Introduction
Hip care · Outer hip pain
Outer hip pain
Specialist orthopaedic surgeon · hip problems
Dr Sean LeoOrthopaedic Surgeon, Singapore
Clinic enquiries · Not an emergency service
Illustrative image
Pain at the outside of the hip is often the tendons and the bursa together, and treatment starts without surgery.
Pain at the outside of the hip is often the tendons and the bursa together, and treatment starts without surgery.
Pain at the outside of the hip is often the tendons and the bursa together, and treatment starts without surgery.
- Outer hip pain is the everyday name for pain at the outside of the hip, over its bony point. Doctors may call it greater trochanteric pain syndrome (GTPS), or gluteal tendinopathy when the tendons are involved. The older name is hip bursitis.[5]
- The cause is often the tendons and the bursa together, over the bony point of the hip.[2]
- The initial treatment does not involve surgery, and surgery is rarely needed.[1]
- OrthoKinetics is Dr Sean Leo’s professional brand. Clinical care is provided through OrthoSports Orthopaedic & Sports Surgery. Dr Sean Leo is a specialist orthopaedic surgeon who cares for hip problems.
What’s covered on this webpage
Follow the route in order, or jump to the stop you need. Stops you have read are marked.
The point of the hip is where the gluteal tendons and a cushioning sac sit.
The point of the hip is where the gluteal tendons and a cushioning sac sit.
The point of the hip is where the gluteal tendons and a cushioning sac sit.
The pain of outer hip pain is felt over the bony point of the hip bone, called the greater trochanter.[1]
A bursa covers that point. Bursae are small, jelly-like sacs that hold a little fluid and sit between bones and soft tissues, acting as cushions that help reduce friction during joint motion.[1] Inflammation of the bursa over the greater trochanter is called trochanteric bursitis.[1]
The gluteal tendons attach around the same point, and the bursa and the tendons are often affected together.[2]
The different names for outer hip pain
- Outer hip pain: the everyday name for pain at the outside of the hip.
- Trochanteric bursitis: inflammation of the bursa that covers the bony point of the hip.[1]
- Gluteal tendinopathy: a problem of the gluteal tendons at the same point.[2]
- Greater trochanteric pain syndrome (GTPS): the name often used when bursitis and gluteal tendinopathy occur together, with pain at the side of the hip over the greater trochanter.[2]
- Hip bursitis: the older name for the same region.[5]
These are names for pain in one region, and this page uses “outer hip pain” for all of it.
It is more common in women and in middle-aged or older people, and several factors are linked with it.
It is more common in women and in middle-aged or older people, and several factors are linked with it.
It is more common in women and in middle-aged or older people, and several factors are linked with it.
Outer hip pain can affect anyone, but it is more common in women and in middle-aged or older people. It is less common in younger people and in men.[1]
Several things have been associated with it. These are risk factors, not proven single causes.[1]
The factors linked with outer hip pain
- Overuse. This can happen when running, climbing stairs, cycling or standing for long periods.[1]
- A knock to the point of the hip. This can be a fall onto the hip, a bump, or lying on one side of the body for an extended period.[1]
- A tight iliotibial (IT) band.[1]
- A significant difference in leg length, which affects the way you walk and can lead to irritation.[1]
The main symptom is pain at the point of the hip, often worse when lying on it.
The main symptom is pain at the point of the hip, often worse when lying on it.
The main symptom is pain at the point of the hip, often worse when lying on it.
The main symptom is pain at the point of the hip. The pain typically extends to the outside of the thigh.[1]
In the early stages the pain is often described as sharp and intense. Later it may become more of an ache and spread across a larger area of the hip.[1]
Typically the pain is worse at night, when lying on the affected hip, and when getting up from a chair after being seated for a while. It may also get worse with prolonged walking, stair climbing or squatting.[1]
These are typical patterns, not a checklist. They do not diagnose the condition on their own.
Is outer hip pain the same as hip arthritis
Is outer hip pain the same as hip arthritis
Is outer hip pain the same as hip arthritis?
Outer hip pain and hip arthritis are different problems, and an assessment helps tell them apart. One question a clinician can use is whether putting on shoes and socks is difficult.[5] An X-ray can be used to exclude osteoarthritis of the hip as another cause.[5]
The hip osteoarthritis page covers hip arthritis.
When should this be assessed?
When should this be assessed?
When should this be assessed?
