Symptoms
How it tends to show up
Pain and tenderness over the bony outer hip; pain lying on that side at night; aching with stairs, walking, or standing from sitting; pain that can spread down the outside of the thigh; stiffness getting going after rest.
How Common
You're not alone in this
That nagging pain on the outside of your hip is one of the most common hip complaints adults bring in, and it affects women far more often than men — studies estimate it touches roughly 15% of women and 8% of men, with most cases showing up between ages 40 and 60. Here is what I want you to hear first: this is a well-understood, mostly soft-tissue problem, and the large majority of people get better with conservative care. You are not dealing with something rare or mysterious — and most people improve without surgery.
The Root
Why it keeps coming back
Outer-hip pain is usually a load-and-control problem. When the deep hip and glute muscles aren't doing their job, the tendons and bursa on the outside of the hip get compressed and overloaded with every step. Cortisone or rest can quiet it, but if the hip control isn't restored the irritation returns.
Who Gets It
Common risk factors
- Female, especially ages 40 to 60
- Higher body mass index (linked to roughly 3x the incidence)
- Weak hip abductor and gluteal muscles
- A leg-length difference between the two sides
- Repetitive running, walking, or stair climbing
- Sleeping or leaning consistently on one hip
- Sudden ramp-up in activity or mileage
- Prior hip surgery, low back pain, or arthritis nearby
Look-Alikes
Is it Hip Bursitis, or something else?
Several other problems can mimic this, and they're managed differently — so part of the assessment is telling them apart.
Wondering if this is what's going on — and what care would look like?
Book an Assessment →The Approach
How Dr. Imada approaches it
Using Advanced Muscle Integration Technique (AMIT), I restore the deep hip and glute muscles that should be controlling the hip, taking the compressive load off the outer-hip tissues. Chiropractic care helps the pelvis and low back move evenly, and Foundation Training rebuilds hip strength. This is what I consistently see help — offered as insight, not a guarantee.
Getting Answers
How it's assessed
Clinically, I assess this by reproducing your pain with direct pressure over the bony point on the outside of your hip (the greater trochanter) and with resisted hip movements — and importantly, by watching how your whole kinetic chain is loading. Here is a common myth worth clearing up: most "hip bursitis" today is now understood as Greater Trochanteric Pain Syndrome, where the real driver is usually the gluteal tendons rather than a swollen bursa — true bursal inflammation shows up in only a fraction of cases. What I consistently see is that the tendons and bursa get irritated because the hip abductors switched off and the pelvis lost stability, so the side of the hip absorbs load it was never meant to. That is why I look up and down the chain — at your core, glutes, and even leg length — rather than only at the spot that hurts.
Your Visit
What to expect
An assessment of the hip, pelvis, and how you load it walking; a clear read on what's overloading the outer hip; hands-on care to restore control; and a loading plan to keep it settled.
At Home
What you can do yourself
- Avoid lying on the painful side; place a pillow between your knees
- Ease off running, stairs, and long standing for now
- Use ice on the bony point after activity that flares it
- Avoid crossing your legs or standing hipshot on one side
- Start gentle hip-abductor strengthening once pain allows
- Check your shoes and walking surfaces for one-sided loading
These steps calm the irritation at home, but they work best alongside restoring the hip stability and gluteal strength that let the area get overloaded in the first place.
Outlook
Recovery & realistic timelines
Here is the honest timeline: this is usually not a quick fix, and most people need 3 months or longer for symptoms to fully settle — but the outlook is genuinely good, with conservative (non-surgical) care succeeding in over 90% of cases. The catch is recurrence: when the underlying pattern is not addressed, the pain tends to come back, and outcomes are tougher when arthritis is also present. My aim is to shorten that arc — and reduce the odds of relapse — by rebuilding the hip and core stability that quietly failed, not just waiting for the irritation to fade.
Staying Ahead
Keeping it from coming back
- Keep your glutes and hip abductors strong
- Increase mileage and intensity gradually
- Avoid habitually leaning on one hip
- Address any leg-length or gait imbalance
- Maintain a healthy body weight
- Warm up and ease into new activities
Related
Related conditions
FAQ
Common questions
Is it actually a bursitis?
Often not in the way the name suggests. Most cases are now classified as Greater Trochanteric Pain Syndrome, where irritated gluteal tendons — not just a swollen bursa — drive the pain.
Will it come back?
It can, if the underlying weakness and load pattern aren't addressed — which is exactly why we strengthen the hip and look up the chain rather than only at the sore spot.
Do I need an MRI?
Usually not at first. I can assess most cases clinically; imaging is reserved for ruling out a tendon tear or arthritis when things don't respond as expected.
Do I need surgery?
Very rarely. Surgery is typically only considered after 6 to 12 months of conservative care has failed, and that decision belongs with an orthopedic surgeon.
Why does lying on that side hurt so much?
Direct pressure compresses the already-irritated tendons and bursa against the bone. A pillow between your knees and switching sides usually helps right away.
Should I just rest until it goes away?
Some relative rest helps calm a flare, but pure rest rarely fixes it — the weak, switched-off muscles that caused the overload need to be retrained.
Can chiropractic care help hip bursitis?
What I consistently see is that addressing pelvic alignment, gluteal activation, and the whole kinetic chain takes load off the irritated tissue so it can finally calm down.
Is a cortisone shot the answer?
It can relieve pain quickly, but the literature links it to a higher chance of the problem returning over time, so I prefer to address the cause first — and that decision is one to make with your physician.
Could this pain be coming from my back instead?
It can. Low-back and nerve issues sometimes refer pain to the hip, which is one reason I examine the whole chain rather than assuming the problem is only where it hurts.
Dr. Imada is trained in Advanced Muscle Integration Technique (AMIT), the CHEK Institute holistic lifestyle program, Foundation Training, and Nasal Specific — care that looks at the whole person, not just the spot that hurts.
This page is for education and is not a substitute for in-person diagnosis or treatment. Care described reflects Dr. Imada's clinical experience and current literature; individual results vary.