Pain on the outside of the hip has a frustrating habit of appearing at night. You lie on one side and the hip aches. You roll over and eventually that side starts hurting too. During the day, stairs, long walks or standing on one leg may bring the same discomfort back. Many people call this 'hip bursitis', but persistent lateral hip pain is often better described as greater trochanteric pain syndrome, or GTPS.

What is GTPS?

GTPS is an umbrella term for pain around the bony prominence on the outside of the hip, called the greater trochanter. The problem can involve the gluteal tendons and surrounding soft tissues. NHS physiotherapy guidance notes that GTPS is also referred to as lateral hip pain or gluteal tendinopathy. The gluteal tendons connect important hip muscles to the thigh bone and help keep the pelvis controlled when walking and standing on one leg.

Why does lying on the side hurt?

Side-lying can compress sensitive tissues around the outside of the hip. That helps explain why someone may walk reasonably well during the day yet struggle to find a comfortable sleeping position. Other positions can increase compression too, such as habitually hanging on one hip while standing or crossing the legs. The aim is not to become afraid of those positions forever. Temporary modification can calm symptoms while rehabilitation improves the hip's ability to tolerate load.

What tends to trigger GTPS?

There may be no single injury. Symptoms can develop after a sudden increase in walking, running, stair climbing or other activity. In other people, discomfort appears after a less active period in which hip strength and general capacity have fallen. Revive's article on why the body can feel stiff without a clear injury is useful related reading because persistent tightness and guarding can coexist with a load-related hip problem, even though stiffness itself is not the diagnosis.

Why stretching is not always the solution

When something feels tight, stretching seems logical. But with gluteal tendon pain, repeatedly stretching into positions that strongly compress the tendon can sometimes make symptoms more irritable. NHS guidance on gluteal tendinopathy emphasises reducing unnecessary tendon compression and using exercise to develop the capacity and control of the hip and pelvic muscles. That is different from simply stretching the painful side several times a day.

What can physiotherapy do?

Assessment starts by checking whether the pain pattern is consistent with GTPS and considering other sources of hip or referred pain. A physiotherapist may look at hip strength, single-leg control, walking and stair mechanics, recent changes in activity and lumbar-spine symptoms where relevant. Rehabilitation can begin with exercises the irritated tissues tolerate and progress toward stronger resistance, single-leg work and the actual demands of the patient's life. Revive's physiotherapy services page provides an overview of how individualised rehabilitation can combine exercise, movement training and selected hands-on options.

How can you make nights easier?

Comfort matters because poor sleep can make any painful condition harder to manage. For some people, avoiding prolonged direct pressure on the painful side for a period can help. When lying on the opposite side, a pillow between the knees may reduce how far the painful hip falls across the body. These are comfort strategies rather than cures. Long-term improvement usually requires addressing activity and strength as well.

When should hip pain be medically reviewed?

Seek medical assessment for severe pain after a fall, inability to bear weight, fever or systemic illness, a hot or markedly swollen joint, unexplained weight loss, or pain that is unusual and unrelenting. Persistent hip pain also deserves assessment rather than automatically assuming it is bursitis. Revive's chronic pain guide can be helpful when symptoms have been present for months, but a long duration should never be used to dismiss red flags.

The practical takeaway

Outer hip pain is often less about one 'inflamed bursa' and more about how the gluteal region is tolerating load and compression. The rehabilitation goal is not merely to make the sore spot quieter. It is to help the hip become capable of walking, climbing stairs, exercising and sleeping comfortably again.

Related Revive resources

• Why You Feel Stiff Even If You Are Not Injured

• Chronic Pain and Physiotherapy

• Physiotherapy Services

Sources

• Cambridge University Hospitals - Gluteal tendinopathy

• Kingston and Richmond NHS Foundation Trust - Greater trochanteric pain syndrome

• South Tees Hospitals NHS Foundation Trust - Gluteal tendinopathy / GTPS

Medical disclaimer: This article is for general informational and educational purposes only. It does not provide a diagnosis or personalised treatment plan and does not replace advice, examination or treatment from a qualified doctor, physiotherapist or other healthcare professional. Seek appropriate medical attention for severe, rapidly worsening, traumatic, neurological or otherwise concerning symptoms.