Greater trochanteric bursitis: Definition, Uses, and Clinical Overview

Greater trochanteric bursitis Introduction (What it is)

Greater trochanteric bursitis is a term used for pain and tenderness on the outside of the hip.
It refers to irritation of a bursa near the greater trochanter, the bony prominence on the side of the femur.
It is commonly discussed in orthopedics, sports medicine, and physical therapy when evaluating lateral hip pain.
In many clinics, it overlaps with a broader diagnosis called greater trochanteric pain syndrome.

Why Greater trochanteric bursitis used (Purpose / benefits)

Greater trochanteric bursitis is used as a clinical label to describe a recognizable pattern of lateral hip pain and to organize the evaluation. The main purpose is to connect a patient’s symptoms (often pain on the outside of the hip, worse with pressure or activity) with nearby soft-tissue structures that can be irritated.

In practical terms, the “benefit” of naming Greater trochanteric bursitis is that it:

• Focuses the differential diagnosis toward lateral hip conditions (bursal irritation, gluteal tendon problems, iliotibial band friction) rather than inside-the-joint causes alone.
• Guides exam and imaging choices by highlighting the trochanteric region and surrounding tendons and bursa.
• Creates a shared vocabulary among clinicians (orthopedics, primary care, sports medicine, radiology, physical therapy) when documenting findings and planning next steps.
• Supports treatment planning by suggesting categories of care often used for lateral hip pain, such as activity modification, rehabilitation approaches, or injections when appropriate.

It is also important to note a modern clinical nuance: many cases once labeled “bursitis” involve gluteus medius/minimus tendinopathy (tendon degeneration/irritation) with or without true bursal inflammation. Because of that, some clinicians preferentially use greater trochanteric pain syndrome (GTPS) as an umbrella term. Naming conventions vary by clinician and case.

Indications (When orthopedic clinicians use it)

Orthopedic and sports medicine clinicians may consider Greater trochanteric bursitis in scenarios such as:

• Lateral hip pain with point tenderness over the greater trochanter
• Pain that is worse when lying on the affected side
• Pain provoked by walking, climbing stairs, running, or prolonged standing
• Symptoms developing after a change in training volume, new activity, or altered gait
• Pain associated with hip abductor weakness or poor pelvic control on exam
• Lateral hip pain in the setting of lumbar spine symptoms, where both regions may contribute
• Persistent symptoms after a fall or impact, once fracture has been excluded
• Post–hip surgery lateral pain, where trochanteric soft tissues may be irritated (assessment is individualized)

Contraindications / when it’s NOT ideal

As a diagnosis label, Greater trochanteric bursitis is not ideal when lateral hip pain is better explained by another condition or when warning signs point elsewhere. Situations where another approach may be more appropriate include:

• Inability to bear weight, severe acute pain, or a concerning injury mechanism where fracture (including femoral neck fracture) must be considered
• Night pain with systemic symptoms (fever, unexplained weight loss) where infection, inflammatory disease, or malignancy enters the differential diagnosis
• Red, hot, markedly swollen lateral hip area (uncommon for deep trochanteric bursa) where infection or superficial skin/soft-tissue processes may need evaluation
• Pain that localizes more to the groin/anterior hip, suggesting intra-articular pathology (such as osteoarthritis or labral disorders) rather than trochanteric pain
• Prominent radiating pain, numbness, or tingling suggesting lumbar radiculopathy or peripheral nerve involvement as a primary driver
• Athletes with high-risk bone stress concerns, where stress fracture evaluation may take priority
• Persistent or complex symptoms where the term “bursitis” may be too narrow, and GTPS or a tendon-focused diagnosis better captures the problem

If interventions are being considered (for example, injections), additional “not ideal” situations can include allergy to components, bleeding risk, uncontrolled medical conditions, or local skin infection near an injection site. Specific contraindications vary by clinician and case.

