Blog · Hips

Hip pain on the outside: what helps

By the Calm Joints physio team · Updated October 20, 2026 · 9 min read

Illustration of a person side-lying with a pillow between the knees to keep the top leg level

Pain on the outside of the hip is common, and it is usually a problem with the gluteal tendons and the tissues over the bony point of the hip, not a sign that the joint is worn out. A large trial found that education plus exercise beat a cortisone injection and a wait-and-see approach for this pain. Easing the positions that squash the outside of the hip, then building strength you can tolerate, is the approach research supports.

Why does the outside of my hip hurt?

The sore spot is usually the greater trochanter, the bony bump you can feel on the side of the hip. The tendons of the gluteal muscles attach there. A small fluid sac, the bursa, sits nearby. For years this pain was called trochanteric bursitis. Clinicians now use greater trochanteric pain syndrome, or gluteal tendinopathy, because the tendon is often the main irritated tissue, not only the bursa. ^[1]

NICE describes the typical picture: pain on the outer hip, worse with activity, and tenderness right over that bony point. It can spread down the outer thigh. Walking, stairs, standing on one leg, and lying on the sore side are common triggers. ^[1]

This is not the same as hip arthritis. Arthritis pain is more often felt in the groin or deep in the front of the hip. Outer-hip pain can exist on its own, and it can sit alongside arthritis. A physio can help sort which pattern you have.

It is more often reported in women, and in midlife. In the best-known trial, 167 of 204 participants were women, with an average age of about 55. ^[2] That matches who asks about it: people who walk a lot, stand at work, or notice the hip after a change in training or a long stretch of sitting.

Is it bursitis, and do I need a scan?

Often neither label nor a scan changes the first plan. NICE says the diagnosis is made from the history and the exam: where it hurts, what stirs it up, and tenderness when the outer-hip tissues are loaded. Other causes, including lumbar nerve irritation, hip joint arthritis, and infection, should be considered. ^[1]

A scan can help if the story is unclear, if pain follows a fall, or if symptoms are not settling. It is not the starting point for a typical outer-hip ache that you can still walk on. An international physiotherapy consensus puts education and graded strengthening ahead of injections and surgery for most people. ^[3]

What makes the outside of the hip worse?

Compression. The tendon is pressed against the bone when the thigh crosses the midline, or when you hang all your weight on one hip. NHS rehabilitation advice lists the positions that do this: sitting or standing with legs or feet crossed, sitting low with the knees wide, standing with weight on one leg, and lying on the sore side. ^[4]

Everyday versions are easy to miss. Crossing your legs in a meeting. Perching on one hip while you wait for the kettle. Side-sleeping so the top knee drops across the body. In a Canadian winter, standing on one leg on an icy curb can load the same spot. None of these cause the pain by themselves. Together they keep the tendon annoyed.

Stretching the leg across the body feels like it should help. It often does the opposite, because that stretch is another compression. ^[3]^[4] Strength and position changes do more than long holds into a stretch.

What the research says

The clearest trial is the LEAP study, published in The BMJ in 2018. Two hundred and four people with gluteal tendinopathy were assigned to education plus exercise (14 physio sessions over 8 weeks), a single corticosteroid injection, or wait and see. ^[2]

At 8 weeks, 51 of 66 people in the education-and-exercise group rated themselves a success, compared with 38 of 65 after injection and 20 of 68 who waited. At 52 weeks the exercise group was still ahead of injection (51 of 65 versus 36 of 63) and ahead of waiting. Pain scores at one year were similar for exercise and injection, and both were better than waiting. ^[2]

A 2024 systematic review pooled six randomized trials and 733 people with greater trochanteric pain syndrome. Exercise slightly reduced pain and disease severity and slightly improved function compared with a control, with no serious adverse events. Compared with corticosteroid injection, exercise improved the chance of a meaningful global improvement in the longer term. The authors recommended exercise as first-line care, and they noted the certainty is low to moderate because there are still few trials. ^[5]

The 2022 international physiotherapy consensus says the same thing in practical terms: start with education about positions that compress the lateral hip, then progress from gentle isometrics to heavier hip-abductor work as the person tolerates it. Physiotherapy should continue even if a medicine or injection is used. ^[3]

Research suggests this is a load problem you can train, not a joint that has to be rested until it is quiet. Rest eases a flare. It does not rebuild the tendon’s tolerance.

What should I change this week?

Three habits do most of the early work.

Sleep. Lie on your back if you can. If you sleep on your side, lie on the comfortable side with a pillow between your knees so the top leg does not drop across. Avoid the sore side while it is irritable. ^[4]

Sitting and standing. Uncross your legs. Sit so both feet are under you, not wide on a low soft seat. When you stand, put weight through both feet. If you have to wait, perch rather than hang on one hip. ^[4]

Walking. Keep walking, but find the amount that does not leave the outer hip clearly worse that night or the next morning. Shorter walks more often beat one long push.

