups and single-leg work. Exercise and education carry the strongest evidence of any treatment for this condition, and they are part of every plan we build.

Is exercise really better than a cortisone shot for hip bursitis?

Yes. In an Australian trial, 204 adults aged 35 to 70 with more than three months of outer hip pain got an eight-week program of load education and exercise, one cortisone shot, or nothing. At eight weeks, 51 of 66 people in the exercise group called themselves better, against 38 of 65 after the shot and 20 of 68 who waited. At one year exercise still led on overall improvement, though pain scores had drawn even with the shot.

So the program is the treatment, and any injection, steroid or PRP, is the bridge that lets a painful hip do the work. Six quiet weeks spent loading the tendon are worth having. Spent on the couch, they buy nothing.

Why does the outer hip tendon give out after menopause?

Estrogen keeps tendon cells making collagen. When it falls, the gluteal tendons lose part of that upkeep, at the age most women first notice outer hip pain. In the trial above, 167 of the 204 people enrolled were women, average age 55. Blood sugar is the second hit. Glucose that lingers in the blood sticks to collagen and forms stiff cross-links, turning a springy tendon brittle, while belly fat sends out a low, steady stream of inflammatory signals that slows repair everywhere.

The third driver is the life around the hip. Many of the women we see from Granite City and Collinsville stand on concrete for a full shift, then carry a grandchild on one hip at home. Nobody writes a rest day into that schedule, so the plan has to fit it: protein at each meal so the tendon has raw material for new collagen, less refined starch so less sugar is left to stiffen it, and seven or more hours of sleep, because that is when growth hormone peaks and repair runs.

Dr. Padda spent years as a strict vegetarian defending the dietary guidelines he now argues against, until a beef sandwich at a Kansas City barbecue counter ended it. He dropped the old model because the physiology said to. The bursa deserved the same treatment: it kept the blame for decades because it was easy to inject, not because it was the problem.

Does a torn gluteal tendon ever need surgery?

Sometimes. When the tendon has torn all the way through and pulled away from the bone, the hip drops with every step and a limp sets in that rehab and injections do not fix. An MRI shows the size of the gap, and a surgical repair is a fair choice for that hip. Most painful hips are nowhere near that point. We tell you which group you are in and coordinate with the surgeon when you need one.

What happens on the day?

You are awake. We numb the skin with local anesthetic and use ultrasound to guide the needle. No sedation, so most people drive themselves home. The hip is sore for about two days. A second injection depends on how the first one does. Some hips also do well with focused shockwave, which we can add to the plan.

When is outer hip pain not bursitis at all?

Go to an emergency room, not a clinic appointment, for any of these:

• A fall onto the hip, then groin pain and trouble putting weight on the leg. Treat it as a broken hip until an X-ray says otherwise.
• Fever, chills, or a hip that is hot, red and swollen.
• Numbness in the groin or between the legs, or new trouble controlling your bladder or bowels.
• A leg that turns cold, pale or blue.
• Pain at rest that keeps building week after week, with weight loss you did not plan.

Our when it is an emergency page covers the rest of the list.

Frequently asked questions

Do I need a referral to have hip bursitis treated?

No. You can book a hip bursitis visit yourself, by phone or online, with no referral and no scan in hand. Some insurance plans, mostly HMOs, still want a referral from your primary doctor on file before they pay, so check your card. Your first visit from Illinois walks through the drive and the paperwork.

Is hip bursitis the same as hip arthritis?

No. Hip bursitis hurts on the outside point of the hip. Hip arthritis hurts deep in the groin. They can happen together, and the exam tells them apart.

Can I sleep on my side with hip bursitis?

Sleep on the other side with a pillow between your knees, or on your back. Lying on the sore side presses the tendon against the bone.

Will walking make hip bursitis worse?

Normal walking is usually fine and helps. Long climbs, steep stairs and standing on one hip are what flare it.

Can hip bursitis come back?

It can, if the habits that squeeze the tendon come back. Keeping the side hip muscles strong is the best protection.

Does insurance cover PRP for hip bursitis?

Most plans do not. That is a choice about what the plan funds, not a verdict on the treatment. HSA and FSA funds can generally be used.

How long does hip bursitis take to heal?

With the right rehab, many people improve over two to three months. A frayed tendon that has hurt for years can take longer.

Related reading

• Hip pain
• Sciatica
• Sacroiliac joint pain
• Patellar tendonitis
• Sleep, movement and chronic pain
• Every orthobiologic we offer, and where each one goes