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Other Hip Treatments
Outer Hip Pain & Bursitis Treatment in London
Pain on the outer side of the hip, the part you lie on at night and press when you cross your legs, is one of the commonest hip problems I see. It is usually gluteal tendinopathy or trochanteric bursitis, together called greater trochanteric pain syndrome. It is far more common in women between 45 and 65, it is rarely a problem with the hip joint itself, and it responds well to the right treatment in the right order.
The pain everyone calls bursitis
Almost everyone who comes to me with outer hip pain has been told they have bursitis. Often they have been injected with steroid, once, twice, sometimes more, and the pain has come back each time. The reason is that the label is usually only half right. The bursa, a small fluid sac over the bony point of the hip, can be inflamed, but underneath it the gluteal tendons, the tendons that hold your pelvis level when you walk, are frequently the real problem. Injecting the bursa and ignoring the tendon is why the pain keeps returning. Getting the diagnosis right is most of the treatment.
Why it is so common in women 45 to 65
The outer hip takes a particular kind of load, and changes around and after menopause make the gluteal tendons less tolerant of it. Add a change in activity, a new exercise class, a long walk on holiday, more standing, and a tendon that was coping quietly starts to complain. This is not a sign of a worn-out hip. It is a tendon and load problem, and that is good news, because load problems respond to the right plan far better than they respond to another injection.
How I treat it
The foundation is not an injection. It is understanding how your hip is loading and correcting it: targeted strength work for the gluteal tendons, changing the positions and habits that compress them, and managing the activity that flared them. Done properly this settles most cases. Where the pain is limiting that work, a well-placed injection has a role, and this is where it matters that it is guided and chosen correctly. You can read about steroid and PRP hip injections and when each is the right tool. I use ultrasound to place them accurately, because a blind injection into the wrong layer is how the cycle of failed injections starts.
At a Glance
When it is not just the outer hip
Honesty runs both ways. Sometimes what feels like outer hip pain is coming from the hip joint itself, or referred from the back, and treating the tendon will never fix it. Part of a proper assessment is ruling those in or out, with examination and, where needed, imaging, so you are not treated for the wrong thing. If your hip is genuinely arthritic, you can read about that on the hip arthritis page.
Do you need surgery for outer hip pain?
Almost never. The great majority of outer hip pain settles without an operation, and I will tell you plainly if yours is one of the rare cases where a gluteal tendon tear genuinely needs surgical repair. For nearly everyone, the answer is the right diagnosis, the right rehabilitation, and a precisely placed injection only if it is needed to let the rehabilitation work.
Frequently Asked Questions
Most often gluteal tendinopathy or trochanteric bursitis, together called greater trochanteric pain syndrome. It is a tendon and load problem rather than a problem with the hip joint itself, and it is especially common in women between 45 and 65.
Because you lie on it. Pressure on the irritated tendons and bursa when you sleep on that side, or with your knees together, is a classic feature of this condition. A calm assessment tells you whether it is this or something that needs closer review.
Usually because the injection treated the bursa but not the underlying gluteal tendon, or was not placed accurately. Lasting improvement comes from correcting how the tendon is loaded, with an injection used to support that, not replace it.
Almost certainly not. The great majority of outer hip pain settles with the right rehabilitation and, if needed, a guided injection. Surgery is reserved for the uncommon genuine gluteal tendon tear.
Book a consultation and bring any imaging you have. I will work out what is actually causing the pain and give you an honest plan. Call 0207 859 4016 or email admin@ortholongevity.co.uk.
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