Lateral Hip Pain: Causes, Symptoms, and Expert Treatment Options

Introduction

That nagging pain on the outside of your hip when you get out of bed, jog a few miles, or pivot during your weekend soccer match? You're definitely not alone. As physical therapists serving Rhode Island and Massachusetts, we see this issue daily at Highbar Physical Therapy, especially as spring sports seasons kick into high gear.

Lateral hip pain, often diagnosed as Greater Trochanteric Pain Syndrome (GTPS), affects countless New Englanders—from dedicated runners training for the Boston Marathon to teenage lacrosse players. As the official physical therapy provider for Rhode Island FC, we're particularly attuned to how this condition impacts athletes at all levels, but it can just as easily affect weekend golfers, baseball coaches, or anyone trying to stay active. Whether you're enjoying a morning run along the coastline, cheering at a professional soccer match, or simply making it through 18 holes without discomfort, hip pain can be a real roadblock. The good news? With proper diagnosis and targeted treatment, most people can find significant relief and return to their active lifestyles.

Here in New England, we see a considerable number of lateral hip pain cases. Around 10% of the general population experiences chronic hip pain, with women aged 40-60 being particularly vulnerable due to hormonal and biomechanical factors. For individuals already dealing with low back pain, the prevalence can jump to 20-35%.

Early intervention is key. The longer hip pain persists, the more likely it is to create compensatory movement patterns that can lead to additional problems in the knee, back, or even the opposite hip. That repetitive golf swing or baseball pitch won't get better on its own, and can often worsen without proper care. That's why we've created this comprehensive guide to help you understand, identify, and address lateral hip pain effectively.

Understanding Lateral Hip Pain

What is Lateral Hip Pain?

Simply put, lateral hip pain is discomfort that occurs on the outer side of your hip—the area where your leg connects to your pelvis. This region contains several important structures, including the greater trochanter (a bony prominence at the top of your thigh bone), various muscles, tendons, and bursae (fluid-filled sacs that reduce friction between tissues).

A helpful way to understand this is with the "hip sandwich" analogy: imagine your greater trochanter as the meat in a sandwich, with muscles and tendons as the bread on either side, and the bursa as the condiment that helps everything glide smoothly against each other. When any part of this sandwich gets irritated or inflamed, lateral hip pain can result.

There are several common misconceptions about lateral hip pain that should be addressed:

Myth: It's all about bursitis. 🔎 Truth: While trochanteric bursitis was once thought to be the primary cause of lateral hip pain, research now shows that many cases are actually caused by gluteal tendinopathy—where the tendons connecting your gluteal muscles to the greater trochanter become irritated or damaged.

Myth: Imaging is essential for diagnosis. 🔎 Truth: A good clinical exam performed by an experienced physical therapist is often more predictive than imaging. Physical tests like resisted external de-rotation and single-leg stance are highly accurate for diagnosing the source of your pain.

Myth: Cortisone is the gold standard treatment. 🔎 Truth: While cortisone injections may provide temporary relief, physical therapy, strengthening of the gluteal muscles, and load management are often more effective long-term solutions.

Causes of Lateral Hip Pain

What are the most common causes of lateral hip pain?

Lateral hip pain typically falls under several categories:

1. Gluteal Tendinopathy: The most common cause we see at Highbar Physical Therapy. This involves irritation or degeneration of the tendons that attach your gluteal muscles (particularly the gluteus medius and minimus) to the greater trochanter. Think of it like a fraying rope that's under too much tension or compression.
2. Hip Bursitis: Inflammation of the bursa (those fluid-filled cushions) around the hip joint. This often occurs secondary to tendon problems. Think of it like getting a blister from shoes that rub too much—repeated friction causes inflammation.
3. Iliotibial Band Syndrome: Irritation of the iliotibial band—a thick band of tissue that runs from the hip to the knee along the outside of the thigh. This is especially common in runners and cyclists in our Providence-area clinics.
4. Muscle Strains: Overuse or sudden movements can strain the muscles around the hip, especially the tensor fascia latae (TFL) and gluteal muscles. We see this frequently in weekend warriors who push too hard after a sedentary work week.
5. Hip Osteoarthritis: While typically causing groin pain, hip arthritis can sometimes present with lateral hip pain, especially in more advanced cases.

Risk Factors

Several factors can increase your risk of developing lateral hip pain:

Demographic Factors

• Age and Gender: Women over 40 are 4 times more likely than men to develop GTPS. This may be related to hormonal changes and anatomical differences in the pelvis and hip structure.

Lifestyle and Activity Factors

• Sedentary behavior followed by sudden activity bursts
• Poor biomechanics during repetitive activities
• Inadequate recovery between workouts or games
• Sudden increases in training volume (like ramping up mileage too quickly for running season)

Sports-Specific Risks

• Runners: Overstriding, weak hip muscles, and excessive downhill running
• Soccer players: Repetitive cutting, kicking, and quick direction changes
• Golfers: Repetitive rotational forces during swings
• Baseball/softball players: Rotational stresses during batting and throwing
• Lacrosse players: Quick pivoting and lateral movements

New England-Specific Factors 

Living in New England brings unique challenges for hip health throughout the year:

Winter Challenges:

• Slipping on icy surfaces (especially common in Providence and Boston neighborhoods)
• Tense walking patterns on snow and ice
• Reduced activity levels during cold months
• Seasonal sports like skiing and snowshoeing that place different demands on the hips

Spring and Summer Transitions:

• Sudden increases in activity levels after winter dormancy
• Beach sports on uneven sand surfaces
• Hiking the varied terrain of New England trails
• Gardening with repetitive bending and squatting

These seasonal transitions often lead to overuse injuries when activity levels increase too quickly without proper conditioning. Gradual progression is key to preventing lateral hip pain as the seasons change.

Recognizing Symptoms of Lateral Hip Pain

Common Symptoms

How can patients differentiate lateral hip pain from other types of hip pain?

The location and behavior of your hip pain provide important clues:

• Lateral Hip Pain: Pain on the outside of the hip that often radiates down the thigh, typically worse with lying on that side, climbing stairs, or prolonged walking. For runners, this often flares up a few miles into a run. Soccer players might notice it most during cutting movements or when striking with the outside of the foot.
• Hip Joint Pain/Arthritis: Usually felt in the groin or front of the hip, often with limited range of motion and stiffness. Golfers with this type of pain typically feel it during the backswing.
• Sciatica/Back-Related Pain: Typically radiates from the buttock down the back of the leg, often with numbness or tingling. Baseball and lacrosse players with rotational demands often experience this type of referred pain.
• Sacroiliac Joint Pain: Located at the dimples of your lower back, can radiate into the buttock but rarely below the knee. Common in runners with poor pelvic stability.

The hallmark of lateral hip pain is, unsurprisingly, pain on the outer side of the hip. However, the way this pain presents can vary significantly from person to person:

• Pain Patterns: Many patients describe a deep, aching pain that can radiate down the outside of the thigh. For some, the pain is sharp and intense during certain movements, while for others, it's a constant, dull ache.
• Pain Triggers: Common activities that provoke pain include:
  
  • Lying on the affected side at night
  • Getting up from a low chair
  • Climbing stairs
  • Walking or running, especially on uneven surfaces
  • Standing on one leg (like when putting on pants)
  • Sitting with legs crossed
• Associated Symptoms: Beyond pain, you might experience:
  
  • Stiffness, especially after periods of inactivity
  • Weakness in the hip muscles that becomes noticeable during activities like walking or climbing stairs
  • A clicking or snapping sensation in the hip
  • Difficulty finding a comfortable sleeping position

When to Seek Professional Help

When should patients seek professional help for hip pain?

While some mild discomfort might resolve with conservative care, there are several signs that indicate it's time to consult a health care provider:

Red Flags (seek immediate medical attention):

• Severe pain that comes on suddenly
• Inability to bear weight on the affected leg
• Hip pain accompanied by fever
• Significant swelling or redness around the hip
• Pain following a fall or injury, especially in older adults
• Any noticeable deformity of the hip

Signs You Should Schedule an Appointment Soon:

• Pain that persists for more than two weeks despite rest
• Pain that interferes with daily activities or sleep
• Recurrent hip pain that keeps coming back
• Hip pain that's gradually worsening
• Pain that's accompanied by other symptoms like back pain or knee pain

Early intervention is crucial. Many patients wait months before seeking help, by which time the problem has often become more complex to treat. The sooner we can identify the cause of your hip pain, the more effectively we can address it—often with less invasive methods.

Diagnosis Process

Initial Assessment

When you come to Highbar Physical Therapy with lateral hip pain, we start with a comprehensive assessment:

Clinical Examination: 

A thorough physical therapy evaluation examines how your body functions as a whole—from spine and pelvis to hips and legs. Physical therapists assess walking and running patterns, measure strength and flexibility, and identify muscle imbalances contributing to pain. Through hands-on assessment and specialized tests like FABER and OBER, they can pinpoint the source and reason for your discomfort.

The key distinction in quality care lies in looking beyond the diagnosis of Greater Trochanteric Pain Syndrome (GTPS) to understand its underlying causes. Is it muscle weakness or imbalance? Poor movement patterns? Daily habits creating repetitive strain? This investigative approach is essential because addressing root causes—not just symptoms—creates lasting relief rather than temporary fixes. Understanding these factors allows for a targeted treatment plan that provides sustainable results and prevents recurrence. By understanding why the tissues are being overloaded or compressed, physical therapists can implement targeted interventions that create lasting changes in how the body moves and functions.

Diagnostic Testing: While the clinical examination is often sufficient, sometimes we may recommend:

• X-rays: To rule out arthritis or fractures
• Ultrasound: Can visualize soft tissues like tendons and bursae
• MRI: For more detailed imaging when the diagnosis is unclear or when symptoms don't improve with initial treatment

It's worth noting that imaging findings don't always correlate with symptoms. Many people with no hip pain show abnormalities on imaging, while some with significant pain show minimal changes on scans. That's why the clinical examination remains the cornerstone of diagnosis.

Differential Diagnosis

Lateral hip pain can mimic other conditions, and getting the diagnosis right is crucial for effective treatment. Some conditions that can present similarly include:

• Hip osteoarthritis (typically causes groin pain but can refer to the lateral hip)
• Lumbar spine problems with referred pain
• Sacroiliac joint dysfunction
• Hip labral tears
• Piriformis syndrome
• Femoral stress fractures

Physical therapists are trained to differentiate between these conditions through careful examination and testing. To learn about physical therapy click here. 

Treatment Options for Lateral Hip Pain

Conservative Treatments

For many patients, conservative measures are the first step in managing lateral hip pain. These approaches include temporarily modifying activities to reduce movements that aggravate symptoms, particularly those that compress the lateral hip, while maintaining proper form during permitted activities. Applying ice for 15-20 minutes several times daily can help reduce acute pain and inflammation, while heat may improve tissue extensibility in more chronic cases—many patients benefit from alternating between the two. Over-the-counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or acetaminophen can help manage pain, though patients should always consult with a healthcare provider before starting any medication regimen. These conservative approaches often provide sufficient relief to begin a more active rehabilitation program.

Physical Therapy Interventions

How does physical therapy help in treating lateral hip pain?

Physical therapy is the cornerstone of effective treatment for lateral hip pain, and at Highbar Health, we take a comprehensive approach:

Evidence-Based Exercise Programs: Exercise is the first-line treatment for lateral hip pain. Research shows that a progressive strengthening program focusing on the gluteal muscles can significantly improve pain and function in 80-85% of cases. Effective physical therapy involves developing individualized programs based on evaluation findings to address specific strength, flexibility, and neuromuscular deficits. A comprehensive approach includes strategic gluteal strengthening without compression, hip external rotator training for stability, core strengthening for a stable foundation, and balance training to refine movement patterns. These elements, when tailored to individual needs, create a sustainable path to recovery.

Education: Understanding your condition is crucial for recovery, which is why education about the underlying causes of pain, movement mechanics, activity modification, and the importance of progressive loading forms an essential part of treatment. This knowledge empowers patients to actively participate in their rehabilitation and ensures a successful return to desired sports and activities with strategies to prevent recurrence. 

Manual Therapy Techniques: Skilled manual therapy interventions play a vital role in comprehensive lateral hip pain treatment. Soft tissue mobilization, including Instrument-Assisted Soft Tissue Mobilization (IASTM), effectively releases tight and restricted muscles, tendons, and fascia, helping to restore proper tissue mobility and reduce pain. Joint mobilization techniques address restrictions in the hip, pelvis, and spine, improving overall movement quality throughout the kinetic chain. When these hands-on approaches are combined with therapeutic exercise, particularly in the case of dry needling with strengthening programs, research shows significantly enhanced outcomes compared to either intervention alone. These techniques work synergistically to create an optimal environment for healing and functional restoration.

Lifestyle Adjustments: Addressing daily habits and movement patterns is essential for comprehensive hip pain management. This includes modifying sleeping positions to avoid direct pressure on the affected side, correcting sitting postures by limiting prolonged periods of leg crossing, and improving standing habits to ensure even weight distribution. For active individuals, training modifications may involve altering running stride length, adjusting golf swing mechanics to reduce rotational stress, modifying soccer kicking technique, or changing pitching mechanics for baseball players. These sport-specific technical adjustments, combined with appropriately periodized training schedules that include adequate recovery time, create an environment that promotes healing while allowing continued participation in modified activities.

What are the best exercises for relieving lateral hip pain?

While each treatment plan is individualized, these exercises have proven particularly effective for our patients:

1. Sidelying Clamshells: Lying on the unaffected side with knees bent, open and close the top knee while keeping feet together. The key is to avoid rolling the pelvis backward—a common mistake that reduces the exercise's effectiveness. This is a favorite for runners as it builds strength in a different plane to running, targeting the often-neglected lateral hip muscles that provide crucial stability during the single-leg stance phase of each stride. Even dedicated marathoners are often surprised by how challenging these seemingly simple movements can be!
2. Glute Bridge: Lying on your back with knees bent, lift your hips toward the ceiling by squeezing your glutes. Progress by extending one leg while maintaining a level pelvis.
3. Standing Hip Abduction: Using a counter for balance, lift your leg straight out to the side without leaning. Keep the movement controlled and avoid hiking your hip. Golfers particularly benefit from this exercise as it helps stabilize during the rotational forces of a swing.
4. Bird Dog: From hands and knees, extend the opposite arm and leg while maintaining a stable core. This engages the entire posterior chain and helps baseball pitchers and batters with rotational control.
5. Step-Downs: Standing on a small step, slowly lower your opposite heel to the floor while maintaining proper knee alignment. Runners and lacrosse players find this particularly helpful for controlling downhill movements and quick direction changes.

Advanced Treatment Options

When conservative approaches aren't providing sufficient relief, several advanced options may be considered:

Injectable Treatments

• Corticosteroid Injections: Provide short-term pain relief, most effective when combined with physical therapy. Limited to 2-3 annually due to potential side effects.
• Platelet-Rich Plasma (PRP): Uses components from your own blood to promote healing. Shows promise for tendinopathies, though research for GTPS is still emerging and insurance coverage is limited.

Surgical Interventions Rarely needed for lateral hip pain, but may be considered when conservative measures fail after 6-12 months or when specific structural problems require repair. Common procedures include endoscopic iliotibial band release, gluteal tendon repair, and trochanteric bursectomy.

At Highbar, we work closely with trusted orthopedic specialists throughout Rhode Island and Massachusetts when surgical consultation is needed, ensuring seamless coordination of your care.

Preventing Lateral Hip Pain

Lifestyle Modifications

Are there any lifestyle changes that can help prevent lateral hip pain?

Prevention is always better than cure. Here are some strategies to keep your hips healthy:

Proper Exercise Techniques:

• Gradually increase exercise intensity and duration (the 10% rule is a good guideline)
• Include hip-strengthening exercises in your regular fitness routine
• Ensure proper form during activities like running, squatting, and lifting
• Cross-train to avoid overloading the same tissues repeatedly

Ergonomic Considerations:

• Use proper ergonomics at work and home
• Avoid prolonged sitting; take movement breaks every 30-45 minutes
• Ensure your workstation supports good posture
• Consider standing desk options to vary your position throughout the day

Weight Management:

• Maintaining a healthy weight reduces stress on your hips
• Even modest weight loss (5-10%) can significantly reduce symptoms

Footwear Choices:

• Wear supportive shoes appropriate for your activities
• Replace running shoes regularly (typically every 300-500 miles)
• Consider custom orthotics if you have significant foot mechanics issues

An analyst working in Providence found significant relief by simply setting a timer to stand up and walk for a few minutes every hour. In addition, investing in a standing desk, combined with proper chair adjustments for when sitting, made a dramatic difference in her comfort. These workplace modifications improved her daytime symptoms so dramatically that she was now able to sleep through the night without waking due to pain, especially when using a pillow between her legs during side sleeping to maintain proper hip alignment.

Strengthening and Flexibility Program

A balanced program to maintain hip health should include:

Key Exercises for Hip Health:

• Glute bridges and variations
• Clamshells with proper form
• Hip hikes and side steps with resistance bands
• Single-leg balance exercises
• Gentle stretches for the hip flexors and IT band

Consistency is Key:

• Aim for 2-3 strength sessions per week
• Incorporate brief movement breaks throughout your day
• Remember that maintaining hip strength is an ongoing process, not a one-time fix

Many physical therapists tell their patients that hip exercises are like brushing your teeth—a few minutes of prevention daily can save you from much bigger problems down the road.

