Why Your Hip Pain Isn’t Just Bursitis

If you’re a woman over 50 and struggling with a nagging ache on the outside of your hip — especially when you lie on it, walk upstairs, or get out of a low chair — you’ve probably been told you have bursitis.

And maybe you've even had a cortisone injection (or two)… but the pain came back.

Here’s the thing: it might not be bursitis at all.

So What Is Causing That Pain?

Let’s talk about a part of your body called the greater trochanter — that bony bump on the side of your hip you can feel if you press on it.

Around that spot, you’ve got:

• The gluteal tendons (attachments from deep muscles like the gluteus medius and minimus)

• A bursa (a little fluid-filled sac meant to cushion movement)

• The IT band (a long band of tissue running down the outer thigh)

For a long time, doctors blamed the pain on the bursa — hence the name “trochanteric bursitis.” But now we know better. The real troublemaker is often the tendons, not the bursa.

It’s called gluteal tendinopathy, and it’s way more common than people think.

Signs It’s Not Just Bursitis

Here are some telltale clues:

• It hurts to lie on your side (even the “good” side sometimes)

• You get pain walking up stairs or hills

• You feel sore when getting up from a chair or in/out of the car

• The pain is mostly on the outside of your hip, maybe traveling partway down your thigh

• It disrupts your sleep — every night you’re shifting positions, trying to find a spot that doesn’t hurt

Sound familiar? You’re not alone — and you’re not imagining it.

Why Cortisone Doesn’t Work (for Long)

Cortisone shots reduce inflammation, which is why they can feel good at first. But if your tendons are irritated, weak, or even torn, the injection doesn’t fix that. At best, it masks the pain for a while.

In some cases, too much cortisone can even make tendons weaker over time.

So if you’ve had an injection that didn’t last — or maybe didn’t help at all — that’s a sign your issue runs deeper than bursitis.

How Did This Happen?

Honestly? Just living your life.

As we age, tendons naturally lose some of their strength and elasticity. Add in decades of walking, lifting, gardening, side-sleeping — and eventually, those hip stabilizers can start to fail.

Here’s what tends to wear them down:

• Repetitive motions (climbing stairs, long walks, uneven ground)

• Sitting too long, then suddenly moving

• Sleeping on the same side for years

• Weak glutes or poor pelvic control

Your gluteus medius and minimus muscles are the unsung heroes that keep your hips stable every time you walk or stand on one leg. When their tendons start to struggle, they let you know — loudly.

What We See In the Clinic

When women like you come in with these symptoms, here’s what we look for:

• Can you stand on one leg without your hip dropping?

• Does pushing out against resistance hurt on that side?

• Is there tenderness over the outer hip when we press?

• Do you feel pain with certain movements but not deep in the groin (which would suggest arthritis)?

If needed, we might refer for an MRI, which gives us a clear look at the tendons.

We’re looking for signs of:

• Tendon irritation or degeneration

• Partial or full tears

• Inflammation in the bursa (usually a side effect, not the cause)

The Good News? It’s Treatable — Without Surgery

If we catch it early enough, gluteal tendinopathy responds really well to the right care plan.

That means:

• Building strength in the gluteal muscles (gently and progressively)

• Improving pelvic control and hip alignment

• Hands-on therapy to release tension in tight surrounding tissues

• Modifying movements and sleeping positions

Surgery is rare — it’s only considered in severe cases, and even then, many people recover well with non-invasive care.

Why You Shouldn’t Wait

Ignoring this kind of hip pain doesn’t make it go away — and it might make things worse.

Left untreated, gluteal tendinopathy can:

• Make walking painful

• Limit your independence

• Raise your risk of falls

• Affect your sleep, mood, and overall quality of life

You deserve better. Book an Appointment — Let’s Get You Moving Again

As chiropractors, we work with women like you every day — identifying the real source of your pain and building a care plan that works with your body, not against it.

If your hip pain is hanging around and getting in the way of life, don’t wait. Book an appointment today, and let’s get you back to moving, walking, and sleeping without pain.

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Dr Mark has a special interest in helping recreational athletes of all ages perform better and prevent injury. Correct breathing and postural alignment are critical for top performance and injury prevention and is an integral part of “The Over 40 Athlete System” that Mark has developed.

Dr Julie has a special interest in helping mothers and “mothers to be”. Her Post Graduate qualifications in Paediatric Chiropractic and as an ex-midwife give her a unique ability to help pregnant women, new mums and their young children.

Yours in Health,

Dr's Mark & Julie