Part of Greater trochanteric pain syndrome
Hip bursitis pain location: where it hurts and where it travels
Warning signs, and when to get help
Where is hip bursitis pain felt?
Lie on your back and run two fingers down the side of your hip from the waist. A few inches below the rim of the pelvis they will drop onto a hard, rounded prominence sitting right under the skin. That is the greater trochanter, and in most people with this problem the pain has its center there or within an inch or two of it. Press it and compare it with the other side: on the sore hip it usually objects.
Most people land here to check that their own pain sits where it should for the label they have been given. OrthoInfo describes the pain at the point of the hip, usually extending to the outside of the thigh, sharp and intense in the early weeks and more of a widespread ache later on. It also records the pattern that brings people to look it up: worse at night, worse lying on the affected hip, worse getting up out of a chair after sitting, and worse with a long walk, stairs or squatting.
The name needs one correction before the rest of this makes sense. The gluteus medius and gluteus minimus tendons attach to that bony point, and they are now regarded as a main local source of the pain, so the condition is called greater trochanteric pain syndrome or gluteal tendinopathy rather than trochanteric bursitis (Grimaldi and colleagues, 2015). The greater trochanteric pain syndrome program explains what that changes about the treatment, and the home checks that separate the joint from the tendon takes the terminology question in full.
How far does the pain travel, and where does it stop?
It travels down the outside of the thigh, and that is where the published descriptions leave it. OrthoInfo takes the pain from the point of the hip to the outside of the thigh and no further. Neither of the two NHS leaflets behind this page, from Cambridge University Hospitals and from Kingston and Richmond, sends it past the knee either.
A band of ache down the outer thigh is ordinary, then, and it still catches people out. They expected a problem at the hip to stay at the hip. In clinic it is one of the commoner reasons somebody arrives convinced they have a trapped nerve.
Further down the leg the picture changes. Pain that carries on below the knee, and particularly pain with burning, tingling, numbness or weakness in the leg or foot, fits what the NHS describes for sciatica, which is a nerve irritated in the lower back rather than a tendon at the hip. Telling outer hip pain and sciatica apart works through that comparison, including the awkward case where both are happening. Below-knee pain has its own timing on the warning list at the end of this page, and the leg symptoms that need help faster are there too.
Why is it tender when you press it, and what does that tell you?
Depth explains all of it. The tendons and the bursa over the greater trochanter are close enough to the surface that a thumb reaches them, while the ball and socket joint is buried behind the crease of the groin, where no amount of pressing from outside gets near it. Finding your pain with a fingertip is useful information, and so is not being able to find it at all.
It is not a diagnosis, and the limits of it are published. The ISHA physiotherapy agreement says pressing over the greater trochanter may contribute, while noting that it lacks specificity, and that there is no test or cluster of tests that identifies which specific structure is involved (Disantis and colleagues, 2023). Imaging has the same problem in reverse: when 40 people with pain on one side of the hip had both hips scanned, the findings that turned up in the painful hips also turned up in the pain-free ones, bursitis especially, and the strength of agreement between the radiologists reading them varied (Woodley and colleagues, 2008).
One group should stop here. If that hip has been replaced or operated on, pressing it tells you nothing about a tendon. The implant lies directly under that spot, and the operation may have gone through the tendons that attach there. Read pain at the side of a hip that has been replaced or operated on instead of this section.
For everybody else, a tender spot is one line of evidence, and a clinician reads it alongside the others before calling it anything. What a scan does and does not settle carries that argument further.
What does it mean if the pain is in the groin instead?
Groin pain moves the hip joint itself up the list. The joint sits deep, and pain from it is reported in the groin or across the front of the thigh, with stiffness rather than a sore spot you can put a finger on. The giveaway people recognize is a hip that has become awkward to bend, so putting on socks or shoes is harder than it was.
Where hip arthritis pain is felt covers the joint's own map, and groin pain runs through the wider list for that area. Groin pain with a stiff hip is on the warning list below with a timing attached, because that one wants checking, not working out at home.
Both can be true in one hip. A worn joint and a sore tendon keep company, and nothing on this page should be read as choosing one and ruling the other out.
What about pain at the front of the hip, or on the sitting bone?
The groin side of the hip has its own bursa, the iliopsoas bursa. OrthoInfo describes inflammation there as putting pain in the groin, and says it is less common than the version over the greater trochanter although it is often treated in a similar way. Front-of-hip and groin pain is assessed differently from pain over the bony point, so it needs its own look, not this page's reasoning.
Then there is the sitting bone. Pain right on the bone you sit on, worst on a hard chair and in the car, usually belongs to the hamstring tendons where they attach there, and hamstring tendinopathy is the page for it. People mix the two up because the trigger is so similar: both dislike compression and both get worse with sitting. The location separates them cleanly, one at the side of the hip and the other underneath you.