If you are not sure what is causing pain at the outside of your hip, an assessment is how to find out. It cannot be done reliably from a description on a webpage. The next section explains what it involves.
A hip problem that follows a fall, or one where you cannot put weight on your leg, is a different situation. The hip fracture page covers it.[6][7]
How is outer hip pain assessed?
How is outer hip pain assessed?
How is outer hip pain assessed?
Assessment has three parts: your story, an examination, and imaging where it helps.
Your story. People commonly describe lateral hip pain, localised over the bony point of the hip, that is worse with weight-bearing activities and when lying on that side at night.[5] The clinician asks about what the pain is like, what brought it on and what makes it worse. A simple question, whether putting on shoes and socks is difficult, helps tell outer hip pain from hip osteoarthritis.[5]
The examination. The doctor carries out a physical examination, looking for tenderness over the bony point of the hip.[1] No single test is enough on its own, so a combination of tests is used.[5]
The bedside tests in a little more detail
In general practice two tests that can be used are direct palpation of the greater trochanter and the single leg stance test, which asks whether pain starts within 30 seconds of standing on one leg. Other tests that put the gluteal tendons under tension can be added.[5]
These are tests a clinician carries out. They are not self-tests.[5]
Imaging. Outer hip pain is a clinical diagnosis, which means it is made from your story and an examination. In persistent cases or when the picture is mixed, imaging can be used to exclude other causes and to confirm the diagnosis.[5] A hip X-ray is a useful first test. It is typically normal when the symptoms and signs of outer hip pain are present, but it can exclude other common causes, including osteoarthritis of the hip and fractures.[5] Ultrasound and MRI are useful second-line tests to confirm the diagnosis.[5]
MRI changes are common in people who have no symptoms, so a result has to be read together with your examination.[5]
Treatment starts without surgery, and education plus exercise is an effective approach.
Treatment starts without surgery, and education plus exercise is an effective approach.
Treatment starts without surgery, and education plus exercise is an effective approach.
The initial treatment for outer hip pain does not involve surgery.[1] Surgery is rarely needed.[1]
One treatment tested in a randomised trial is a physiotherapy-led programme of load-management education plus exercise.[3] In that trial of people with gluteal tendinopathy, the results supported education plus exercise as an effective management approach.[3]
An injection of corticosteroid was one of the comparison groups in the trial. It also helped, compared with no treatment, but education plus exercise performed better than the injection.[3] At 52 weeks, education plus exercise led to better overall improvement than the injection, with no difference in pain intensity between the two.[3]
What the trial compared, in more detail
The trial had three groups: education plus exercise, a corticosteroid injection, and a wait-and-see approach with no treatment.[3]
At 8 weeks, education plus exercise and the injection both led to higher rates of patient-reported global improvement and lower pain intensity than no treatment. Education plus exercise performed better than the injection.[3]
At 52 weeks, education plus exercise led to better global improvement than the injection, but there was no difference in pain intensity.[3]
Which exercises suit you is worked out at assessment.
Structure / Patient / Goal
Structure / Patient / Goal
Deciding together
Structure / Patient / Goal
S
Structure: what is affected?
Structure is what is affected at the side of the hip: the gluteal tendons and the bursa over the bony point, and what the assessment shows.
P
Patient: how does it affect you?
Patient means you as a whole person. Your pain, including at night, how active you are, your sleep, your general health and your preferences all shape which options are reasonable.
G
Goal: what are you hoping to return to?
Goal is what matters to you, whether that is sleeping on that side, walking, taking the stairs, or something more specific. A useful plan starts from a clear purpose.
Your plan
No single factor decides the plan alone, and one scan or one symptom does not determine it.
Recovery takes time, and how long depends on the cause.
Recovery takes time, and how long depends on the cause.
Recovery
Recovery takes time, and how long depends on the cause.
In the trial, improvement was measured at 8 weeks and again at 52 weeks.[3] NHS Inform says the condition can often take 6 to 12 months of rehabilitation to settle, but this will depend on the cause.[4]
These are trial measurement points and patient-information guidance. They are not a promise for any one person.
Risks and limitations of treatment
Risks and limitations of treatment
Risks and limitations of treatment
The exercise programme. It is not a quick fix. NHS Inform says it is normal to have flare-ups during rehabilitation. If that happens, it may be best to reduce the repetitions or rest for a few days before starting again.[4]
If the exercises cause a large increase in your pain, or your day-to-day symptoms are not improving, seek further advice.
