Age
Most prevalent in the fourth to sixth decades of life.
Gender
More common in women than men.
Onset
Usually develops gradually, linked to overloading, tendon problems in the hip abductors, or tightness in the iliotibial band, rather than a single injury.
Gluteal tendinopathy
Wear and degeneration of the gluteus medius and minimus tendons where they attach to the hip, without an actual tear. Usually caused by overuse, sudden increases in activity, or repeated compression of the tendons against the bone.
Gluteal tendon tears
A partial or complete tear in one of these tendons, causing weakness in the hip as well as pain.
Bursal inflammation
Inflammation of the small fluid-filled sacs (bursae) that cushion the hip. This can contribute to symptoms, though it's now understood to be less often the main cause than previously thought.
Iliotibial band tightness
A tight IT band (the band of tissue running down the outside of the thigh) increases pressure on the tendons and bursae underneath it.
Biomechanical factors
Things like running technique, muscle imbalances around the hip, one leg being longer than the other, or poor hip alignment during movement can all increase strain on the area.
Lateral hip pain
Pain on the outside of the hip, over the prominent bony point on the outer side of the upper thigh (the greater trochanter). This location distinguishes it from the deep groin pain of FAI, dysplasia, and hip arthritis.
Pain lying on the affected side
One of the most characteristic and disruptive features, frequently causing night pain and disrupted sleep.
Pain walking, particularly climbing stairs
Loading the hip abductor tendons under the body's weight aggravates symptoms.
Tenderness over the greater trochanter
Pressing on this spot typically reproduces the pain, a key sign used to identify the condition.
Pain sitting with legs crossed
This position stretches the iliotibial band over the greater trochanter.
Clinical assessment
In most cases, the pattern of pain and tenderness found on examination is enough to make a diagnosis.
Ultrasound or MRI
Used to confirm the diagnosis, or when a tendon tear is suspected.
Excluding other causes
At OI, we also check for conditions that can cause similar symptoms, particularly pain referred from the lower back, or an underlying problem within the hip joint itself.
Load management and physiotherapy
The first-line and most important treatment. This involves reducing provocative loading (activities that compress the tendons, such as lying on the side, crossing the legs, sitting low, or running with excessive trunk lean) combined with progressive hip abductor strengthening. Published evidence supports structured tendinopathy rehabilitation programmes as the most effective long-term treatment.
Corticosteroid injection
Ultrasound-guided injection of corticosteroid into the trochanteric bursa provides meaningful, often rapid symptom relief, particularly useful for severe or sleep-disrupting pain that is preventing participation in physiotherapy. At OI, injections are performed under ultrasound guidance for precision and safety.
PRP injection
For chronic hip bursitis that hasn't responded to other treatments, or where there's significant tendon damage, platelet-rich plasma (PRP) injection may be considered as an alternative to corticosteroid. This treatment uses growth factors taken from your own blood to help the tendon heal.
Tendon repair
For patients with confirmed, significant gluteal tendon tears that have not responded to non-surgical management, surgical tendon repair may be appropriate.
Hip replacement
Where underlying hip joint disease is contributing to symptoms, a hip replacement may be the relevant treatment.
