Lateral Hip Pain and GTPS: Why the Side of Your Hip Hurts and What May Help

Lateral hip pain is pain felt on the outer side of your hip and it hurts to lie on that side at night. If you have started sleeping on your back to avoid the discomfort or wedging a pillow between your knees or you realise that you feel pain climbing the stairs and getting out of the car, then this page should be helpful and relevant to you. You may have been told you have bursitis or trochanteric bursitis. That label is outdated because the modern understanding of this condition has changed and the change matters for how it is best managed from a chiropractic perspective.

The updated term for this pattern of pain on the outside of the hip is called greater trochanteric pain syndrome (GTPS) and the encouraging news is that it responds well to a structured, patient approach[1]

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What is greater trochanteric pain syndrome (GTPS)?

The greater trochanter is the bony knob you can feel on the outside of your hip. Your gluteal tendons anchor there with small fluid-filled cushions called bursae nearby. For decades, pain here was called trochanteric bursitis and assumed to be an inflamed bursa. Imaging studies have since shown that an inflamed bursa is the exception rather than the rule and that the usual culprit is gluteal tendinopathy, an irritated and deconditioned gluteus medius or minimus tendon.[2][3]

GTPS is the umbrella term covering all of the above. It is common, particularly in women over the age of 40 and although it can grumble on for months but it is very treatable. Tendons respond to being loaded correctly which is why the strengthening approach I describe below has the strongest evidence behind it.[1]

what causes lateral hip pain

Gluteal tendons dislike two things: too much compression and sudden changes in load. Compression comes from positions that press the tendon against the bone such as sitting with crossed legs, standing with your hip hitched out to one side or lying down on the affected side. Load changes come from routines: a sudden increase in walking or hill work, a new exercise programme or the loss of muscle strength that follows a period of inactivity. Hormonal changes around menopause play a part too, which helps explain why this condition affects women the most. In clinic I regularly see it triggered by something as ordinary as a walking holiday or a new fitness class.

Lady running on a promenade in the sun in an article about lateral hip pain and exercise

Explore our hip and pelvic guides

Hip and pelvic pain: the main guide

Hip and groin

Side of the hip and buttock

Pain in the side of the hip: gluteal tendinopathy, bursitis and GTPS (you are here)
Piriformis syndrome and deep buttock pain

Pelvis and tailbone

Related guides

When hip or buttock pain starts in the back

When the problem shows up further down the leg

Wear and tear, bones and staying active

When sport or training is behind it

Symptoms of lateral hip pain

The symptoms of this type of hip pain that patients describe are an ache or sharp pain over the outer hip bone, often spreading down the outer thigh towards their knee. Lying on the painful side is the classic aggravator and many people say that the night pain often bothers them more than the daytime symptoms. Stairs, hills, standing on one leg to get dressed and getting moving after sitting are the other usual complaints.

a sporty woman holding her hip in the location of the pain from lateral hip pain or GTPS dressed in shorts and a sports top

Patients describe the pain of lateral hip pain as an ache or sharp pain over the outer hip bone, often spreading down the outer thigh towards their knee

Location is the key to telling this apart from other complaints across the hip and pelvic pain spectrum of conditions. Hip joint problems such as hip osteoarthritis hurt in the groin, not the outer hip. Pain that starts in the buttock and travels below the knee with pins and needles points towards the sciatic nerve rather than the gluteal tendons. Whereas burning or numbness over the front and outer thigh has its own explanation, covered in the section below on meralgia paraesthetica.

Burning pain in the outer thigh: meralgia paraesthetica

Some outer hip and thigh pain is not tendon pain at all. Meralgia paraesthetica is irritation of the lateral femoral cutaneous nerve, a purely sensory nerve that passes under the inguinal ligament at the front of the pelvis. It produces burning, tingling or numbness over the front and outer thigh, often worse standing and walking and classically linked with tight waistbands and belts, weight gain and pregnancy.[4] Because it is a sensory nerve, there is no weakness and because the problem is at the front of the pelvis, pressing on the outer hip bone does not reproduce it. Most cases settle with conservative measures starting with removing the compression and looser clothing and it is a condition needing correct diagnosis because it is managed quite differently from GTPS. This is part of a full chiropractic assessment.