A corticosteroid injection. Injections may not cure the condition. They are used to help with the pain.[4] A review of the evidence notes that corticosteroid injections provide effective short-term pain relief, although at 12 months clinical trials show no difference in outcome compared with a watch-and-wait approach.[5]
OrthoKinetics Recovery Reflection
Recovery reflection
If the pain is loudest when you are trying to rest, what changes when you stop arguing with it in the dark?
For some people, pain is loudest at night, when they are trying to rest. In the dark it can feel bigger, and a guess made at 3am can feel like a fact. It is hard work to argue with a fear at that hour. It can help to carry the question into daylight instead, to describe it plainly and ask for it to be properly understood.
What would it mean to let an honest picture take the place of a 3am guess?
An honest picture is one put together in daylight: what is known, what is still being worked out, and what you would like to do next. It can sit alongside the pain without pretending the pain is not there.
A 3am guess is only a guess, and daylight can give it an honest shape.
Illustrative image
With you through the seasonsMeet Dr Sean Leo
Meet Dr Sean Leo
A consultant orthopaedic surgeon whose clinical focus is the knee, sports injuries and the lower limb.
- Dr Sean Leo is a consultant orthopaedic surgeon. OrthoKinetics is his professional brand; clinical services are provided through OrthoSports Orthopaedic & Sports Surgery at Mount Elizabeth Novena Specialist Centre and Connexion, Farrer Park Hospital.
- His clinical interests include sports injuries, including those in adolescent athletes; ligament reconstruction; realignment surgery; cartilage repair and joint-preservation approaches; knee replacement; and technology-assisted hip and knee surgery.
- The consistent aim is to return people to meaningful function and activity while avoiding unnecessary downtime.
- Qualifications: MBBS, MRCS (Ed), MMed (Ortho), FRCSEd (Ortho).
More detail: Meet Dr Sean Leo
- Training and career: Dr Leo trained in medicine at the National University of Singapore and served in the Singapore Armed Forces Medical Corps from 2000 to 2012, where his work included the care of soldiers in physically demanding roles. He completed postgraduate orthopaedic training in 2009 and a one-year clinical fellowship at Royal North Shore Hospital in Sydney, Australia, before joining Changi General Hospital as an orthopaedic consultant in 2012, where he later held the positions of Senior Consultant and Director of the Hip and Knee Service. With seniority, his educational contribution has evolved towards mentorship and support for junior doctors.
Questions people often ask
Common outer hip pain questions
Common outer hip pain questions
What causes pain on the outside of the hip?
The cause is often the tendons and the bursa together, over the bony point of the hip. Outer hip pain can affect anyone but is more common in women and in middle-aged or older people. Overuse and a knock to the point of the hip are among the factors linked with it, and none is a proven single cause.[1][2]
Is hip bursitis the same as gluteal tendinopathy?
Hip bursitis is the older name for pain over the bony point of the hip.[5] Bursitis is inflammation of the bursa there, and gluteal tendinopathy is a problem of the tendons. They often occur together, and together they are often described as greater trochanteric pain syndrome.[1][2]
Why does my hip hurt when I lie on my side?
Pain that is worse at night, when lying on the affected hip, is typical of outer hip pain. It is also typically worse when getting up from a chair after sitting for a while. On its own it does not diagnose the condition, so an assessment is how to find out.[1]
Can outer hip pain be treated without surgery?
The initial treatment for outer hip pain does not involve surgery, and surgery is rarely needed. In a randomised trial, a physiotherapy-led programme of load-management education plus exercise was supported as an effective management approach for gluteal tendinopathy.[1][3]
What is greater trochanteric pain syndrome?
Greater trochanteric pain syndrome, or GTPS, describes pain at the side of the hip, over the greater trochanter, the bony point of the hip. Bursitis there and gluteal tendinopathy often occur together, and this is often described as greater trochanteric pain syndrome.[1][2]
What exercises help outer hip pain?
The approach with trial support is a physiotherapy-led programme of load-management education plus exercise. In the trial, at 52 weeks it led to better overall improvement than a corticosteroid injection. Which exercises suit you is worked out at assessment.[3]
Is outer hip pain the same as hip arthritis?
