Hip Bursitis: Symptoms

Hip bursitis causes pain at the bony point of the hip that extends to the outside of the thigh. The American Academy of Orthopaedic Surgeons describes it as usually worse at night, when lying on the affected hip, and when getting up from a chair after being seated for a while.

The pain pattern, as described by the AAOS

• Worse at night, and specifically when lying on the affected side.
• Worse getting up from a chair after sitting for a stretch.
• Worse with prolonged walking, stair climbing, or squatting.
• Tender to direct touch over the greater trochanter, the bony bump on the outside of the hip.

The reason night is the worst part is mechanical: lying on that side presses directly on the inflamed sac. Switching sides or putting a pillow between the knees takes the load off.

Two bursae, two locations

The AAOS names both. The trochanteric bursa covers the greater trochanter and is the one behind the classic outer-hip pain most people mean by hip bursitis. The iliopsoas bursa sits in the groin and produces pain there instead — same condition, different address.

Risk factors, and one that is missing

What the AAOS lists: repetitive stress or overuse injury, such as running, stair climbing, cycling or standing for long periods; hip injury from a fall or a direct blow or lying on one side for an extended time; spine disease, including scoliosis and arthritis of the lower spine; leg-length inequality; a tight iliotibial band; rheumatoid arthritis; previous hip surgery; and bone spurs or calcium deposits in the tendons that attach at the trochanter.

What is not on it: being sedentary. Inactivity is often given as a cause of hip bursitis, but neither the AAOS, nor StatPearls, nor MedlinePlus lists it. The pattern those sources describe is pressure, overuse and mechanical loading. The same holds for bursitis elsewhere — see bursitis symptoms for the general picture, and knee bursitis: symptoms for the joint where kneeling pressure makes the mechanism most obvious.

How it is treated

Nonsurgical care first: activity modification, anti-inflammatory medicines, physical therapy, and a corticosteroid injection into the bursa if needed. Surgery to remove the bursa is rarely necessary and, when done, is typically an outpatient procedure.

When to see an orthopedist

Seek evaluation if the pain persists beyond a few days, repeatedly disrupts sleep, or limits normal walking. Redness, warmth over the hip, or fever suggest an infected bursa and call for faster attention.

This content is informational and does not replace a medical consultation, diagnosis, or treatment.