Lateral Hip Pain

One of the commonest presentations to a Sports Medicine clinic is for pain at the side of the hip that hurts to go up stairs and to lie on the side at night.

Many people assume this means that they have arthritis in the hip joint. Generally, this is not the case. In most cases, pain on the outside of the hip is from the tendons of the buttock muscles, where they attach to the bone.
Many others have been told they have “bursitis”. A bursa is a little fluid filled sac, like a water balloon containing a drop of fluid. It sits between 2 structures in the body, to allow them to glide safely past each other. There are a number of these on the outside of the hip. They can become inflamed, swollen and painful. It is VERY unusual for this to occur without an underlying cause. Cortisone injections can help to settle the inflammation, but it will usually recur within 6 weeks if the cause is not addressed.

SO WHAT ARE THE CAUSES?
Most people with pain at the outside of the hip have some issues with muscle activation around the hip, resulting in overload of the tendons.
There are many things that affect the muscle activity. These include, but are not limited to, age, menopause, previous back pain, hip joint pathology, recent illness, weight gain and poor exercise technique.

WHAT CAN I DO?
A great first line treatment is to use a tennis ball to massage through the buttock muscles twice a day. You can do this leaning against the wall. It will be uncomfortable, but with frequent massage, the tightness should start to reduce.
Pop a heat pack on for a few minutes after massaging and before going to bed.
Avoid sitting with your legs crossed and sleep with a pillow between your knees to take the tension off the tendon.
Once your pain starts to improve, get some advice regarding your exercise program and make sure your technique is right. The last thing you want to do is load it all up again.

WHAT IF THAT DOESN’T WORK?
You need an accurate diagnosis. Sometimes tendon tears are harder to get better.
Sometimes the pain is not from the tendons, but referred from structures in your back or elsewhere.
An ultrasound, X-rays and possibly and MRI may be required to establish your diagnosis.
From there, accurate advanced treatment can be commenced .