Trochanteric Bursitis: Non-Invasive Hip Care
Trochanteric bursitis is pain over the greater trochanter, the bony point on the outer hip. Current understanding treats it largely as a tendon problem involving the gluteal tendons rather than pure inflammation of the bursa, which is why the broader term greater trochanteric pain syndrome is now often preferred for it.
Compression is the characteristic aggravator: lying on that side, climbing stairs, crossing the legs, or standing with the weight shifted onto that hip. Direct pressure over the spot reproduces it. Sleeping on the other side with a pillow between the knees prevents the upper leg dropping across and compressing the tendon overnight, and gluteal strengthening is what keeps it settled afterward.
Key Takeaways
- Usually a tendon problem: in most cases labeled trochanteric bursitis, the gluteal tendons show more change than the bursa (Grimaldi and Fearon, 2015).
- Compression keeps it going: side-lying, crossed legs, low seats and hanging on one hip press the tendon against the bone.
- Exercise and education first: a graded loading program with changes to daily positions is the main treatment, with injections and surgery a last resort.
What Trochanteric Bursitis Is
The greater trochanter is the bony prominence on the outer side of the upper thigh bone. The gluteus medius and minimus tendons attach to it, and a bursa, a small fluid-filled sac, lies over it to reduce friction. Pain in this area was traditionally called trochanteric bursitis. Imaging studies have since shown that the tendons are usually the main source, so the condition is now often called greater trochanteric pain syndrome or gluteal tendinopathy.
Arranging an Outer Hip Assessment at CSC
To arrange an assessment of outer hip pain, see the Bukit Damansara contact page and the Bandar Sri Damansara contact page, or call either center directly:
- Bukit Damansara (KL, main center): Call +603 2093 1000 or WhatsApp +60 17 269 1873 to see the Bukit Damansara / KL center.
- Bandar Sri Damansara (KL): Call +603 6262 5777 or WhatsApp +60 12 455 6939 to see the Bandar Sri Damansara center.
Symptoms
- Pain and tenderness on the point of the outer hip.
- Pain lying on the affected side, and sometimes on the other side if the top leg drops across.
- Pain with stairs, walking uphill, standing on one leg, or getting up from a low chair.
- Pain that can spread down the outside of the thigh, which is sometimes mistaken for sciatica or pain from the lower back.
Who Develops It and Why
Outer hip pain of this kind is most common in women in mid-life and later, and in people whose daily positions or activities compress the outer hip. It can follow a sudden increase in walking, running or stair climbing, a fall onto the side of the hip, or long periods of sitting with the legs crossed. It is more common in people who also have lower back pain or knee or hip osteoarthritis, and after hip surgery.
Weakness of the hip abductor muscles, and positions that bring the thigh across the midline, both increase the compression of the tendons against the bone.
How It Is Assessed
The assessment usually confirms the diagnosis clinically: tenderness over the greater trochanter, pain on standing on one leg, and pain with specific resisted hip movements. The hip joint, the lower back and the sacroiliac region are examined as well, because each can cause pain in a similar area.
Imaging is not always needed. Ultrasound or MRI can show tendon and bursa changes where the diagnosis is unclear, and X-rays are used when a fracture or hip joint arthritis is suspected.
Conditions That Often Occur Alongside It
Trochanteric pain often coexists with lower back problems, including disc problems, and with hip or knee osteoarthritis. Where the history suggests these, the assessment looks at them too, and an MRI may be considered if it would change the plan.
How It Is Managed at CSC
At CSC, physiotherapy and chiropractic treatment are planned together around what is compressing the tendon and how irritable it currently is. A typical plan includes:
- Education on the compressive positions and practical changes to sleep, sitting and standing.
- A graded exercise program for the hip abductors and gluteal tendons, progressed as symptoms allow.
- Non-rotatory chiropractic care for the lower back and pelvis where the examination points there.
- Pain-relief methods such as ultrasound or interferential current, used as short-term additions to exercise rather than on their own.
