Pain on the side of your hip is most commonly caused by irritation of the soft tissues that attach to the bony prominence on the outside of your upper thigh bone. This area, called the greater trochanter, is where tendons and fluid-filled sacs (bursae) can become overloaded, compressed, or inflamed. The umbrella term for this is greater trochanteric pain syndrome, or GTPS, and it’s far more common than hip joint arthritis as a source of lateral hip pain. Women are affected roughly 50% more often than men, with overall hip pain prevalence around 10% in women and 7% in men.
What’s Actually Happening in Your Hip
The muscles that stabilize your pelvis when you walk, stand on one leg, or climb stairs attach to the side of your hip through thick tendons. When these tendons are repeatedly stressed or compressed, the tissue starts to break down at a microscopic level. Early on, this looks like small micro-tears that trigger inflammation (tendinitis). Over time, if the load doesn’t change, the tendon tissue can deteriorate further into a chronic condition called tendinopathy, where the tendon loses its normal structure and becomes persistently painful.
This can happen from overuse or underuse. Runners, walkers, and people who suddenly ramp up their activity are prone to overloading these tendons. But a sedentary lifestyle causes problems too: tendons that aren’t regularly loaded become weaker and less resilient, so even normal daily activities can push them past their threshold. Weight gain, a naturally wider pelvis, and hip instability all increase compression on the tendons and raise your risk.
The iliotibial band, a thick strip of connective tissue running from your outer hip to your knee, can also contribute. It repeatedly slides over the bony point at the side of your hip during movement, creating friction and inflammation in the underlying tendon. This is why lateral hip pain and IT band problems frequently overlap.
How Lateral Hip Pain Typically Feels
The hallmark of GTPS is pain that’s worse with direct pressure. Lying on the affected side at night is one of the most common complaints, and it often disrupts sleep. You might also notice pain when:
- Walking, standing, or running for extended periods
- Climbing stairs
- Sitting with your legs crossed
- Standing with your weight shifted onto the sore side (“hanging on the hip”)
- Swinging your legs in or out of a car or bed
There’s usually no single injury that starts it. Most people describe a gradual onset, with the pain building over weeks or months. Tenderness to touch directly over the bony point on the side of your hip is a reliable indicator. A simple self-check: stand on the affected leg for 30 seconds with your eyes open and one finger lightly touching a wall for balance. If this reproduces your familiar pain, there’s a very high likelihood that gluteal tendon irritation is the source.
How This Differs From Hip Joint Arthritis
Many people assume any hip pain means arthritis, but the location tells you a lot. Pain from inside the hip joint (osteoarthritis, labral tears, impingement) almost always shows up in the front of the hip or deep in the groin. It gets worse with hip rotation and deep bending. Lateral hip pain, by contrast, sits squarely on the outside and is aggravated by compression and sustained loading rather than specific joint movements. People with GTPS can usually rotate and bend their hip without much trouble, whereas those with joint problems often feel a catch, click, or deep ache when they do.
Nerve Compression as a Cause
If your pain includes tingling, burning, or numbness on the outer thigh, the issue may be a compressed nerve rather than a tendon problem. A nerve that supplies sensation to the upper outer leg can get pinched where it passes through a ligament near the groin. This causes burning pain, heightened sensitivity to light touch, and sometimes patches of numbness on the outer thigh. The key distinction: this nerve only affects sensation, so your leg strength and movement stay normal. Symptoms tend to worsen after walking or standing and typically affect only one side. Tight clothing, weight gain, pregnancy, and prolonged standing are common triggers.
What Helps Lateral Hip Pain
Exercise-based rehabilitation is the most effective long-term strategy. A systematic review of six clinical trials involving 733 patients with GTPS found that structured exercise outperformed steroid injections for sustained improvement. Injections can provide short-term relief, sometimes within days, but the benefits tend to fade. Exercise programs that progressively load the gluteal tendons lead to more lasting results, though they require patience: meaningful improvement typically takes 8 to 12 weeks of consistent work.
The exercises that help most target the muscles on the side of your hip, specifically the gluteus medius and minimus. These are the muscles responsible for keeping your pelvis level when you walk or stand on one leg. Starting with low-load, pain-tolerable exercises (like side-lying leg lifts or isometric holds) and gradually increasing difficulty is the standard approach. Stretching the affected side aggressively or foam-rolling directly on the sore spot can actually make things worse by compressing the irritated tendon further.
Sleep and Daily Adjustments
If lying on your side triggers pain, placing a pillow between your knees helps align your hips and reduces compression on the outer structures. Sleeping on your back with a pillow under your knees is another option. During the day, avoid standing with your weight shifted to one side, crossing your legs while seated, or sitting in very low chairs that force your knees above your hips. These positions all increase load and compression on the lateral hip.
Signs That Something More Serious Is Going On
Lateral hip pain is rarely dangerous, but certain features warrant prompt medical attention. Acute pain with fever could indicate an infection in or around the joint. Unexplained weight loss alongside hip pain raises concern for cancer, particularly since breast, prostate, and gynecological cancers can spread to the hip bone. A history of heavy alcohol use or long-term steroid medication increases risk for a condition where blood supply to the hip bone is compromised, causing the bone to deteriorate. In women, hip and groin pain can sometimes originate from gynecological conditions, so persistent pain that doesn’t follow a typical musculoskeletal pattern is worth investigating further.
For most people, though, pain on the side of the hip is a soft-tissue problem that responds well to targeted exercise, load management, and simple changes to how you sleep and move throughout the day. The discomfort can be stubborn, but it rarely requires surgery and tends to improve steadily once the right load is applied consistently.