Why Your “Trochanteric Bursitis” Diagnosis May Not Be the Whole Story

If you’ve been told you have trochanteric bursitis, you’re not alone. It’s one of the most common diagnoses given for pain on the outside of the hip.

People with this diagnosis often describe pain when:

• Lying on their side

• Walking uphill

• Climbing stairs

• Standing on one leg

• Getting up from a chair

But here’s something many patients don’t realize:

The problem may not actually be bursitis.

Over the last decade, research has helped us better understand what’s really causing pain in many of these cases.

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The Term “Trochanteric Bursitis” Can Be Misleading

A bursa is a small fluid-filled sac that helps reduce friction between tissues. When a bursa becomes irritated or inflamed, it’s called bursitis.

Because of this, the diagnosis “trochanteric bursitis” suggests that inflammation is the primary problem.

Traditionally, that has led to treatments such as:

• Rest

• Anti-inflammatory medications

• Corticosteroid injections

• Passive therapies like ultrasound or electrotherapy

While these treatments may sometimes reduce symptoms temporarily, they often don’t address the true underlying issue.

And that’s because isolated bursitis in this region is actually uncommon.

Research has shown that inflammatory cells are rarely present in the bursa in people with lateral hip pain.

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What’s Often Really Happening: Gluteal Tendinopathy

Today, we understand that many people diagnosed with trochanteric bursitis are actually experiencing gluteal tendinopathy.

This condition involves the gluteus medius and gluteus minimus tendons, which attach to the outer portion of your hip bone.

These tendons play a crucial role in:

• Stabilizing your pelvis when walking

• Controlling single-leg balance

• Supporting hip movement during daily activities

When these tendons become overloaded or weakened over time, they can develop tendinopathy—a change in the tendon’s structure and capacity to handle load.

This is not primarily an inflammatory condition.

Instead, it’s better understood as a load management and tendon capacity problem.

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Why the Diagnosis Matters

If the issue is treated purely as inflammation, the treatment strategy often focuses on short-term symptom relief.

But if the underlying problem is tendon dysfunction, the long-term solution looks different.

Tendons generally respond best to:

• Gradual, progressive strengthening

• Improving hip stability

• Addressing movement patterns that overload the tendon

• Building tolerance to everyday activities

Without this approach, symptoms may continue to return even after injections or periods of rest.

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Other Structures May Also Play a Role

In some individuals, changes in surrounding structures can also contribute to outer hip pain.

For example, the iliotibial band (IT band)—a thick band of tissue running along the outside of the thigh—can develop structural changes or increased tension that place additional compression on the gluteal tendons.

This is another reason why a comprehensive movement assessment is important.

Looking at the hip in isolation rarely tells the full story.

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Moving Beyond “Quick Fix” Treatments

Because trochanteric pain has historically been labeled as bursitis, many treatments still focus on passive, short-term strategies.

These can include:

• Cortisone injections

• Modalities like ultrasound or electrical stimulation

• Rest alone

While these may temporarily reduce symptoms, they often don’t restore the tendon’s ability to tolerate load.

And without rebuilding that capacity, pain can return when activity increases again.

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A More Modern Approach to Lateral Hip Pain

A more effective strategy typically focuses on:

• Improving gluteal strength

• Restoring single-leg stability

• Addressing movement patterns that overload the hip

• Gradually increasing activity tolerance

This approach helps the tendon adapt and become more resilient over time.

The goal isn’t just to calm symptoms—it’s to help you return to walking, exercising, and daily activities with confidence.

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When to Consider a Deeper Evaluation

If you’ve been told you have trochanteric bursitis but are still experiencing ongoing symptoms, it may be worth evaluating whether gluteal tendinopathy or other contributing factors are involved.

Understanding the true source of your pain is the first step toward finding the right solution.

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Ready to Address the Root Cause of Your Hip Pain?

If you’re dealing with persistent lateral hip pain, learn more about our Gluteal Tendinopathy Program designed to restore hip strength, reduce pain, and rebuild long-term resilience.

Book your evaluation today and begin your personalized recovery plan.