In a randomized trial of people with gluteal tendinopathy, education plus exercise produced more global improvement than a corticosteroid injection at eight weeks and at one year; the injection helped more than waiting in the short term (Mellor et al., 2018). Injections and surgery are therefore a last resort, considered when a properly conducted program has not helped.
How This Is Told Apart From the Other Causes of Outer Hip Pain
Pain on the outside of the hip has a short list of causes, and they are distinguishable at the first visit with a careful examination.
- Gluteal tendinopathy, the usual culprit. Tender to press directly on the bony point, worse lying on that side at night, worse after sitting low or standing on one leg.
- Hip joint osteoarthritis. Pain in the groin rather than the outer hip, restricted rotation on examination, stiffness first thing in the morning.
- Referred pain from the lower back. No local tenderness over the bone, symptoms changed by back movement, and often a band of pain down the outside of the thigh.
- Sacroiliac or pelvic sources. Pain closer to the back of the pelvis, provoked by single-leg loading and transfers.
- A stress fracture, in a runner or an older adult with low bone density. Pain in the groin, worse with every step, not relieved by rest positions. This needs imaging, not a program.
The name bursitis has stuck, but imaging studies have repeatedly found tendon change rather than an inflamed bursa in most of these cases, which is why the plan is a tendon plan. Our page on greater trochanteric pain syndrome goes into the trial evidence in more depth.
The Sleep and Sitting Setup That Changes This Fastest
The tendon here is irritated by compression against the bone, which happens whenever the thigh crosses the midline. Three changes address most of it:
- Sleeping. On the unaffected side with a pillow between the knees and ankles, so the top leg does not drop across. On the back is better still if you can manage it.
- Sitting. No crossed legs, knees roughly hip width apart, and a seat high enough that the hips are not below the knees. Low sofas and low car seats are the common offenders.
- Standing. Weight through both feet rather than hanging on one hip. People do this while queueing, cooking and carrying a child, and it is the position that reproduces the pain most reliably.
Two to three weeks of that, alongside graded hip abductor loading, is where most of the early change comes from.
When Outer Hip Pain Needs Medical Assessment
- Inability to bear weight, or pain in the groin with every step, particularly after a fall or in anyone with osteoporosis.
- A hot, swollen hip with fever.
- Night pain that is unrelenting rather than position related, unexplained weight loss, or a history of cancer.
- Loss of bladder or bowel control needs same-day medical attention. Progressive weakness, a foot that drags should not be ignored; it should be assessed promptly by a competent provider, and conservative care may still be a reasonable route depending on what that assessment finds.
For planning, the chiropractic price list in Kuala Lumpur and physiotherapy fees in Kuala Lumpur pages set out what each visit costs.
Peer-Reviewed Medical References
- Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. 2018;361:k1662.
- Grimaldi A, Fearon A. Gluteal tendinopathy: integrating pathomechanics and clinical features in its management. J Orthop Sports Phys Ther. 2015;45(11):910-922.
- Lustenberger DP, Ng VY, Best TM, Ellis TJ. Efficacy of treatment of trochanteric bursitis: a systematic review. Clin J Sport Med. 2011;21(5):447-453.
- Reid D. The management of greater trochanteric pain syndrome: a systematic literature review. J Orthop. 2016;13(1):15-28.
- Gollwitzer H, Opitz G, Gerdesmeyer L, Hauschild M. Greater trochanteric pain syndrome. Orthopade. 2014;43(1):105-116.
- Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 2009;108(5):1662-1670.
The Author of Trochanteric Bursitis: Outer Hip Pain Explained
Trochanteric Bursitis: Outer Hip Pain Explained was written by Yama Zafer, D.C., a graduate of Cleveland University - Kansas City with 30+ years in chiropractic and physiotherapy.
Last Updated: Trochanteric Bursitis: Non-Invasive Hip Care
Trochanteric Bursitis: Non-Invasive Hip Care was last reviewed and updated on September 25, 2026.
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