Hip Bursitis: What Is It and Why Does Your Outer Hip Hurt?
Hip bursitis is inflammation of the small, fluid-filled sac (bursa) that cushions the bony point on the outside of your hip. It causes a deep, aching pain on the outer hip. This pain often gets worse when you lie on that side, climb stairs or walk for a long time. It is common in adults over 40 and is more frequent in women.
Key points
- Hip bursitis typically causes pain on the outer hip, not deep in the groin.
- Repeated friction, poor alignment or muscle weakness are common triggers.
- A problem at the knee, pelvis or lower back can shift load onto the hip and inflame the bursa.
- Standing, weight-bearing imaging can show alignment issues that lying-down scans miss.
- ScanAlign provides diagnostic imaging only, not treatment.
The greater trochanteric bursa sits between the large tendon on the outside of your hip and the bony bump of the thighbone. Its job is to reduce friction when you move. When this bursa becomes irritated, each step can feel like a dull burn on the outer thigh. Many people call this "trochanteric bursitis" or "greater trochanteric pain syndrome."
Standard treatment often focuses on the painful spot itself. But the reason the bursa became inflamed in the first place may lie somewhere else entirely: in the way your whole body lines up when you stand and move.
What are the main symptoms of hip bursitis?
The main symptom is a persistent ache on the outer side of the hip. It sometimes spreads down the outer thigh. It tends to build slowly rather than start suddenly.
If you notice sudden, severe hip pain with swelling or redness, or if you develop numbness, weakness or loss of bladder or bowel control, get urgent medical help from your doctor or the nearest emergency department. These symptoms need immediate assessment.
What causes hip bursitis?
Hip bursitis happens when something irritates the bursa again and again. The direct cause is usually friction or pressure. But the deeper reason often involves how your body spreads load when you stand and walk.
Other causes include previous hip surgery, a fall directly onto the hip, or conditions such as osteoarthritis. But in many cases, the bursitis is a symptom of a wider alignment issue rather than a problem in the bursa alone.
How does whole-body alignment affect hip bursitis?
Your body is a connected chain from your feet to your head. When one link is out of position, the links above and below make up for it. This often shows up as pain somewhere other than the original problem.
With hip bursitis, the story often looks like this. A slight pelvic tilt, a small leg length difference, or a knee that angles inward changes the way your thighbone sits in the hip socket. The tendons crossing the greater trochanter start pulling at an awkward angle. The bursa beneath them takes most of the strain.
This is why treating only the painful spot sometimes fails. The inflammation settles for a while, but the alignment issue remains, so the bursitis comes back. Seeing the full picture, from feet to spine, is the key to understanding why the bursa keeps flaring up.
How does a standing EOS scan help with hip bursitis?
A standing EOS scan captures your entire skeleton, from head to feet, in one image while you are upright and bearing your weight. This matters because alignment problems only show their true extent when gravity is acting on your body.
You stand naturally. Gravity loads your joints the way they are loaded every day. A pelvic tilt, leg length difference or shifted spinal curve appears exactly as your body experiences it. The EOS system uses about 90% less radiation than a standard X-ray, around ten times less, so it is a low-dose option for whole-body imaging.
You lie flat on a table. Your muscles relax. Your pelvis levels out. A mild tilt or leg length difference can disappear entirely. The image may look normal even when your standing alignment is adding to your bursitis.
An EOS scan does not diagnose bursitis directly. Instead, it shows the mechanical reasons the bursa may be under extra strain. Your clinician or surgeon can then use this information to target the root cause rather than just the symptom.
When MRI is the better choice: EOS shows bones, joints and alignment very clearly. But if your specialist suspects a soft-tissue problem such as a tendon tear, labral damage or nerve irritation, MRI is usually the more suitable test. The two scans answer different questions and can work well together.
Not sure whether an alignment assessment would help your hip before you plan a trip to London? Talk to us first. There is no obligation.
Book a free video consultationWhat generally helps manage hip bursitis?
Most hip bursitis gets better with conservative measures recommended by a physiotherapist or your doctor. Common approaches include the following.
- Changing activity. Reducing or changing activities that aggravate the bursa, such as long walks or climbing stairs.
- Targeted exercises. Strengthening the gluteal muscles and stretching the iliotibial band can reduce friction across the bursa. A physiotherapist can guide you on safe, effective hip bursitis exercises for your situation.
- Anti-inflammatory measures. Your doctor may recommend ice, over-the-counter anti-inflammatory medicine or a corticosteroid injection to calm sudden flare-ups.
- Addressing alignment. If a pelvic tilt, leg length difference or spinal imbalance is playing a part, correcting the underlying cause can prevent it from coming back.
ScanAlign does not provide treatment. We provide the detailed, weight-bearing imaging that helps your treating clinician understand the full mechanical picture behind your bursitis.
Before you start treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in your pelvis, your legs or your spine changes what will actually help.
Frequently asked questions about hip bursitis
It usually feels like a deep, aching pain on the outer side of the hip. It may spread down the outer thigh. Lying on the affected side, climbing stairs and standing up after sitting often make it worse.
No. Arthritis involves wear of the joint cartilage and typically causes groin pain. Bursitis involves inflammation of the bursa on the outer hip. The two conditions can happen together, but they are different problems in different places.
Mild cases can settle with rest and changes in activity. However, if an alignment issue is causing repeated irritation, the bursitis often comes back until the underlying cause is addressed.
No. ScanAlign is a private, self-pay clinic. You can book yourself. We recommend starting with a free video consultation so we can confirm the scan is right for your situation.
An EOS scan uses about 90% less radiation than a standard X-ray, around ten times less. This makes it a low-dose option for full-body skeletal imaging.
EOS is an X-ray based system, so it shows bones and joints rather than soft tissue. It will not image the inflamed bursa directly. What it does show is any alignment issue, such as a pelvic tilt or leg length difference, that may be driving the bursitis.
The price for patients travelling from abroad is confirmed during the free video consultation. You can find more general answers on our FAQs page.
Yes. Even a small difference changes the way you walk and shifts extra load onto one hip. Over time, this repeated imbalance can irritate the bursa. A standing whole-body image is one of the most reliable ways to measure leg length while your body bears its natural weight.
A normal hip X-ray captures only the hip area, often while you lie down. An EOS scan images your entire skeleton while you stand, so your clinician can see how the hip relates to the spine, pelvis, knees and feet. It also uses much less radiation.
You stand in the EOS system for a short time while the scan is taken. It is quick and painless. There is no injection, no closed tunnel and no special preparation. Full details are on our what to expect page.
Wondering if alignment is behind your hip pain?
A free video consultation lets you talk through your symptoms with our team from home, before you commit to anything or plan travel.
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Written by Abbas Dhami (Specialist Diagnostic Radiographer)
Sources
- NHS. "Bursitis." nhs.uk. Available at: https://www.nhs.uk/conditions/bursitis/
- Segal NA, et al. "Greater trochanteric pain syndrome: epidemiology and associated factors." Archives of Physical Medicine and Rehabilitation, 2007;88(8):988-992.
- Illés T, Somoskeöy S. "The EOS imaging system and its uses in daily orthopaedic practice." International Orthopaedics, 2012;36(7):1405-1411.
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.