How it works (Mechanism / physiology)

The relevant anatomy

• Greater trochanter: the prominent bony area on the outside of the upper femur.
• Bursa: a thin, fluid-containing sac that reduces friction between tissues (for example, between tendons and bone).
• Gluteus medius and gluteus minimus tendons: hip abductor tendons that attach near the greater trochanter and help stabilize the pelvis during walking.
• Iliotibial band (IT band): a thick band of connective tissue running along the outer thigh that passes near the trochanteric region.

The physiologic principle

Greater trochanteric bursitis describes pain thought to arise from irritation of the trochanteric bursa and nearby soft tissues. The bursa can become irritated when it is repeatedly compressed or exposed to friction. That irritation can increase local sensitivity and pain signaling.

However, many patients with “trochanteric bursitis” symptoms also have contributions from:

• Gluteal tendinopathy: degenerative or reactive tendon changes that can be painful and load-sensitive.
• Abductor weakness or altered pelvic mechanics: increased stress on tendons and local soft tissues during gait.
• IT band tension/compression: which may increase pressure over the trochanteric region.

Because the condition can involve multiple tissue types, some clinicians describe the pain generator as a trochanteric pain complex rather than a single inflamed bursa.

Onset, duration, and reversibility

Greater trochanteric bursitis symptoms may appear gradually (overuse or repetitive loading) or after an inciting event (a fall onto the side of the hip). The course can be short-lived or prolonged, depending on contributing factors and coexisting tendon pathology. “Reversibility” is not a property of the diagnosis itself; rather, symptoms may improve or recur over time depending on biomechanics, activity demands, and the underlying tissue status.

Greater trochanteric bursitis Procedure overview (How it’s applied)

Greater trochanteric bursitis is a diagnosis, not a single procedure. Clinicians “apply” it through a structured evaluation and, when appropriate, a stepped approach to confirming the source of pain and reducing symptoms.

A typical high-level workflow may include:

1. Evaluation / exam – History focused on pain location (lateral hip), triggers (lying on side, stairs, walking), and functional impact. – Physical exam including palpation over the greater trochanter, hip range of motion, gait assessment, and tests that load the abductors. – Screening for non-trochanteric causes (lumbar spine, intra-articular hip disease, fracture risk).

2. Preparation (if testing is needed) – Selection of imaging based on the clinical question. – Plain radiographs may be used to look for bony issues (for example, arthritis or fracture indicators) even though bursae are not directly visible on X-ray.

3. Intervention / testing – Ultrasound may identify bursal fluid and can evaluate gluteal tendons; it can also guide injections when performed. – MRI may be used when symptoms persist, diagnosis is uncertain, or tendon injury is suspected, as it can evaluate soft tissues in greater detail. – In some cases, a diagnostic injection may be used to see whether numbing the region changes pain, recognizing that interpretation varies by clinician and case.

4. Immediate checks – Reassessment of pain and function after exam maneuvers or after any in-clinic intervention (when performed). – Monitoring for immediate adverse reactions if an injection was given.

5. Follow-up – Re-evaluation of symptoms and function over time. – Adjustment of the working diagnosis (for example, shifting emphasis from “bursitis” to “gluteal tendinopathy”) if the clinical pattern supports it.

Specific treatment steps and timing vary by clinician and case.

Types / variations

Greater trochanteric bursitis is often discussed within a spectrum of lateral hip pain conditions. Commonly described variations include:

• Isolated bursitis vs mixed-tissue pain
• Some patients have prominent bursal irritation.

• Others have predominant gluteal tendon pathology with secondary bursal involvement.

• Greater trochanteric pain syndrome (GTPS)

• An umbrella term that may include bursitis, gluteus medius/minimus tendinopathy or tears, and IT band–related compression.

• Acute vs chronic presentation

• Acute symptoms may follow a direct impact or sudden workload change.

• Chronic symptoms may reflect ongoing mechanical overload, deconditioning, or tendon degeneration.

• Mechanical vs systemic contributors

• Mechanical factors include gait changes, hip abductor weakness, leg-length discrepancy (assessment varies), and training errors.

