What causes outer hip pain

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Last updated: April 4, 2026

Quick Answer: Outer hip pain, often felt on the side of the hip, is commonly caused by overuse injuries affecting the tendons and muscles around the hip joint, particularly the gluteal tendons and the iliotibial (IT) band. Conditions like IT band syndrome and trochanteric bursitis are frequent culprits, often exacerbated by repetitive movements, muscle imbalances, or direct impact.

Key Facts

Iliotibial (IT) band syndrome is a common cause, involving inflammation of the thick band of tissue running down the outside of the thigh.
Trochanteric bursitis involves inflammation of the bursa, a fluid-filled sac that reduces friction over the bony prominence on the outer hip.
Gluteal tendinopathy refers to damage or degeneration of the tendons of the gluteal muscles on the outer hip.
Muscle strains in the hip abductors (muscles that move the leg away from the body) can also lead to outer hip pain.
Activities involving repetitive hip flexion and extension, such as running or cycling, are common triggers.

Overview

Outer hip pain, medically known as lateral hip pain, is a prevalent condition affecting individuals of various ages and activity levels. It is characterized by discomfort felt on the side of the hip, often radiating down the outer thigh. While sometimes mistaken for hip joint problems, the pain often originates from structures outside the joint capsule, primarily the muscles, tendons, and bursa surrounding the hip.

Common Causes of Outer Hip Pain

1. Iliotibial (IT) Band Syndrome

The iliotibial band is a thick, fibrous band of connective tissue that runs along the outside of the thigh, from the hip to just below the knee. IT band syndrome occurs when this band becomes inflamed, typically due to repetitive friction where it crosses the bony prominence of the outer hip (greater trochanter) or the lateral femoral epicondyle (part of the thigh bone near the knee). This friction is often caused by:

Overuse: Sudden increases in running mileage, intensity, or frequency, especially on hard surfaces or downhill.
Muscle Imbalances: Weakness in the hip abductor muscles (gluteus medius and minimus) or core muscles can lead to increased tension and strain on the IT band.
Biomechanical Factors: Leg length discrepancies, poor running form, or inadequate footwear.
Tightness: Tightness in the IT band itself or the tensor fasciae latae (TFL) muscle at the hip can also contribute.

Pain from IT band syndrome is often described as a sharp or burning sensation on the outside of the hip and can worsen during activity, particularly when the foot strikes the ground. It may also be present at rest after activity.

2. Trochanteric Bursitis

Bursae are small, fluid-filled sacs that act as cushions between bones, tendons, and muscles. The trochanteric bursa is located on the outer aspect of the hip, overlying the greater trochanter of the femur. Inflammation of this bursa, known as trochanteric bursitis, is a frequent cause of lateral hip pain. It can be triggered by:

Direct Trauma: A fall directly onto the hip.
Repetitive Motion: Activities like walking, running, or climbing stairs that repeatedly stress the hip muscles and tendons, leading to irritation of the bursa.
Muscle Tightness/Weakness: Tightness in the IT band or weakness in the gluteal muscles can increase pressure and friction over the bursa.
Arthritis: Osteoarthritis in the hip joint can sometimes lead to secondary bursitis.
Spurs: Bone spurs on the greater trochanter can irritate the bursa.

The pain is typically felt over the point of the hip and may be tender to the touch. It often worsens when lying on the affected side, walking, climbing stairs, or standing up from a seated position.

3. Gluteal Tendinopathy (Gluteus Medius/Minimus Tendinopathy)

This condition involves damage or degeneration of the tendons of the gluteus medius and/or gluteus minimus muscles, which attach to the outer part of the hip bone. These muscles are crucial for stabilizing the pelvis during walking and running. Factors contributing to gluteal tendinopathy include:

Overuse and Overload: Gradual wear and tear from repetitive activities, especially in middle-aged women.
Muscle Weakness: Weakness of the gluteal muscles is strongly associated with this condition.
Biomechanical Issues: Poor posture, gait abnormalities, or pelvic instability.
Reduced Blood Supply: The gluteal tendons have a relatively poor blood supply, making them more vulnerable to degeneration, particularly in certain areas.

Pain is usually felt over the greater trochanter and may radiate down the side of the thigh. It often worsens with prolonged standing, walking, climbing stairs, and lying on the affected side. Tenderness directly over the tendon insertion point is common.

4. Hip Osteoarthritis

While osteoarthritis typically causes pain deep within the hip joint, it can sometimes present as or contribute to outer hip pain. As the cartilage in the hip joint wears away, bone spurs may form, and the inflammation associated with arthritis can affect surrounding structures, including the bursa and tendons.

5. Other Less Common Causes

Muscle Strains: Tears or pulls in the hip abductor muscles.
Referred Pain: Pain originating from the lower back (e.g., lumbar radiculopathy) can sometimes be felt in the outer hip area.
Fractures: Stress fractures of the femur or pelvic bone.
Nerve Entrapment: Compression of nerves like the lateral femoral cutaneous nerve (meralgia paresthetica).

When to Seek Medical Attention

While many cases of outer hip pain resolve with conservative treatment, it's advisable to consult a healthcare professional if the pain is severe, persistent, limits your ability to perform daily activities, is accompanied by fever or swelling, or follows a significant injury.