Hip bursitis is most often caused by repetitive stress on the hip joint, though a single injury, underlying medical conditions, or structural imbalances in the lower body can also trigger it. The condition develops when one of the fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles around your hip becomes irritated and inflamed.
Two Types of Hip Bursitis
Your hip has two major bursae that are prone to inflammation. The more common type, trochanteric bursitis, affects the bursa covering the bony point on the outside of your hip. This is the kind most people mean when they say “hip bursitis,” and it produces pain along the outer hip and thigh. The second type involves the iliopsoas bursa, located on the inner, groin side of the hip. When this bursa flares up, the pain shows up in the groin rather than the outer hip, which can make it harder to identify.
Trochanteric bursitis affects roughly 1.8 per 1,000 people each year, with the highest rates occurring between the ages of 40 and 60. Women are affected more often than men, likely because of differences in hip width and lower-limb alignment that change how forces travel through the joint.
Repetitive Motion and Overuse
The single most common cause of hip bursitis is repeated friction or pressure on the bursa. Activities that involve the same hip motion over and over gradually irritate the sac until it swells. Running and cycling are frequent culprits because they involve thousands of repetitive hip flexion cycles in a single session. Climbing stairs repeatedly, standing for long stretches, or lifting heavy objects at work can do the same thing.
You don’t need to be an athlete for this to happen. Jobs that require prolonged standing, frequent bending, or regular heavy lifting put consistent low-grade stress on the hip bursae. Gardening, painting, carpet laying, and tile setting all involve positions or motions that load the hip in ways that can lead to bursitis over time. Even playing a musical instrument can contribute if it keeps your body in an asymmetric posture for hours.
Acute Injury and Trauma
A direct blow to the outer hip, such as a fall onto a hard surface, can cause the bursa to fill with blood and become inflamed. While the body typically reabsorbs the blood, the resulting irritation can turn into bursitis that lingers for weeks or months. Landing hard on your side during a sport, bumping your hip against furniture, or falling on ice are all common triggers. Even something as minor as lying on one side on a hard floor for an extended period can be enough.
Structural and Biomechanical Factors
The way your body is built and how you move plays a significant role. People with a leg length difference, even a small one, alter their gait in ways that shift extra load onto one hip. Scoliosis and other spinal alignment issues can do the same thing. Tight iliotibial bands (the thick strip of tissue running from your outer hip to your knee) create friction over the greater trochanter with every step, and this is one of the strongest associations researchers have found with trochanteric bursitis.
Knee osteoarthritis also appears to increase risk, again because it changes the mechanics of the entire leg. When your knee doesn’t move normally, your hip compensates. The higher prevalence of hip bursitis in people with existing knee problems and iliotibial band tightness suggests that altered lower-limb biomechanics is a central driver of the condition, not just local irritation at the hip itself.
Body Weight and Hip Pressure
Carrying extra weight increases the mechanical load on the hip bursae with every step. Obesity is a recognized risk factor for both hip and knee bursitis. The effect is straightforward: more body weight means more compressive and shearing force across the joint surfaces and the soft tissues that cushion them. Losing even a moderate amount of weight can meaningfully reduce the daily stress your hip bursae absorb.
Prior Surgery and Hip Hardware
Hip replacement surgery and other procedures around the hip can irritate the surrounding bursae. Surgical hardware, scar tissue, or changes in how the muscles and tendons sit after an operation can all create new friction points. Bursitis that develops after hip surgery is common enough that surgeons typically watch for it during follow-up visits.
Underlying Medical Conditions
Several systemic conditions raise your risk. Rheumatoid arthritis and gout both cause widespread joint inflammation that can extend to the bursae. People with low back pain are also more likely to develop trochanteric bursitis, probably because chronic back problems change the way you walk, sit, and distribute weight through your hips. Bone spurs or calcium deposits on the tendons that attach near the bursa can cause ongoing mechanical irritation as well.
What Hip Bursitis Feels Like
Trochanteric bursitis typically starts as a sharp or burning pain on the outer point of your hip. Early on, the pain is most noticeable during the activity that triggered it. Over time, it often becomes a broader ache that spreads down the outer thigh. Many people notice it most when lying on the affected side at night, climbing stairs, or getting up from a chair after sitting for a while. The pain tends to worsen with prolonged activity and improve with rest, at least initially.
Iliopsoas bursitis, by contrast, causes groin pain that can be mistaken for a hip flexor strain or even a hernia. It tends to flare when you bring your knee toward your chest or rotate the hip.
How It’s Typically Managed
Most cases of hip bursitis improve without surgery. The first step is usually reducing or modifying the activity that caused the inflammation. Ice applied to the outer hip for 15 to 20 minutes several times a day helps control swelling in the early stages. Over-the-counter anti-inflammatory medications can reduce both pain and inflammation.
Physical therapy plays a central role, particularly exercises that stretch the iliotibial band and strengthen the muscles around the hip to improve how forces are distributed across the joint. If the bursitis developed because of a biomechanical issue like leg length difference or gait abnormality, addressing the root cause is essential to prevent recurrence. A corticosteroid injection into the bursa can provide significant relief when conservative measures aren’t enough, though the effect is sometimes temporary.
Surgery to remove the inflamed bursa is rarely needed and is typically reserved for cases that don’t respond to months of nonsurgical treatment. When it is performed, recovery is generally straightforward, and the hip functions normally without the bursa.