• Systemic contributors may include inflammatory conditions or metabolic factors; relevance varies by individual.

• Septic bursitis (infection)

• Infection is commonly discussed with superficial bursae (like the elbow) but is less typical in deep trochanteric bursae.

• When infection is a concern, clinicians usually broaden evaluation beyond routine “bursitis” care.

• Coexisting conditions

• Hip osteoarthritis, lumbar spine disease, or sacroiliac joint pain can coexist and complicate the picture.

Pros and cons

Pros:

• Provides a clear, common label for a typical lateral hip pain pattern
• Helps clinicians localize evaluation to the trochanteric region and abductor mechanism
• Encourages a broad differential that includes tendons and biomechanics, not only the hip joint
• Can be assessed with noninvasive examination and, when needed, imaging
• Often supports stepwise management from conservative strategies to procedural options
• Helps standardize communication across referrals (primary care, PT, orthopedics, radiology)

Cons:

• The term “bursitis” can oversimplify the problem when tendinopathy is the main driver
• Symptoms can overlap with lumbar radiculopathy and intra-articular hip disease, making diagnosis less straightforward
• Imaging findings (fluid, tendon changes) do not always match symptom severity, complicating interpretation
• Pain may become persistent or recurrent if contributing mechanics and tendon load issues continue
• The label may lead some patients to assume the problem is purely “inflammation,” which is not always accurate
• When procedures are used (for example, injections), results can be variable and dependent on diagnosis accuracy and tissue involvement

Aftercare & longevity

Because Greater trochanteric bursitis is a condition rather than a single treatment, “aftercare” refers to what typically influences outcomes after evaluation and any interventions used.

Factors that commonly affect symptom course and durability include:

• Underlying tissue involvement
• Predominant tendon pathology (gluteal tendinopathy) may behave differently from primarily bursal irritation.
• Severity and duration of symptoms
• Longer-standing pain can involve strength deficits, altered movement patterns, and increased sensitivity.
• Biomechanics and activity demands
• Repetitive hip loading, hill/stair exposure, running volume changes, or occupational standing can influence recurrence risk.
• Rehabilitation participation
• When physical therapy is part of the plan, consistency and appropriate progression can matter; exact protocols vary.
• Comorbidities
• Conditions affecting tendon health, sleep, or overall conditioning may influence recovery trajectory.
• Follow-up and reassessment
• Persistent symptoms sometimes prompt a refined diagnosis (for example, partial abductor tendon tear) and a different plan.
• Intervention selection
• If injections or procedures are used, outcomes may depend on accurate targeting, imaging findings, and the specific agent or technique chosen. Longevity varies by clinician and case.

In general informational terms, many care pathways emphasize monitoring function (walking tolerance, sleep disturbance from side-lying, stair pain) rather than focusing on pain alone.

Alternatives / comparisons

Because lateral hip pain has multiple possible sources, Greater trochanteric bursitis is often evaluated alongside alternatives in two ways: diagnostic comparisons (what else could it be?) and management comparisons (what are the options once trochanteric pain is suspected?).

Diagnostic comparisons (common “look-alikes”)

• Hip osteoarthritis
• Often more groin/anterior thigh pain and stiffness, though lateral pain can occur.
• Lumbar radiculopathy
• May include radiating pain, numbness, tingling, or back symptoms; can coexist with trochanteric pain.
• Femoral neck stress fracture or occult fracture
• Considered when pain is severe, weight-bearing is difficult, or risk factors are present.
• Intra-articular pathology (labral disorders, femoroacetabular impingement)
• More commonly produces groin pain and mechanical symptoms, though overlap exists.
• Sacroiliac joint or pelvic sources
• Can refer pain to the lateral hip region.

