Lateral Hip Pain – Causes, Symptoms, and Treatment 

You have probably heard the word bursitis, on television or in popular films, where someone injures themselves or suffers from bursitis as they age. In the medical world, this is known as lateral hip pain. Bursitis isn’t the only cause of lateral hip pain though. 

Lateral hip pain is outer hip pain of the lateral hip muscle near the gluteus maximus, or the behind. The pain occurs at the bony section near the top of the thigh in the lateral hip muscle and typically radiates down the leg. The pain is sore to the touch and becomes worsened when you are walking or running, climbing stairs, or trying to sit in different ways, like cross-legged.

Lateral hip pain is an extremely painful condition, with pain worsening when it is left untreated. It is often described as a burning or shooting pain that is tender to touch. There are a number of ways that this pain can be treated. You can start with some home remedies or solutions, that include stretching, heat compresses, or non-steroidal anti-inflammatories (NSAIDs). 

For serious or chronic bursitis or lateral hip pain, you may require surgery. Learn more about lateral hip pain causes and treatments here.

Causes of Lateral Hip Pain

Lateral hip pain can go by many names, with one of the most common names for this condition being known as trochanter bursitis. However, lateral hip pain differential diagnosis is often difficult, because there are so many causes of this pain. 

This is a pain that originates from the top of your hip bone at the bony section of the femur or thigh bone and moves down the leg. The most common lateral hip pain causes are gluteal tendinitis, overuse or athletic injury, tightened muscles, or spine problems. Hip fracture and osteoarthritis are other common causes of this outer hip pain.

When you are not suffering from outer hip pain in the lateral hip muscle, you aren’t fully aware of how every bone and tissue is interconnected in the body here, right back to the spine. If you injure or overuse one of these tissues, you will feel it everywhere these muscles are connected. The most common causes of lateral hip pain are:

  • Gluteus Medius Tendinopathy
  • Trochanteric Bursitis
  • Iliotibial Band Syndrome (ITBS)
  • Hip Fracture
  • Osteoarthritis
  • Referred pain from elsewhere in the body

Gluteus Medius Tendinopathy

The colloquial word for gluteus medius tendinopathy is tendinitis in the gluteus maximus tissue. This is lateral hip pain or outer hip pain that begins in the buttocks. This is a tendon disorder in the hips and buttocks that results in the tendon breaking down. This may be caused by muscle imbalance, crisscrossing your legs too much, or even sitting on your wallet too frequently. 

Other causes of this kind of tendinitis include excess pressure on the tissues and bones, and this could be caused by obesity. Living a sedentary lifestyle that underuses these muscle groups can also cause that. The pain here is moderate to severe and starts at the top and outside of the leg extending to the knee.

Trochanteric Bursitis

Trochanteric bursitis is an inflammation of the bursa around the hip bone. The bursa around the hip bone is a tiny sac that has fluid that can help to cushion the bone from any friction between the bone and the soft tissue on top of the bone. When this sac becomes inflamed and irritated, you may experience pain that will move to the outer thigh.

Iliotibial Band Syndrome (ITBS)

Iliotibial band syndrome (ITBS) is a syndrome that begins on the outer section of the knee. This condition that results in outer hip pain or lateral hip pain is often an athlete’s condition. The lateral hip pain begins with the knee joint and the thigh bone or femur and includes the shinbone or the tibia, and kneecap. 

The iliotibial band is a band of muscle tissue that runs along the side of your thigh and goes from your hips to your shin. ITBS is a syndrome that occurs when there is repetitive motion from bending and moving the knee and the leg and is very common in runners and athletes.

Hip Fracture

Hip fractures are among the most commonly reported sources of lateral hip pain or outer hip pain. These fractures affect millions of people every year. It is estimated that as many as 1 in 3 women will sustain a hip fracture in their lifetime, and 1 in 12 men will fracture their hip. This most commonly happens in people that are over 65 years old. It is estimated there could be as many as 840,000 hip fractures in the United States by 2040. Hip fractures may cause outer hip pain for life, even when they are treated properly.


Osteoarthritis is a condition that is also frequently referred to as wear and tear arthritis. This is a disease that is progressive in nature, which means that your outer hip pain will get worse with time. Osteoarthritis is not a condition that can be reversed. Instead, your lateral hip pain will be managed and you can get treatment for the symptoms. 

This disease is a result of the cartilage breaking down between the bones at the top of the hip bone. It is accompanied by pain and swelling. You might see bony lumps along the joints of the bones that take on a knobbly look. As the joints and bones age, they will become more stiff and less mobile. The pain will worsen with time.

Referred Pain

Lateral hip pain or outer hip pain can also be caused by referred pain. Referred pain is pain that is detected in one location of the body, but has begun in another part of the body. Referred pain is a common reason why the lateral hip pain differential diagnosis can be so difficult. If there is nothing obvious like a hip fracture present that indicates the source of the lateral hip pain, it will be difficult to diagnose. 

The condition can be so many things. Referred pain that is causing lateral hip pain symptoms could include gluteal tendon pain, pain at the gluteal cuff or hip bone, or inflammation caused by tendonitis along any of the tendons in this muscle group. The muscle group includes the anterior hip muscles, the groin, the gluteus maximus muscles, and the lateral hip muscles. 

