Hip Bursitis

Information About a Common Cause of Hip Pain

hip bursitis
Hip bursitis causes pain over the outside of the hip. Jeannot Olivet / Getty Images

Hip bursitis is a common problem that causes pain over the outside of the upper thigh and hip joint. A bursa is a fluid filled sac that allows smooth motion between two surfaces. For example, in the hip, a bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the firm tendon that passed over this bone. When the bursa becomes inflamed, each time the tendon has to move over the bone, pain results.

Because patients with hip bursitis move this tendon with each step, symptoms of this condition can be quite painful.

Causes of Hip Bursitis

Hip bursitis can be associated with different types of patients:

  • Athletes
    Hip bursitis is commonly seen in runners or athletes who participate in running-oriented sports (e.g. soccer, football, etc.).
  • Injuries
    Hip bursitis is sometimes associated with patients who fall onto their upper thigh, causing a so-called traumatic bursitis. The symptoms are similar to a hip pointer.
  • Post-surgical
    Patients who have had surgery, such as hip fracture surgery or hip replacement, may complain of pain over the outside of the hip. These symptoms are often due to irritation to the bursa causing hip bursitis.

Diagnosis of Hip Bursitis

The diagnosis of hip bursitis is made most reliably on physical examination. The most common symptoms of hip bursitis include:

  • Tenderness over the bony prominence of the upper/outer thigh
  • Swelling over the bursa
  • Difficulty sleeping on the affected side

Most people find there are specific activities that aggravate their symptoms. These may be sports or exercise-related activities. In addition, many people with hip bursitis complain of difficulty sleeping on the affected side at night. While it is easy to recommend that people not sleep on the affected side, it can be difficult to control, especially for people who are side sleepers--often they don't even realize they're on their side until they wake up in discomfort from aggravation of their bursitis.

An x-ray is often obtained to ensure there are no bone spurs or calcifications that could be contributing to the problem. Occasionally, your doctor may obtain an MRI if the diagnosis is unclear or if the problem does not resolve with initial treatment.

As with any medical condition, other problems that can cause similar symptoms should be considered. Hip bursitis is usually a clear diagnosis, and the symptoms can be distinguished from other conditions. However, some cases of hip bursitis can be confused with other medical conditions. These include:

These are the most common causes of pain over the upper/outer thigh, other than hip bursitis. Other causes of pain in this area include hip joint problems, such as hip arthritis and labral tears, but these problems usually cause symptoms in areas other than the outside of the thigh.

Treatment of Hip Bursitis

Treatment of hip bursitis usually begin with some simple steps, and progresses depending on the individual's response to these treatments.

Most people can find relief from their symptoms with noninvasive treatments for hip bursitis. However, some people have challenges curing their symptoms of hip bursitis, and may require more invasive treatments.

The usual course of treatment begins with avoidance of activities that cause increased of symptoms. This may mean avoiding a specific sports or exercise activity, or at least limiting the amount, or something as simple as not lying on your side at night. Other simple steps include ice application to the hip, anti-inflammatory medications, and a home stretching program. Many times working with a physical therapist can help with an exercise and stretching program, and help ensure that the problem does not become recurrent. A cortisone shot is also a frequent treatment for hip bursitis. However, I always advise my patients to also do the stretching program in addition as the cortisone shot is only likely to relive symptoms transiently. If combined with other treatments, the cortisone injection may lead to more lasting relief.


Paluska SA. "An overview of hip injuries in running. " Sports Med. 2005;35(11):991-1014.

Fox JL. "The role of arthroscopic bursectomy in the treatment of trochanteric bursitis." Arthroscopy. 2002 Sep;18(7):E34.

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