When outer hip pain is coming from somewhere else
The lower back refers pain into the buttock, the hip and down the leg, which is the pattern described above, and sciatica is the page for it. Iliotibial band syndrome causes its trouble at the outer knee, so pain centered at the side of the knee belongs with IT band syndrome.
Last, the list below. It is the one part of this page that does not depend on where the pain sits. A hot, swollen hip, pain after any fall if your bones are fragile, night pain that keeps building, and pain spreading below the knee each have a timing attached, and locating the pain more precisely settles none of them.
Pain at the side of a hip that has been replaced or operated on
A hip that has been replaced is its own situation, and the reasoning on this page does not carry over to it. What sits behind soreness on the side of an operated hip depends on the operation, so it is a question for the team that did it rather than one to work out from a web page. Your surgeon and the hospital team decide what you do and when, and their protocol comes before this page. If you have had an operation on your hip, follow the program from your surgical team and physio rather than the one on the greater trochanteric pain syndrome page, and hip replacement rehab sets out the usual stages.
Two things make the map on this page unreliable in an operated hip. Some approaches cut through or detach the muscles and tendons that attach to that bony point and others are designed to leave them alone, so what lies under your tender spot depends on which operation you had, and the page cannot know. And the implant sits directly beneath that area, so pain felt there can be coming from the joint itself rather than from tissue a thumb can reach. Tenderness over the bony point after a replacement is therefore not evidence of a tendon problem.
Surgeons also disagree about this pain. In a survey of 54 Canadian surgeons who perform hip replacements, most diagnosed outer hip pain after the operation on examination alone, treatment was divided between anti-inflammatory tablets, structured physiotherapy and steroid injections, and the authors report no agreed guideline for either the diagnosis or the treatment (Axelrod and colleagues, 2023). That is another reason the answer comes from your own surgeon and not from here.
New or rapidly worsening pain, a wound that is red, hot or leaking, a fever, or a calf that is newly swollen or getting more swollen, warm or tender all mean contacting that team the same day rather than waiting. The warning list at the end of this page carries the routes for a new hip that dislocates, for a leg that changes shape, for pain after even a small knock, and for an infection that can turn up years later.
When to see a physio or doctor
Book a routine appointment with a doctor or physio if outer hip pain is stopping you sleeping or doing what you normally do, if it keeps coming back, or if it has not improved after 2 weeks of looking after it at home (NHS). Go sooner if the location does not fit anything on this page, or if the pain has moved since it started.
Take the map with you. Which finger-width of skin hurts most, whether pressing it reproduces the pain, how far down the thigh it runs, and what it does when you lie on that side: those four answers cover most of what the first few minutes of an examination is after. Outer hip pain covers the fuller list of causes in this spot, with the triggers and the exercises.
Some signs need help faster, from an emergency visit to a doctor within a few days. They are listed under the warning signs below, each with its own timing. Several of them apply only to a hip that has been operated on, and each of those says so in its first words.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: you have had a fall or an injury and now have severe hip pain, or you cannot walk or put weight on the leg. Call emergency services or go to an emergency department. This can be a sign of a broken hip (hip fracture).
- Emergency: tingling or loss of feeling in the hip or leg after a fall or injury. Call emergency services or go to an emergency department.
- Emergency: pain, tingling, numbness or weakness in both legs, numbness or altered feeling around your genitals or bottom, or new trouble peeing or controlling your bladder or bowels. The same applies if you lose feeling in one leg. Call emergency services or go to an emergency department straight away. These can be signs of pressure on the nerves at the base of the spine (cauda equina syndrome).
- Emergency: you have had a hip replacement and have sudden severe pain in your hip or groin, sometimes with a clunk or pop, and you cannot move the leg or put weight on it, or the leg suddenly looks shorter or turned in or out. Do not try to walk on it or push it back into place. Keep still and call emergency services or go to an emergency department, and do not drive yourself. Your new hip may have come out of its socket (dislocated), and a medical team needs to put it back.
- Emergency: your operated leg looks shorter than it did, or its foot turns in or out more than before, or the hip moves in an unusual way, even if the pain is not severe. Keep your weight off it and go to an emergency department straight away, and do not drive yourself. If you are in severe pain or cannot move the leg, call emergency services.
- Emergency: since your operation, you suddenly become short of breath, you get chest pain or pain in your upper back that may be worse when you breathe in, you cough up blood, your heart is beating very fast, or you faint. Call emergency services straight away, even if your leg looks normal. These can be signs of a blood clot in the lungs (pulmonary embolism).