How chiropractic care may help lateral hip pain

The best evidence for GTPS supports education plus progressive exercise. The LEAP trial, published in the BMJ, found that an education and exercise programme produced better outcomes at twelve months than either a corticosteroid injection or a wait-and-see approach.[1] That trial is very encouraging because it means you can be proactive and help yourself in recovery alongside treatment and guidance.

My role as your chiropractor is to confirm the diagnosis, settle the irritable early phase with soft tissue work through the gluteals and hip, gentle mobilisation of the hip, pelvis and lower back where they are stiff and then guide you through the two things that matter next: avoiding tendon compression, which is mostly about adjusting positions and your sleeping set-up and a graded gluteal strengthening programme that builds over weeks.

Chiropractic care may help ease symptoms and support that process, though exercise is the driver and the hands-on work supports that. Tendinopathy improves over weeks and months rather than days so expect a chiropractic plan measured in that timescale which is reviewed and adjusted around your own progress.

If pain in the side of your hip is getting in the way of things you would rather be doing, come and talk it through. I offer a free 15-minute consultation, you can come in for a short no-obligation chat with no examination or treatment.

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red flags

Lateral hip pain is almost never a sign of anything serious. Do see a doctor first if the pain follows a significant fall or accident and you cannot take weight, if you have a fever or feel systemically unwell alongside the pain, if the area is hot and swollen or if you have constant, unrelenting night pain in every position combined with unexplained weight loss. In those situations call your GP, 111, or A&E.

For the familiar “can’t lie on that side” pain pattern, assessment at my chiropractic clinic is appropriate.

your first visit to Bournemouth Chiropractic

At your first full chiropractic visit I take a full history, then examine your hip, pelvis and lower back, using specific tests such as single-leg loading and palpation of the greater trochanter to separate gluteal tendinopathy from joint, nerve and spinal causes. You will leave knowing what the problem is and with a plan forward we that have agreed together.

Frequently Asked Questions

Why does my hip hurt when I lie on my side at night?

Hip pain when you lie on your side at night is the hallmark signal of greater trochanteric pain syndrome (GTPS). Lying on the painful side compresses the gluteal tendons directly and lying on the other side stretches them across the bone. A pillow between your knees, keeping the top knee level with your hip, usually helps while treatment progresses.

Can a chiropractor help with lateral hip pain and GTPS?

A chiropractor may help with lateral hip pain and GTPS by confirming the diagnosis, easing symptoms with hands-on care and guiding the education and exercise approach that carries the strongest evidence. In my chiropractic clinic the emphasis sits firmly on progressive gluteal strengthening and load advice with treatment supporting that process.

Is hip bursitis the same as gluteal tendinopathy?

Hip bursitis and gluteal tendinopathy overlap but are not the same. Imaging research shows most outer hip pain once labelled bursitis is actually gluteal tendinopathy with true bursal inflammation being uncommon. Both fall under the umbrella of greater trochanteric pain syndrome and both could respond to the same load-based management.

Should I get a steroid injection for GTPS?

A steroid injection for GTPS can ease pain quickly but the LEAP trial found education plus exercise gave better results at one year. Injections remain an option your GP can discuss with you for severe, stubborn pain and they work best alongside a strengthening programme rather than instead of one.

Why is the outside of my thigh burning and numb?

Burning and numbness on the outside of your thigh suggests meralgia paraesthetica, an irritated sensory nerve at the front of the pelvis, rather than a tendon problem. Tight waistbands, weight change and pregnancy are common triggers. It usually settles with conservative care, starting with removing whatever is compressing the nerve.

Whatever may be causing your lateral hip pain, come and find out

Pain in the side of your hip that stops you lying on it at night can be tiresome and most people simply want to know what it is and what will settle it. Book in for treatment or before that I'd happily see you first for a free 15 minute consultation, a short, no-obligation chat to talk through what's going on, not an examination or treatment. I'll answer your questions and be honest about whether chiropractic may help and you can then choose whether to book a full visit for examination and treatment.

Outer hip pain like this is a very common reason people come to see me from all over Bournemouth.

In many of the cases I see, chiropractic care is a very well-tolerated option worth considering and I'll explain clearly whether it's likely to help in your particular case. If I think you'd be better served by your GP, a specialist or another practitioner, I'll say so and help point you in the right direction.

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