Many people at times suffer from pain on the outside of their hips. This problem is given many names, such as bursitis, or in medical jargon, greater trochanteric pain syndrome.
Commonly this is due to irritation of the iliotibial band on the outside of the hip. The iliotibial band is a tight band that runs from the pelvis over the hip to the knee. The band is protected from the outside bone of the hip by a bursa. In patients who have a limp, either severe or very mild, the band can rub across the outside of the hip, causing inflammation of the bursa and pain on the outside of the hip. A common cause for limp is gluteal muscle weakness. The gluteal muscles may be weak from inactivity, tendinopathy or gluteal tendon tears.
Bursitis can be treated with simple analgesics, such as paracetamol or anti-inflammatories, or steroid can be injected into the bursa to settle the inflammation. Often these injections will give short to medium term relief from pain, but the pain will recur unless weakness in the gluteal muscles is addressed. Strengthening of the gluteal muscles with rehabilitation is the first line of treatment, but if this fails, tests such as ultrasound or MRI scan can look for gluteal tendon tears, which may be repairable with surgery.
This problem can be terribly debilitating and is very common. It is most commonly seen in women in their 40’s and older. The pain is often worse at night and can cause sleeplessness. The pain is worse after being seated for long periods and when getting up from seated positions, with prolonged walking or physical activity or climbing stairs and hills. The pain is typically burning in nature and may start from the outside of the hip, radiating down the outside of the thigh and occasionally into the outside of the calf.