Management comparisons (high-level)

• Observation / monitoring
• For mild or improving symptoms, clinicians may prioritize watchful follow-up and activity review.
• Medication-based symptom management
• Oral or topical anti-inflammatory medications may be used when appropriate; suitability depends on medical history and clinician preference.
• Physical therapy / exercise-based rehabilitation
• Often used to address hip abductor strength, pelvic control, and graded return to activity; specific programs vary.
• Corticosteroid injection
• Sometimes used for pain relief, particularly when bursal inflammation is suspected; benefits and duration can be variable.
• Other injections or biologic approaches
• Options such as platelet-rich plasma are used in some settings, but indications and evidence interpretation vary by clinician and case.
• Extracorporeal shockwave therapy
• Used in some practices for tendinopathy-related lateral hip pain; availability and protocols vary.
• Surgical options
• Reserved for selected cases (for example, confirmed abductor tendon tears or refractory pain with defined structural causes). Surgical techniques and candidacy vary by surgeon and patient factors.

Imaging comparisons may include ultrasound vs MRI: ultrasound can be dynamic and guide injections; MRI offers broader soft-tissue detail. Selection depends on the clinical question and local resources.

Greater trochanteric bursitis Common questions (FAQ)

Q: What does Greater trochanteric bursitis pain typically feel like?
Pain is often felt on the outside of the hip, directly over the bony prominence. Many people notice it with walking, stairs, or getting up from a chair, and it can be worse when lying on that side. Pain may also spread along the outer thigh without following a clear nerve pattern.

Q: Is Greater trochanteric bursitis the same as greater trochanteric pain syndrome (GTPS)?
They are related but not identical. GTPS is a broader umbrella term that includes bursitis, gluteal tendinopathy, and other lateral hip soft-tissue pain sources. Some clinicians use “bursitis” as shorthand, while others prefer GTPS to reflect tendon involvement.

Q: How is it diagnosed if X-rays don’t show a bursa?
Diagnosis is usually based on history and physical exam, including focal tenderness and pain with certain movements or loading tests. X-rays may still be used to evaluate bones and rule out other conditions. Ultrasound or MRI may be added when the diagnosis is unclear or symptoms persist.

Q: How long do symptoms last?
The timeline varies by clinician and case and depends on factors like symptom duration, tendon involvement, activity demands, and rehabilitation consistency. Some cases improve over weeks, while others can persist longer, especially when tendinopathy is present. Reassessment is commonly used to confirm the pain source over time.

Q: What treatments are commonly used?
Care often starts with non-surgical options such as rehabilitation-focused strategies and symptom management measures. Some patients are offered injections, particularly when a bursal component is suspected, and imaging may be used to guide decisions. Surgery is typically considered only for selected structural problems or persistent cases.

Q: Are injections “curative” for Greater trochanteric bursitis?
Injections may reduce pain for some people, but they do not necessarily address all contributing factors such as tendon load sensitivity or biomechanical issues. Response can be variable, and the duration of benefit can differ between individuals. Clinicians often interpret response in the context of the overall diagnosis.

Q: Can I still walk, work, or drive with it?
Many people can continue daily activities, but tolerance varies with pain severity and job demands. Driving is usually more limited by pain with sitting and leg movement than by the condition itself, but individual circumstances differ. Clinicians typically consider function, safety, and symptom behavior when advising on activity.

Q: Does it require weight-bearing restrictions?
Formal weight-bearing restrictions are not inherently part of the diagnosis. They may be considered if another condition is suspected (such as fracture) or if pain is severe enough to significantly alter gait. Decisions about restrictions vary by clinician and case.

Q: Why does it hurt more at night when lying on that side?
Direct pressure over the tender trochanteric area can irritate sensitive tissues, including the bursa and adjacent tendons. Side-lying can also change hip position and tendon compression against bone. This pattern is common in lateral hip pain syndromes but is not exclusive to bursitis.

Q: What does it cost to evaluate and manage?
Costs vary widely based on setting (primary care vs specialty care), whether imaging is used, and what interventions are included. Office visits, physical therapy, ultrasound-guided injections, and MRI can have different cost profiles. Insurance coverage and regional pricing are major drivers, so ranges are difficult to generalize without specifics.