Heat or a wrapped ice pack can take the edge off. Neither replaces the position changes. ^[4]

If walking is part of how you look after an arthritic hip, keep it. Our piece on walking and hip arthritis covers how to size the walks. Outer-hip tendon pain and joint arthritis are different problems, and they can be managed together.

Try this today

Stop if pain jumps, if you cannot put weight through the leg, or if pain is clearly worse the next day. A mild ache during the exercise that settles within a day is acceptable for many people. Sharp pain is a stop.

1. Pillow between the knees (tonight)

Lie on the comfortable side. Place a firm pillow between your knees and ankles so the top leg stays level with the hip, not dropped forward. Use this for the part of the night you can. If you roll onto the sore side and wake up, roll back and reset the pillow.

2. Standing hip hold

Stand side-on to a counter, sore hip away from the counter. Hold the counter lightly. Gently push the sore foot into the floor and stand tall. Keep the knee soft, not locked. Hold 20 to 30 seconds. Rest. Repeat 5 times. Both feet stay on the floor. Stop if the outer hip sharpens.

3. Bridge with knees apart

Lie on your back, knees bent, feet flat and hip-width. Keep the knees from collapsing inward. Squeeze the buttocks and lift the hips until the body is a line from shoulders to knees. Hold 5 seconds. Lower. Build toward 3 sets of 8. Skip this if it bothers your back.

4. Side-lying leg lift, only if the standing hold is easy

Lie on the comfortable side, pillow between the knees, sore leg on top. Keep the top leg in line with the body, not forward. Lift it a small distance, knee straight, pelvis still. Hold 5 seconds. Lower. Start with 5 repetitions. If the outer hip aches more that evening, drop this one and stay with the standing hold.

Physio tip: Skip the cross-body stretch for now. Pulling the sore leg across your body squeezes the same tendon you are trying to calm. Uncrossed legs and a pillow between the knees usually help more.

These are starters, not a full program. The LEAP program was supervised and progressed over 8 weeks. ^[2] A physio can match the load to your hip.

When to see a physio

Book a visit if the outer hip has been sore for more than a few weeks, if sleep is broken, or if walking is shrinking. A virtual physio visit can review how you stand, sit, and sleep, and can build the exercise progression with you.

Book a virtual visit with a registered Calm Joints physiotherapist at calmjoints.org. Many extended health plans in Canada cover physiotherapy, including virtual visits. Ask your plan what it pays. Coverage varies by province and by policy.

See a clinician urgently, the same day, if:^[1]

You cannot bear weight, or the pain started with a fall.
The hip is hot, swollen, or red, or you feel unwell with a fever.
You have a history of cancer and a new, severe bone pain.
Pain runs below the knee with numbness, weakness, or a change in bladder or bowel control.

Those are not typical outer-hip tendon problems. They need an urgent assessment, not a home exercise. In an emergency, call 911.

Want a plan for your outer hip?

Book a virtual visit with a registered Calm Joints physiotherapist. We'll check what's safe, sort your sleep and sitting setup, and build a strength plan that progresses at your pace.

Book a visit

Want tips like this in your inbox? Join “Get tips for sore joints” on calmjoints.org.

Frequently asked questions

Is outer hip pain the same as hip bursitis?

Often it is the same region, with a newer name. Greater trochanteric pain syndrome and gluteal tendinopathy describe pain from the tendons and nearby tissues over the bony point of the hip. The bursa can be involved. The first treatment is still education and exercise, not a hunt for the bursa. ^[1]^[5]

Should I stop walking?

No, not if you can walk without a clear flare that night or the next day. Find a distance you tolerate and repeat it, rather than resting completely. Complete rest was the weaker option in the LEAP trial. ^[2]

Do I need a cortisone injection?

Not as the first step for a typical case. In the LEAP trial, education plus exercise led to higher rates of feeling much better than a single corticosteroid injection at 8 weeks and at 52 weeks. An injection is a decision for you and a prescribing clinician if pain is severe or exercise is not enough. ^[2]

How long does it take to settle?

In the LEAP trial, many people in the education-and-exercise group rated themselves much better by 8 weeks, and that advantage was still there at one year. Tendons usually need weeks of consistent loading, not a few days. If nothing has changed after a fair trial of these steps, book a physio visit. ^[2]

Can a virtual physio help outer hip pain?

Yes. Education about positions and a graded strengthening plan are the core of care for this pain, and both can be taught on a video visit. A physio can watch how you stand, sit and move, then progress the exercises with you.

Sources

Keep reading

This article is for education. It is not personal medical advice, a diagnosis, or a treatment plan for you. If you have pain that worries you, talk to a registered physiotherapist or your doctor. In an emergency, call 911.