Pain over the outside of the hip can make lying on that side uncomfortable and disrupt sleep. Trochanteric bursitis is one possible explanation, but a symptom alone cannot establish the cause. If hip pain keeps interrupting your nights or daily activities, arrange an assessment. [1, 3]
The sore spot is a useful starting point
The greater trochanter is the bony prominence on the outer upper thigh. A nearby bursa is a small fluid-containing cushion that reduces friction between bone and soft tissue. Inflammation of this bursa is called trochanteric bursitis; pain can spread along the outside of the thigh. [1]
Greater trochanteric pain syndrome is a broader term for pain associated with the gluteal tendons or nearby bursae. The tendons connect buttock muscles to the outer hip. Tendon changes causing pain and weakness are called gluteal tendinopathy. An assessment helps distinguish these problems and plan treatment. [4]
When describing the pain, point to the location rather than simply saying "my hip hurts." Mention whether you also notice groin pain, back pain, numbness, or a change in walking. Tell the clinician whether the problem began gradually or followed a fall, and whether you have had hip surgery or earlier treatment.
Notice the pattern during the day and night
Gluteal tendon pain can occur with stairs, hills, rising from a chair, or standing on one leg to get dressed. A sudden increase in walking distance or hill walking can bring on symptoms. There may also be tenderness over the outside of the hip. These clues belong in the history; they are not a home diagnostic test. [2]
Before a visit, make a brief note of what has changed: the side that hurts, when it started, which sleeping positions disturb you, and what activities make it worse. Include recent changes in work duties, exercise, or walking routes. For an Oahu walker, the difference between a level route and a steep trail is worth describing.
Know when to seek care sooner
Arrange medical assessment when hip pain affects sleep or normal activities, keeps returning, worsens, or has not improved after about two weeks of home care. Seek urgent medical advice for sudden severe pain without an injury, a hot or swollen hip, or hip pain with fever, chills, or feeling unwell. [3]
Go to the emergency room immediately for severe hip pain after a fall or injury, inability to walk or bear weight, or tingling or loss of feeling after an injury. Do not drive yourself. Call 911 if you need emergency transport or cannot safely reach care. [3]
An appointment request should not delay urgent assessment. When contacting a medical service, say immediately if you cannot walk, have had a fall, or feel unwell with a hot hip.
Reduce pressure without guessing at a treatment plan
For gluteal tendon symptoms, avoiding direct pressure on the sore hip may help at night. If sleeping on the other side is comfortable, place a pillow between your knees to support the upper leg. If both hips hurt, lying on your back with pillows beneath the knees is another option. Choose a position you can tolerate rather than forcing yourself to stay in one posture. [4]
During the day, reduce prolonged leg crossing and avoid standing with your weight hanging over one hip. Temporarily reducing hills or long walks may help manage irritation. Strong buttock or iliotibial-band stretches can increase tendon compression, so ask which exercises suit your diagnosis before starting an aggressive stretching routine. [2]
Describe any practical barriers to these changes. Work may involve prolonged standing, stairs, or carrying equipment, while home responsibilities may make rest difficult. Ask which tasks to modify first and how to maintain appropriate activity. A plan should be specific enough to use during an ordinary workday.
What an assessment can clarify
Wiki Wiki Orthopedics evaluates hip conditions, including bursitis and tendon problems. Its X-rays and advanced imaging page explains on-site X-rays and referrals for CT or MRI when further imaging is needed.
Assessment of suspected gluteal tendinopathy generally starts with the symptom history and a physical examination. The clinician may assess tenderness, strength, balance, and hip movement. Ultrasound or MRI is sometimes used, but a scan is not required for every diagnosis. Ask what question any recommended imaging is intended to answer. [2]
Bring previous reports and treatment instructions, plus your medication and allergy lists. Useful questions include: What is the likely source of the pain? Is another condition still being considered? Which sleeping and walking adjustments should I try? When should I return if the plan is not helping?
Rehabilitation and injections have different roles
For gluteal tendinopathy, treatment commonly combines changes to irritating activities with an individualized strengthening program. Improvement can take several months. Ask the treating clinician or physical therapist how to progress exercises and when to reassess symptoms that persist. [4]
A randomized trial published in 2018 compared education plus exercise, one corticosteroid injection, and a wait-and-see approach for gluteal tendinopathy. Education plus exercise produced better overall improvement and pain results than injection at eight weeks. At one year, overall improvement still favored education plus exercise, while pain intensity did not differ between those two groups. The findings support a rehabilitation discussion rather than assuming an injection replaces exercise. [5]
For hip bursitis, a clinician may consider anti-inflammatory medicine or a corticosteroid injection among nonsurgical options. Anti-inflammatory medicines are not suitable for everyone, and repeated steroid injections can damage surrounding tissue. Ask about benefits, risks, and how any proposed treatment fits the diagnosis and longer-term plan. [1]
Sources
- Hip bursitis, American Academy of Orthopaedic Surgeons, accessed 2026.
- Gluteal tendinopathy, Cambridge University Hospitals NHS Foundation Trust, approved 2025.
- Hip pain in adults, NHS, reviewed 2025.
- A patient's guide to gluteal tendinopathy, Royal National Orthopaedic Hospital, updated 2025.
- Education plus exercise versus corticosteroid injection use versus a wait and see approach for gluteal tendinopathy, Mellor and colleagues, BMJ, 2018.
For non-emergency hip pain on Oahu, request an appointment with Wiki Wiki Orthopedics or call (808) 439-6201. Mention how the pain affects sleep and walking. This article provides general education; an examination is needed for individual advice.