All of these will be examined when there is referred pain causing lateral hip pain symptoms.

Symptoms of Lateral Hip Pain

The symptoms of lateral hip pain will start around the gluteus maximus, the anterior hip muscles, and tissues, and in many cases, the hip bone and femur itself. The symptoms include pain that begins on the outside or wide section of the hip and often radiates down the leg. This can also be pain that begins in the buttocks area and moves downwards. It can get worse with certain activities that can be as innocuous or mild as taking a brief walk from one room to the other in your home. Limping and pain while falling asleep are also very common symptoms of lateral hip pain.

With any of the causes of lateral hip pain, there is a symptomatic progression where the symptoms of pain get worse with time. There are some movements that you might make that make the pain worse. Lying down on a particular side makes it worse, and leg crossing is frequently cited as an activity that can make your outer hip pain worse. If the pain is worsening or not going away, talk to a doctor. Your doctor can diagnose the source of these symptoms, and come up with a treatment plan for it.

A conceptual image depicting lateral hip pain

Diagnosis of Lateral Hip Pain

The diagnosis of lateral hip pain will begin with a physical exam and a medical history. Your doctor will want to know what kind of lifestyle you have. If you are a long-distance runner, a couch potato, or have several stories in your home you have to climb, your doctor will want to know it all. All of these factors and lifestyle elements will play a role in your medical history.

Your doctor will want to start by ruling out certain things that could be causing this pain. That includes a hip fracture. So, after taking your medical history, your doctor will want to run a wide battery of tests that include diagnostic imaging. This will rule out fractures, or point to them, and help your doctor to come up with a diagnosis of the cause of the lateral hip pain. Imaging is likely to include MRI, ultrasound, CT scan, X-ray, and in some cases, all of these tests.

A reminder to fix lateral hip pain

Treatment Options for Lateral Hip Pain

There are many different ways to treat lateral hip pain or outer hip pain. You can begin with non-surgical treatment options or at-home strategies to treat your lateral hip pain. If you are working with a doctor to determine your lateral hip pain causes or symptoms, you may also undergo some medical treatments in order to treat the symptoms. You may also want to talk to your doctor about lateral hip pain exercises that can help you to find relief while you are dealing with this pain at home.

Non-Surgical Treatment Options

Your doctor will want to start you on non-surgical treatment options before exploring invasive treatments for your outer hip pain. The most common non-surgical treatment options include:

  • Rest, Ice, Compression, Elevation (RICE)
  • Physical Therapy
  • Medications

The RICE method is exactly what it sounds like. Here you want to take a break from any activity that requires the use of your outer hip. Rest put some ice on it, and elevate the hip. You may also want to apply compression, which could be managed with a compression blanket or wrap that will tighten any loose muscles that are causing pain.

Physical therapy is very common for this kind of pain, and your doctor can help you to access that. You can perform some lateral hip pain exercises at home. These will involve lateral hip pain with external rotation, where you rotate the leg and attempt to alleviate the pain this way.

Other lateral hip pain exercises include stretching the muscle group by moving the hip flexors and the piriformis muscles of the buttocks area. To stretch out these muscles, widen your stance when you are walking or moving around in your home. You can also lie on your back in the situp position and pull your tummy up off the floor as is done in many yoga poses. This will stretch out your lower back and also the outer hip muscles.

Medications such as anti-inflammatories or acetaminophen can also bring relief to outer hip pain. Talk to your doctor about the best course of action for you here.

Surgical Treatment Options

When your lateral hip pain is severe, your doctor may need to perform surgery to repair the muscles and underlying tissues in this muscle group. The most common kinds of surgery for lateral hip pain are:

  • Gluteus Medius repair
  • Trochanteric bursectomy

With the gluteus medius repair, the doctor detected a tear in the rotator cuff. This is a tear in the attachment of the muscle at the lateral hip bone. This tear can be repaired by sewing the gluteus medius tendon back together. The success rate for long-lasting relief from lateral hip pain has been very high here.

A trochanteric bursectomy is a surgery that treats bursitis. Here, the bursa around the hip joint is removed in a procedure that is not as invasive as other hip surgeries. The success rate for relief of pain here is significant.

For other conditions causing outer hip pain, surgery may be more invasive. Repairing a fractured hip, for example, could require invasive surgery with an extensive recovery time. Recovery after a hip fracture surgery can be tenuous for aging populations, and this factor is weighed when helping patients recover from hip fractures.

Learn More About Lateral Hip Pain

If you or a loved one is suffering from lateral hip pain that has gone on too long, talk to your doctor. You can start with some at-home strategies such as RICE or medication. When it goes on too long, discuss your symptoms with someone that can help. Outer hip pain will create an infringement on your quality of life if you do not find relief. Learn more about lateral hip pain and find relief today.

Sean Byers, MD

Sean Byers, MD

Sean Byers is currently a Resident in the Internal Medicine program at UTMB. He studied at the University of Queensland School of Medicine as well as received his Master’s in Public Health with a focus in epidemiology and biostatistics at the University of Southern California. His background is in biology, computer science, public health, and internal medicine.

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