"Trochanteric bursitis" is the traditional name for pain over the bony point on the outer hip (the greater trochanter), historically blamed on an inflamed bursa. But modern assessment shows the bursa is rarely the main culprit — most cases are gluteal tendinopathy, an irritation of the hip tendons, grouped under the umbrella term greater trochanteric pain syndrome (GTPS).
The name matters because it points treatment in the wrong direction: if you treat "bursitis" as pure inflammation, you tend to get short-term relief and recurring pain. Understanding what's actually driving it changes the approach — and the outcome.
Symptoms of trochanteric bursitis
The classic presentation of trochanteric bursitis — or more accurately, GTPS — includes:
Pain over the outer hip bony point
Sometimes radiating down the outer thigh
Worse lying on that side — often disturbs sleep
Worse with stairs, hills and single-leg loading
Worse after sitting cross-legged or hip-hanging
Why the "bursitis" label is misleading
True bursal inflammation does occur — but imaging studies show tendinopathy of the gluteus medius and minimus tendons is the usual driver, sometimes with a reactive (secondary) bursa rather than a primary one. The key difference:
Bursitis = primary inflammation of the bursa — the bursa is the problem.
Gluteal tendinopathy = primary tendon problem, with a reactive bursa as a secondary consequence — the tendon is the problem.
Treating only the bursa misses the tendon — the actual driver. That's why injections into the bursa often help briefly, then pain returns. The name directs you toward the wrong structure.
For the full mechanism — including why compression drives this — see our guide to lateral hip pain and gluteal tendinopathy.
What actually causes trochanteric bursitis
It's fundamentally a load-and-compression problem: the gluteal tendons are subjected to more load than they currently tolerate, compounded by compression of the tendon against the bone when:
- You lie on the affected side, compressing the tendon against the greater trochanter
- You sit with legs crossed, doing the same from below
- You stand with all your weight dumped to one side ("hip-hanging")
The underlying issue is often weakness in the hip abductor muscles — gluteus medius and minimus — meaning the tendon takes more load than it should have to. Rest settles the pain, but it doesn't rebuild capacity — so when you return to activity, it comes back.
What actually treats it
The strongest evidence comes from the LEAP randomised trial (BMJ 2018), which compared three approaches for GTPS and found that education plus targeted progressive exercise outperformed both cortisone injection and a "wait and see" approach at one year.
Education + progressive exercise beats injection at one year
The LEAP trial found that cortisone injection gave short-term pain relief but the education-plus-exercise group had significantly better outcomes at 12 months — less pain, better function, and fewer recurrences.
Read the LEAP trial →A effective approach typically follows this sequence:
- Remove the compression — change sleeping position, stop crossing legs, stop hip-hanging when standing
- Load the tendon progressively — starting with what it tolerates, building capacity week by week
- Graded return to activity — not just when pain eases, but when the tissue is ready for the load
Injections can be useful for a stubborn flare in the short term but don't rebuild capacity — which is why recurrence rates are high when injections are used alone, without rehabilitation.
General information only. Loading needs to match your specific presentation — what helps one person may not be right for another. A specialist assessment identifies your individual compression patterns and tendon capacity so the programme is appropriate.
When to see a specialist
Consider a specialist hip assessment if:
- Outer hip pain has lasted more than a few weeks despite rest
- It's disturbing your sleep — one of the most common and impactful features of GTPS
- You've had injections that helped briefly then the pain returned
- You're not sure of the actual cause — and want more than just a label
Get the right diagnosis and a proper plan
John Gravenall offers specialist hip and groin assessments in London, the Midlands, and online.
Book a specialist hip assessment →Frequently Asked Questions
Is trochanteric bursitis serious?
It's not dangerous but can become persistent if the underlying tendon load and compression aren't addressed. Most cases improve with the right approach.
What's the fastest way to settle trochanteric bursitis?
Remove compression first — avoid lying on the affected side, crossing the legs, and hip-hanging. Then introduce progressive loading of the gluteal tendons. Quick fixes like injections often don't last because they don't change the tendon's capacity.
Is trochanteric bursitis the same as gluteal tendinopathy?
Largely yes — most "trochanteric bursitis" is actually gluteal tendinopathy, both grouped under the term greater trochanteric pain syndrome (GTPS). The tendon, not the bursa, is usually the primary driver.
How long does trochanteric bursitis last?
It varies. With appropriate loading and compression reduction, many people improve over 6–12 weeks. Without addressing the underlying capacity problem, it tends to recur.
Should I get a cortisone injection for trochanteric bursitis?
Injections can help a stubborn flare in the short term. However, research (LEAP trial, BMJ 2018) found that education plus targeted exercise gave better outcomes at one year than injection alone.