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Lateral hip pain is a condition where pain is felt on the outside of your hip bone and can sometimes run down your thigh and into your knee.
Lateral hip pain is a general term that has been called a number of things over the years such as; trochanteric bursitis, greater trochanteric pain syndrome (GTPS) and more recently gluteal tendinopathy. Recent research has shown in most cases the pain is non-inflammatory and due to irritation of the gluteal muscle tendons where they attach to the top of the leg. This is also known as a ‘tendinopathy’.
People develop tendinopathy for a number of reasons but there is still a lot to learn about what is actually going on in the tendon that may cause pain. A sudden increase in activity can overload these soft tissues. This could cause a flare up of pain in a sporty individual but also an inactive, deconditioned person. The pain is often aggravated by squashing of these muscle tendons or direct pressure at the point where the muscle attaches into the bone. Sometimes, especially if the condition persists for some time the soft tissue explanation for the pain can become less relevant as the experience of pain involves lots of different factors. It may be worth discussing this with your physiotherapist.
Lateral hip pain can affect anyone at any age but is much more common from middle age onwards. It is actually quite common; females are more likely to be affected than men due to their natural body shape and as many as 1 in 4 women over 50 may experience pain at some time.
You may find that there are certain positions that are uncomfortable as they increase the chance that the muscle tendons on the outside of your hip will be squashed. You can reduce the pressure on the outside of your hip by temporarily avoiding positions such as:
The ideal sleeping position is lying on your back. If you are unable to do this, you can lie on your unaffected side with a pillow in between your legs. An eggshell mattress topper may help to ease the direct pressure when lying on the painful side in bed.
The initial focus of physiotherapy is to reduce the pain, through advice about how to reduce the pressure over your hip bone. There seems to be a link between lateral hip pain and having weak muscles around your hip so strengthening exercises will form an important part of your rehabilitation. Exercises have been shown to help with pain related to tendons, although the improvement can take some time and will involve some hard work.
You may experience some discomfort whilst performing some of the exercises and this may persist for some time after finishing them. How much and how long the pain lasts for is something you will discuss with your physiotherapist, but usually if the pain and the length of the time the pain lasts for is acceptable to you, then it’s fine. The pain you may experience after the exercises does not mean you are damaging anything.
There are some useful exercises which will strengthen your hip muscles available on the patient information sheet and available in video format: