Hip Bursitis

That sharp, aching pain on the outside of your hip that gets worse with walking, climbing stairs, or lying on your side is worth getting properly assessed. Our Burlington clinic can help you understand what is driving it and build a plan to get you moving comfortably again.

What Is Hip Bursitis?

A bursa is a small fluid-filled sac that sits between tissues like bone, muscle, and tendons to reduce friction and cushion movement. When a bursa around the hip becomes irritated or inflamed, the result is hip bursitis, a condition that is more common than most people realise and more manageable than it often feels at its worst.

When hip bursitis shows up, it typically causes pain on the outer side of the hip that can radiate down the thigh. It is often described as a sharp ache that is worse with walking, climbing stairs, lying on the affected side, or after prolonged sitting. The most common form is trochanteric bursitis, which affects the bursa over the bony point on the outer hip, though iliopsoas bursitis at the front of the hip is also seen in clinic.

In some cases there is a clear aggravating event, a sudden increase in activity, a fall, or a direct knock to the hip. In others the pain develops gradually as repetitive movement or sustained compression irritates the bursa over time. Weakness in the gluteal muscles and changes in how the hip and pelvis move are common contributing factors.

It is also worth knowing that the hip does not work in isolation. The lower back, pelvis, and knee all influence how forces are distributed through the outer hip. What feels like a straightforward bursa problem is sometimes being driven or maintained by something further up or down the chain.

Getting to the right diagnosis early matters. A thorough assessment looks at hip strength, movement patterns, and what specifically provokes your symptoms so we can understand what is driving the irritation and build a plan that addresses it properly.

What Causes Hip Bursitis

Hip bursitis rarely appears out of nowhere. More often the bursa becomes irritated when the outer hip is repeatedly compressed or subjected to more friction than it can handle over time.

Common causes include:

A sudden increase in walking, running, or stair climbing that overloads the bursa before it can adapt
Weakness in the gluteal muscles that changes how the hip absorbs force with each step
A previous hip, knee, or lower back injury that altered how weight moves through the outer hip
Repetitive movements like running, cycling, or lateral training that create sustained friction over the bursa

Direct pressure on the outer hip from lying on one side or sitting on hard surfaces for long periods
Leg length differences or gait changes that shift more stress to one side
Tightness through the outer thigh that increases pressure on the bursa during walking or running
Not enough recovery between high volume training days allowing irritation to build

How We Assess Hip Bursitis

Because outer hip pain can come from the bursa, the hip joint itself, the lower back, or the tendons around the greater trochanter, the assessment starts with a detailed conversation. Where exactly is the pain, what brings it on, does it radiate down the thigh, is it worse lying on that side at night, and how long has it been there. The answers help us identify which structure is most likely involved.

From there we look at how the hip is moving and how the gluteal muscles are functioning. That means testing hip strength, checking how the pelvis moves during single leg activities, and using specific provocation tests to confirm whether the bursa is the primary source of pain. Weakness in the gluteal muscles is one of the most consistent findings with hip bursitis, and hip strengthening almost always becomes a central part of what follows.

The lower back, pelvis, and knee are assessed as well. Because changes in how any of these areas move can alter how much compression and friction the outer hip absorbs, addressing the full picture is important for lasting results.

Rather than treating the painful spot in isolation, the goal is to understand why the bursa became irritated in the first place. Imaging is not always necessary and is typically only considered when the diagnosis is unclear or symptoms are not improving as expected.

Sports therapist examining patient hip bursitis in Burlington Ontario clinic

How We Treat Hip Bursitis

Calming the Bursa and Addressing What Irritated It

Treatment starts with understanding what you want to get back to, whether that is sleeping through the night without hip pain, getting back to walking or running, or just making it through a day without that constant ache on the outside of your hip.

Because hip bursitis is almost always driven by a combination of compression, friction, and muscle weakness, treatment works on several things at once. This typically means reducing the irritation in the bursa, improving how the gluteal muscles are supporting the hip, and gradually reintroducing the activities that were previously aggravating things. Understanding what is behind your hip pain is something we prioritise early because people who understand their condition tend to recover faster and manage flare ups better.

Rather than avoiding all activity, the goal is to identify what the hip can currently tolerate and build carefully from there. The bursa responds well to a graded return to movement, but the approach needs to match where you are in recovery.

Hands-on treatment may help reduce sensitivity and improve how the hip moves, but the lasting gains come from strengthening the muscles around the hip and changing the movement patterns and habits that were allowing the bursa to get repeatedly irritated. Adjustments to training volume, footwear, sleep position, and daily habits often make a meaningful difference.

Education is a big part of what we do. Knowing why your hip hurts, what aggravates the bursa, and how to pace your return to full activity gives you the tools to manage this condition confidently and stop it from becoming a recurring problem.

Hip Bursitis Treatment Options in Burlington

Hip bursitis rarely gets better from one thing alone. Depending on what is driving the irritation, care typically combines hands-on treatment to settle the bursa and restore hip mobility with a structured program to build the strength that stops it from flaring up again.

Chiropractic Treatment

When stiffness in the hip joint or lower back is changing how forces are distributed through the outer hip, chiropractic treatment may help restore movement through the affected area. Active Release Technique and Graston Technique are often used alongside joint treatment to address the tight muscles and outer thigh tissue that are increasing compression on the bursa.

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Massage Therapy

Tension through the outer hip, glutes, and surrounding muscles can keep the bursa under sustained pressure long after the initial flare has settled. Soft tissue treatment may help reduce that tension and improve how the hip moves, and works well alongside acupuncture for managing pain and sensitivity during the more acute stages.

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Physiotherapy

Building gluteal strength and retraining how the hip absorbs force during walking, running, and daily activity is usually the most important part of lasting recovery from hip bursitis. Physiotherapy may include progressive strengthening, movement retraining, and for persistent cases, shockwave therapy which has strong evidence for trochanteric bursitis, or laser therapy to support tissue healing.

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What to Expect During Hip Bursitis Recovery

Recovery depends on how the bursa responds as irritation settles and the hip muscles get stronger. The process is gradual and adapts as your comfort with walking, sleeping, and activity builds back up.

Settling the Irritation

Identifying the movements, positions, and habits that are currently aggravating the bursa and reducing compression on the outer hip while things calm down.

Strengthening the Hip

Gradually building gluteal strength and improving how the hip absorbs force during walking and daily activity to take pressure off the bursa long term.

Doing the Work

Following a targeted exercise program between appointments focused on hip strength, movement quality, and the habits that contributed to the problem.

Locking It In

Monitoring how the hip responds as activity increases and adjusting the plan to make sure the condition does not come back.

Hip Bursitis Questions, Answered

Hip bursitis is one of those conditions that often gets misdiagnosed or mismanaged. Here are the questions that come up most from people dealing with outer hip pain.

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Is hip bursitis something that goes away on its own?

It can settle down with rest, but without addressing the underlying causes it tends to come back. Most people who have had hip bursitis for more than a few weeks find that passive rest alone is not enough. Getting the right combination of load management, strengthening, and hands-on treatment in place is usually what makes the difference between short term relief and lasting recovery.

Why is my hip pain so much worse at night when I lie on my side?

Lying directly on the affected hip puts sustained pressure on the bursa, which is already irritated and sensitive. This is one of the most telling signs of trochanteric bursitis. A pillow between your knees can help reduce compression on the outer hip in the short term, but addressing the underlying weakness and inflammation is what resolves the night pain over time.

Do I need imaging to confirm hip bursitis?

Not usually. A thorough clinical assessment is typically enough to confirm the diagnosis and rule out other causes. Imaging may be considered if symptoms are not responding as expected, if a tendon tear is suspected, or if the diagnosis is genuinely unclear after assessment.

Can I keep walking and exercising with hip bursitis?

In most cases yes, with appropriate modifications. High impact activities and anything that directly compresses the outer hip may need to be temporarily adjusted. Walking is generally fine and often helpful, but the intensity and duration may need to be dialled back initially. The goal is to find what your hip can tolerate and build from there.

What is the difference between hip bursitis and a hip tendon problem?

They often go together and can be difficult to distinguish without a proper assessment. Trochanteric bursitis involves inflammation of the bursa, while gluteal tendinopathy involves irritation of the tendons that attach to the same bony prominence on the outer hip. The symptoms can feel almost identical, but the management differs, which is why getting an accurate diagnosis matters.

How long does hip bursitis take to resolve?

It depends on how long you have had it and what is driving it. Acute cases that are caught early and managed well can settle within a few weeks. Chronic cases where the bursa has been repeatedly irritated over months can take longer to fully resolve. From my experience, the people who commit to the strengthening work and address the habits contributing to compression tend to see the best and most lasting results.