What is Lateral Hip Pain?
Lateral hip pain is an umbrella term for 2 different conditions: trochanteric bursitis and gluteal tendinopathy. Both of which cause pain on the outer side of the hip/thigh, and can radiate down the upper thigh.
The bursa is not usually the cause of pain, as it is usually caused by an irritation of the tendons that lay over the bony prominence of the hip known as the gluten tendons. It is a common condition that more often affects people over the age of 50 and is more common in women than men, but it can also occur people younger than that as well.
What Causes it?
A gluteal tendinopathy is the most common cause of lateral hip pain, making up 9/10 of lateral hip pain cases. It is caused by inflammation of the gluteal tendons often because of weakness in the gluteus maximus, minimus and/or medius and overloading of that area.
The less common cause of lateral hip pain is greater trochanteric bursitis. This is inflammation of the fluid filled cushion known as a bursa on the outside of the hip. The bursa acts as a cushion between the bone and the tendons to reduce friction.
Common symptoms include:
Pain around the outer side of the hip that can radiate down the side of the thigh
A deep ache or burning sensation
pain that is aggravated by walking uphill, running, climbing stairs, laying on your side and sitting with your legs crossed.
Some other areas of the pelvis can produce similar pains so it is advisable to see your GP or Physiotherapist to be assessed. This is especially advisable if you experience pins and needles or numbness in addition to pain.
Why do I have it?
Tendon health depends on the loads put through it on a regular basis. If too much load is put through the tendons and bursa and they are unable to cope with it then inflammation occurs leading to pain. This can happen in both athletes and sedentary people. For example if an athlete runs regularly but does not complete and regular strength exercises for the muscles of the outer hip then the tendons will begin to become inflamed as they are not equip to deal with the repeat loading from running.
Lateral hip pain can also begin more abruptly for example if you were to have a slip or fall and land on the outside of the hip. This can cause inflammation and therefore pain in the outer hip.
Often it may not be possible to put a finger on a single factor that will have caused this. Often it is an accumulation of a number of small factors that lead to the increased demand on the outer hip. For example: a gradual increase in weight over time, an gradual decline in general fitness and a recent change from driving to walking to work.
How do I treat it?
Keep moving! - Rest will not cure lateral hip pain, but also exercising through pain will not be helpful either. It is important to load the tendon to promote recovery, however this should be done in a controlled way. For example if you cannot walk more then 15 minutes uphill before the pain starts then consider only walking for 10 minutes or only walking on flat ground. This will help load the tendon without provoking it further.
Lose weight - If you are carrying a bit of extra weight this will mean the tendons will be under more stress. Losing even a small amount of weight can have a significant positive impact on lateral hip pain.
Avoid aggravating movements - avoid crossing your legs and laying on your side.
Stand evenly - when standing try to have your weight evenly distributed through both feet and try not to drop a hip to one side as this will stress those tendons on the outside of the hip.
Hot and cold - Either hot water bottles or ice packs can be helpful in managing your pain. Use an ice pack wrapped in a tea towel for 15 minutes or a hot water bottle in a cover to get relief. Both can be beneficial so use whatever works best for you! Make sure you check your skin regularly to avoid any damage to it. Follow this link to a hot/cold pack we would recommend: https://amzn.to/3mgmqwy
Sleeping well - Ensuring you consistently sleep well can have an enormous impact on your recovery and help reduce pain. If you are used to sleeping on your side you can place a pillow between your knees to elevate any pain. If you do this then do not lay on the painful side as this may provoke your pain. Follow this link to view a cushion adapted to help you sleep on your side with lateral hip pain: https://amzn.to/39E8WpD
Medication - You may be prescribed some simple pain relief or anti-inflammatory medication by your GP. If prescribed it is important to take these regularly as these will allow you to move more and therefor recover faster.
Exercises - Strengthening exercises targeting the muscles around the outer hip. Follow this video below for some exercises to help with lateral hip pain:
Acupuncture - If your hip pain is particularly painful acupuncture may help to settle your pain to allow you to complete more exercises and keep moving.
Sports massage - Similar to acupuncture, sports massage can be really effective in reduce pain and reducing tension in the outer hip muscles. This can get you moving faster and increase the amount of exercises you can do.
Steroid injections - Often used as a last resort option, steroid injections can be used as a more invasive measure to settle stubborn lateral hip pain. It is often used as a last resort as repeat injections can effect the health of the tendons in the outer hip.
Booking an assessment
If you wish to be assessed by our physiotherapist contact us through our website: https://www.kinetixphysiotherapy.com