Get help today
- Same day: the hip is hot and swollen, the skin around it has changed color, or you have hip pain with a high temperature or feel hot, cold or shivery. Get medical help the same day, and go to an emergency department if you feel very unwell. A joint infection needs treatment quickly. If you have a very high or very low temperature, shivering you cannot control, you are breathing very fast or finding it hard to breathe, you are confused or your speech is slurred, your skin, lips or tongue look blue, gray, pale or blotchy (on brown or black skin this can be easier to see on the palms of the hands or soles of the feet), or you have a rash that does not fade when you press it, call emergency services, as this can be sepsis.
- Same day: severe hip pain that came on suddenly without a fall, or pain that is getting worse quickly over a few days. Get medical advice the same day.
- Same day: new hip or groin pain after a fall, even a small one, if you are older, have low bone density (osteoporosis) or have taken steroid tablets for a long time, even if you can still walk. Get medical advice the same day. A broken hip is not always obvious at first.
- Same day: a leg or foot that is getting weaker, for example your foot drags, catches on the ground or slaps down when you walk (foot drop). Get medical advice the same day. If the weakness is getting worse by the hour, go to an emergency department.
- Same day: a calf or thigh that is newly swollen or getting more swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
- Same day: a child or teenager has sudden pain in the hip, thigh or knee, is limping, or cannot put weight on one leg. Get an urgent appointment with a doctor the same day. If they have a high temperature or seem very unwell, go to an emergency department. This page is for adults, and hip pain in children has different causes.
- Same day: at any time after your operation, even years later, new pain in your new hip along with a high temperature or feeling hot, cold or shivery, or a hip that becomes hot, red or swollen, which counts on its own, with or without pain and with or without a temperature. Contact your surgical team or get medical advice the same day. A new joint can become infected long after the operation, and that needs treating quickly. A normal temperature is not an all clear: OrthoInfo says fever is no longer considered a sign of an infection after a joint replacement, that the signs can be as little as mild redness and swelling and sometimes there are none at all, and that increased pain or stiffness in a joint that had been working well is one of them. So do not wait for a temperature before you report new or increasing pain in your new hip to your surgical team.
- Same day: you have had a hip replacement and your hip clunks and feels as if it partly slipped out of place and went back, even if it settles straight away and your leg looks normal. Stop the exercises, avoid the movement that brought it on, go back to your crutches or frame, and keep away from deep bending, crossing your legs and twisting on that leg until you have been seen. Contact your surgical team or get medical advice the same day. If the leg then looks shorter or turned, or you cannot move it or put weight on it, call emergency services.
- Same day: you have had a hip replacement and, after a fall or a knock, even a small one, your hip, groin or thigh is newly painful, bruised or swollen, even if you can still walk and your leg looks normal. Stop the exercises, go back to your crutches or frame and keep your full weight off that leg, and contact your surgical team or get medical advice the same day. A break in the bone around a new hip is not always obvious at first, and walking normally on one can move the broken ends apart.
- Same day: hip pain at night or at rest that does not ease when you change position, and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.
Book an appointment
- Within a day or two: hip pain at night or at rest that does not ease when you change position, and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
- Within a few days: hip pain at night or at rest that does not ease when you change position, and keeps getting worse. See your doctor within a few days.
- Within a few days: new pain in the groin or buttock, and you take steroid tablets long term, or have in the past, or you regularly drink a lot of alcohol. This can be a sign of a problem with the blood supply to the top of the thighbone (avascular necrosis). Book an appointment with your doctor within a few days and mention the steroids or alcohol.
- Within 2 weeks: pain that spreads down the leg below the knee, especially with numbness or tingling in the leg or foot. The pain may be coming from your lower back rather than the hip tendons. Book an appointment with a doctor or physio.
- Within 2 weeks: the pain is mostly in the groin rather than on the outside of the hip, or the hip is stiff and hard to bend, for example when you put on socks. This points more toward the hip joint itself, such as hip osteoarthritis. Book an appointment with a doctor or physio so the cause can be checked.
- Routine: pain in your new hip that had settled and has come back, or pain that is getting worse month by month, for example in the groin or thigh when you first stand up and start to walk. This is not an emergency, but ask your surgical team for a review, as the parts of a new joint can loosen or wear over the years. Get medical advice the same day instead, not a routine appointment, if the hip also becomes hot, red or swollen, or you have a high temperature or feel hot, cold or shivery, or the pain is building week by week rather than month by month. A new joint can become infected years after the operation, and the two can feel similar at first.
Common questions
Where exactly does hip bursitis hurt?
Over the bony point on the side of the hip, level with the top of the thigh, and usually tender if you press on it. OrthoInfo puts the pain at the point of the hip and says it usually extends to the outside of the thigh, sharp and intense early on and more of a spread-out ache later. It is at its worst lying on that side and when you stand up after sitting a while, and it tends to build with a long walk, a flight of stairs or a squat.
