Lateral hip pain: bursitis or tendinopathy?

Hip pain is commonly diagnosed as bursitis… but what is really going on at the hip?

Lateral hip pain (pain on the side of the hip) is commonly diagnosed as bursitis. Pain may also start to travel down the side of the leg towards the knee. Symptoms are usually felt when lying on your side, as well as standing on one leg, or walking up stairs.

The cause of lateral hip pain was previously thought to be inflammation of the shock absorbing sponges (bursa) around the hip joint. However more current research shows that inflammation of the bursa in the hip joint is very highly associated with irritation of the gluteus medius and minimus tendons (i.e. a gluteal tendinopathy). A gluteal tendinopathy develops due to changes in load around the hip joint, which can involve INCREASING or DECREASING your activity levels. Gluteal tendinopathies are more likely to affect women than men.

A study in 2018 on people with gluteal tendinopathy compared 3 treatments, including a cortisone injection, physiotherapy management, and the ‘wait and see approach’. Although both the exercise group and the cortisone group were improved after 8 weeks, the exercise group had significantly better overall outcomes than the cortisone group at the one year follow up. In this case, exercise really is the best medicine!

In physiotherapy, we will have a look at how you move, and give you some alternative options for sitting, sleeping and standing positions to make you more comfortable. From here, an exercise program will be started to help reduce pain and build strength and control around the pelvis.

For more information on hip pain and how we can help you, feel free to contact us. To read the full study, have a look here: https://www.bmj.com/content/361/bmj.k1662

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