Living with Lateral Hip Pain in New England

Adapting to Seasonal Changes

Our New England seasons bring unique challenges for hip health:

Winter Precautions:

• Wear appropriate footwear with good traction
• Take smaller steps when walking on ice or snow
• Consider using walking poles or a cane for additional stability
• Stay active with indoor options like swimming at local indoor pools, mall walking, or home exercise programs

Summer Activities and Hip Health:

• Ease into seasonal activities gradually after winter's relative inactivity
• Consider water exercises at our beautiful beaches and lakes—the buoyancy reduces stress on the hips while still providing resistance
• Choose walking paths with even surfaces when possible (the Blackstone Valley Bikeway offers great options)
• Remember that beach walking on sand requires different muscle activation—start with short distances

Highbar’s Approach to Lateral Hip Pain

Our Expertise

At Highbar Physical Therapy, we've helped thousands of Rhode Island and Massachusetts residents overcome lateral hip pain and return to active lifestyles. Our approach combines:

Specialized Physical Therapy Programs:

• One-on-one sessions with dedicated therapists who specialize in hip disorders
• Customized treatment plans based on your specific diagnosis and lifestyle needs
• Integration of the latest research and evidence-based techniques
• Focus on long-term results, not just symptom management

As a distinguished teaching practice with more board-certified clinicians than any other practice in New England, Highbar Physical Therapy offers an exceptional level of expertise. This academic environment ensures patients receive care that reflects the most current research and advanced treatment approaches. The presence of numerous specialty-certified clinicians brings additional confidence in the quality and sophistication of care provided for even the most challenging lateral hip pain cases.

Success Stories: Our patients' experiences speak volumes about our approach:

Maria, a 52-year-old high school teacher from Warwick, came to us after months of lateral hip pain that was affecting her ability to stand through her classes. Her treatment incorporated specialized dry needling techniques to release deep trigger points in her gluteal muscles, complemented by a progressive strengthening program and targeted activity modifications. This integrated approach proved highly effective—after eight weeks of treatment, she was able to return to teaching pain-free and even resumed her weekend hiking hobby without limitations.

Kevin, a 38-year-old recreational runner, had been sidelined from his weekly 5K routine by persistent lateral hip pain. As a father of three who valued his "me time" on running trails, he was frustrated and concerned about losing his fitness. Our team conducted a comprehensive running analysis to identify biomechanical issues, revealing that his form was contributing to hip overload. Based on these findings, we developed a targeted program that combined specific strengthening exercises for weak hip stabilizers with stretching to address mobility limitations in his ankles and hips. This progressive approach not only resolved his pain but optimized his running mechanics. Six weeks later, he was back to his regular routes and even improved his personal best time.

We've also worked with several Rhode Island FC players who developed hip pain during their competitive seasons. Our sports-specific approach helped them return to the field without missing significant playing time, highlighting why the club chose us as their official physical therapy provider.

What to Expect During Your Visit

How long does it typically take to recover from lateral hip pain?

Recovery timelines vary based on several factors:

• Mild cases with recent onset: Typically 4-6 weeks of consistent treatment
• Moderate cases or those present for 3-6 months: Usually 8-12 weeks
• Chronic cases (present for 6+ months): May require 3-6 months of consistent care

In our experience at Highbar’s patients who seek treatment early and follow their home exercise program diligently recover faster. Most patients begin feeling improvement within 2-3 weeks, though complete resolution takes longer.

When you choose Highbar Physical Therapy for your lateral hip pain care, here's what you can expect:

Initial Consultation:

• A comprehensive evaluation by a licensed Physical Therapist. Note; A referral is not needed to see a physical therapist. 
• Detailed discussion of your symptoms, medical history, and goals
• Hands-on examination to determine the source of your pain
• Same-day education about your condition and initial treatment
• No long waits or rushed appointments—we prioritize quality care

Personalized Treatment Plans:

• Clear explanation of your diagnosis and treatment options
• Collaborative goal-setting based on your needs and preferences
• Specific timelines and expectations for recovery
• Regular reassessment and adjustment of your plan as needed

We believe in empowering you with knowledge and skills to not only overcome your current pain but prevent future recurrences.

Conclusion

Lateral hip pain may be common, but it doesn't have to become your new normal. With proper diagnosis, appropriate treatment, and preventive strategies, most people can find significant relief and return to the activities they love.

At Highbar Physical Therapy, we understand that hip pain isn't just about the physical discomfort—it's about the outdoor adventures you're missing, the sleep you're losing, and the activities with family and friends that become challenging. That's why we're committed to providing comprehensive care that addresses all aspects of your well-being.

Don't let lateral hip pain hold you back from enjoying all that New England has to offer. Whether you're hoping to get back to hiking the Blue Hills, playing with your grandchildren, or simply walking your dog along the beach, we're here to help you reach those goals.

Take the first step toward hip health today. Your future self will thank you.

Ready to address your hip pain? Find a location near you! 

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