They are different problems, and an assessment helps tell them apart. A clinician can ask whether putting on shoes and socks is difficult, and an X-ray can be used to exclude osteoarthritis of the hip as another cause. The hip osteoarthritis page covers hip arthritis.[5]
Do I need a scan for outer hip pain?
Outer hip pain is a clinical diagnosis, made from your story and an examination. In persistent cases or when the picture is mixed, imaging can be used to exclude other causes and confirm the diagnosis. A hip X-ray is a useful first test, and ultrasound and MRI are second-line tests.[5]
Costs and insurance
Costs and insurance
Practicalities
Cost, Medisave and insurance
Ask the clinic team for current information about fees, panel status, pre-authorisation and expected payment arrangements. Insurance coverage and out-of-pocket costs depend on the individual policy and the insurer’s decision; no coverage is guaranteed.
A cost estimate for surgery can be given only after a consultation and assessment, once a surgical plan has been developed. Each individual condition is unique — implants used, time taken, and other factors contribute to the overall estimate. The estimate will be provided to you by the clinic should you decide on surgical management, and will also be used to assist in obtaining pre-authorisation from insurance where applicable.
Insurance panels. Dr Sean Leo, Orthopaedic Surgeon, is on the specialist panels of Great Eastern (GE Panel), HSBC Life (HSBC Life Shield) and Singlife (Singlife Shield), and on the Prudential Panel. AXA Insurance Singapore became part of HSBC Life in 2023, and former AXA Shield plans are now HSBC Life Shield plans.
Corporate health plans. Dr Leo is on the panels of both Alliance Medinet and iXchange, which administer medical benefits for many company health plans. If your company plan uses either panel, you can see Dr Leo as a panel doctor.
If your company uses a different panel. Some company plans still let you see a doctor of your choice outside their panel, then claim reimbursement. This varies from plan to plan, as may the co-payment, so please check your benefits with your company’s HR department.
Panel arrangements change from time to time, so please confirm with your insurer or your company’s plan administrator before your appointment.
Dr Leo is on the panels shown. If your insurer is not listed, you may ask whether co-management with an Orthosports surgeon partner on that panel is clinically and administratively appropriate. Orthosports surgeon partners are collectively on the panels of all Shield plans.
Specific benefits, pre-authorisation, reimbursement and cashless treatment depend on the individual policy and insurer approval and are not guaranteed.
Arrange a consultation: the appointment section is further down this page.
Sources
References
References
- American Academy of Orthopaedic Surgeons (AAOS). Hip Bursitis. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases–conditions/hip-bursitis
- O’Rourke R, El Bitar Y. Femoroacetabular Impingement. StatPearls. NBK547699. Available at: https://www.ncbi.nlm.nih.gov/books/NBK547699/
- Mellor R, Bennell K, Grimaldi A, Nicolson P, Kasza J, Hodges P, 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. doi:10.1136/bmj.k1662. PMID 29720374. PMCID PMC5930290. Available at: https://www.bmj.com/content/361/bmj.k1662
- NHS Inform. Greater trochanteric pain syndrome. Available at: https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/greater-trochanteric-pain-syndrome
- Speers CJB, Bhogal GS. Greater trochanteric pain syndrome: a review of diagnosis and management in general practice. Br J Gen Pract. 2017;67(663):479–480. doi:10.3399/bjgp17X693041. PMID 28963433. PMCID PMC5604828. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5604828/
- NHS. Broken hip. Available at: https://www.nhs.uk/conditions/broken-hip/ (last reviewed 29 July 2026)
- NHS. Hip pain in adults. Available at: https://www.nhs.uk/symptoms/hip-pain/ (last reviewed 20 November 2025)
Final next step
Final next step
Next step
Final next step
Reading about a problem is a starting point. An assessment brings together the history, an examination where needed and any useful tests, and helps you and your clinician decide what to do next. How much physical examination is needed is a matter of clinical judgement. It may be limited when pain makes an examination unreliable, or when imaging clearly shows a problem that matches the symptoms, such as a fracture seen on an X-ray or an MRI scan that clearly shows an injury consistent with the symptoms. The Singapore Medical Council and the UK General Medical Council both allow remote medical consultations, where a physical examination is not possible, with safeguards: the doctor must be clear about the limits of an opinion formed without an examination, and whether an in-person examination is needed, or referral to other services, is left to the clinical judgement of the attending doctor.
If a hip problem may need urgent attention, such as after a fall or if you cannot bear weight, seek urgent medical care.[6][7]
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