How far down the leg does hip bursitis pain go?
Usually as far as the outer thigh and no further. OrthoInfo describes the pain extending to the outside of the thigh, and neither of the two NHS leaflets behind this page sends it past the knee. Pain that carries on below the knee, particularly with pins and needles or numbness in the leg or foot, is a different pattern and has its own timing on the warning list on this page.
Can hip bursitis cause groin pain?
Groin pain points somewhere else first. The sore structures over the bony point sit well out to the side of the ball and socket joint, and pain coming from the joint is reported deep in the groin or across the front of the thigh, with stiffness. OrthoInfo does describe a second bursa on the groin side of the hip, the iliopsoas bursa, which it says is less common than the one on the outside. Either way, groin pain with a stiff hip is a reason for an assessment rather than for assuming the outer hip is the source.
Why is it tender when I press it?
Because the sore structures lie close to the skin, while the hip joint is too deep for a fingertip to reach at all. That is useful information and it is not a test on its own. The 2022 International Society for Hip Preservation physiotherapy agreement says pressing on the greater trochanter may help, while noting it is not specific, and that no test or group of tests identifies which structure is producing the symptoms (Disantis and colleagues, 2023). A hip that has been replaced is the exception to the whole idea: the implant sits close under that spot, the operation itself may have gone through the tendons that attach there, so tenderness over the bone says nothing about a tendon, and that pain belongs to your surgical team rather than to this reasoning.
Is it bursitis if the pain goes below the knee?
That pattern does not fit it. Pain running from the buttock down the leg past the knee, especially with burning, tingling, numbness or weakness, is the pattern the NHS describes for sciatica, where a nerve is irritated in the lower back. The two can also be present together, which is covered on the sibling page comparing them. The warning list on this page gives the timing for below-knee pain and for the leg symptoms that need help faster.
Can both hips have it at once?
Yes, and it is common enough that the NHS leaflets plan for it. The Cambridge University Hospitals leaflet suggests sleeping on your back with pillows under your knees when both hips are sore, rather than picking a good side, because there is not one. If both hips hurt in the groin rather than over the bony point, or several joints ache together, mention that to your doctor rather than treating it as two separate hips.
References
- Grimaldi A, Mellor R, Hodges P, Bennell K, Wajswelner H, Vicenzino B. Gluteal Tendinopathy: A Review of Mechanisms, Assessment and Management. Sports Medicine. 2015;45(8):1107-1119. https://doi.org/10.1007/s40279-015-0336-5
- Disantis A, Andrade AJ, Baillou A, et al. The 2022 International Society for Hip Preservation (ISHA) physiotherapy agreement on assessment and treatment of greater trochanteric pain syndrome (GTPS): an international consensus statement. Journal of Hip Preservation Surgery. 2023;10(1):48-56. https://doi.org/10.1093/jhps/hnac050
- Woodley SJ, Nicholson HD, Livingstone V, Doyle TC, Meikle GR, Macintosh JE, Mercer SR. Lateral hip pain: findings from magnetic resonance imaging and clinical examination. Journal of Orthopaedic and Sports Physical Therapy. 2008;38(6):313-328. https://doi.org/10.2519/jospt.2008.2685
- Axelrod DE, Ekhtiari S, Winemaker MJ, Beer J, Wood TJ. Management of Greater Trochanteric Pain Syndrome After Total Hip Arthroplasty: Practice Patterns and Surgeon Attitudes. Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews. 2023;7(12):e23.00085. https://doi.org/10.5435/JAAOSGlobal-D-23-00085
- American Academy of Orthopaedic Surgeons. Hip bursitis. OrthoInfo. https://www.orthoinfo.org/en/diseases--conditions/hip-bursitis/
- NHS. Complications of a hip replacement. Page last reviewed 6 March 2024. https://www.nhs.uk/tests-and-treatments/hip-replacement/complications-of-a-hip-replacement/
- Cambridge University Hospitals NHS Foundation Trust. Gluteal tendinopathy. Patient information. Approved 14 January 2025. https://www.cuh.nhs.uk/patient-information/gluteal-tendinopathy/
- Kingston and Richmond NHS Foundation Trust. Greater trochanteric pain syndrome. Patient leaflet. Last updated 9 December 2024. https://www.kingstonandrichmond.nhs.uk/patients-and-families/patient-leaflets/greater-trochanteric-pain-syndrome
- NHS. Hip pain in adults. Page last reviewed 20 November 2025. https://www.nhs.uk/symptoms/hip-pain/
- NHS. Sciatica. Page last reviewed 3 December 2024. https://www.nhs.uk/conditions/sciatica/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-17.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.