Lateral Hip Pain

Iliotibial (IT) band syndrome

• IT band syndrome often causes pain that runs from the hip down the outer aspect of the leg to the knee. It is often related to activities and is common in runners. It can be described as sharp or burning pain down the leg.
• Physical therapy is the first line of treatment for IT band syndrome.

Trochanteric bursitis

• Trochanteric bursitis is an inflammation of the hip bursa (small fluid-filled sac that cushions the joint). It can be caused by a trauma such as a fall, or overuse from activities like prolonged standing, climbing stairs, walking, and running. Symptoms can include pain on the outer side of the hip, pain with pressure on the outer side of the hip, inability to sleep on the affected hip, tenderness, and lateral hip pain with daily activities.
• Non-surgical management is the first line of treatment including rest, anti-inflammatory medications (NSAIDs), stretching exercises, and physical therapy.
• Cortisone injections can help in cases that do not improve with physical therapy and anti-inflammatories.

Gluteus medius / minimus tears

• Gluteus tears are an often underrecognized cause of lateral hip pain and can mimic the signs and symptoms of trochanteric bursitis. Gluteus tears can occur from a trauma or from degeneration over time. Symptoms can include pain on the outer side of the hip, pain with pressure on the outer side of the hip, inability to sleep on the affected hip, tenderness, lateral hip pain with daily activities, and hip weakness.
• Non-surgical management is the first line of treatment including rest, anti-inflammatory medications (NSAIDs), stretching exercises, and physical therapy.
• Cortisone injections can help in cases that do not improve with physical therapy and anti-inflammatories.
• In cases where pain and functional limitations persist, surgical repair may be necessary to repair the torn tendon back to the hip bone.

Hip arthritis

• Femoroacetabular impingement (FAI) – Femoroacetabular impingement occurs when there is an overgrowth of bone on the femur (hip bone) and/or the acetabulum (hip socket). This bone overgrowth can cause impingement of the hip labrum which can lead to labral tearing and hip pain. This pain is typically felt in the groin, but can sometimes be referred and cause pain on the outer side of the hip.
• Low back problems (lumbar radiculopathy) – Pinched nerves in the low back can sometimes cause hip pain, weakness, numbness/tingling, and pain that runs down the leg. If Dr. Boden suspects that a back problem may be contributing to your hip or leg symptoms, she may refer you to a back specialist for further evaluation.

Accurate diagnosis of the cause of lateral hip pain involves a thorough evaluation by an experienced orthopedic specialist like Dr. Stephanie Boden. She will begin by discussing the circumstances surrounding the pain including the type of activities associated with pain, the mechanism of injury, and the onset and duration of symptoms.

Dr. Boden will provide a thorough physical exam of the hip and thigh assessing for swelling, bruising, tenderness, range of motion, weakness, and signs of tendon injury.

She will order imaging studies, which may include:

• X-rays: to help assess for bony injuries, impingement, and arthritis which may contribute to lateral hip pain.
• MRI scan: to get a detailed image of the soft tissues of the hip including the labrum, cartilage, muscles, and tendons. This will allow her to confirm the suspected diagnosis, evaluate severity of the injury and evaluate for any other associated injuries.

She may recommend a hip injection. Depending on the suspected cause of the pain, hip injections can be helpful with diagnosis and management of various causes of hip pain.

The treatment of lateral hip pain depends on the underlying cause of the pain. In general, most causes of lateral hip pain can be managed without surgery to start. This will often consist of an early healing period consisting of modified activities and RICE (rest, ice, compression, and elevation) to help reduce swelling and pain. Physical therapy focused on gentle stretching and strengthening exercises is started after the initial healing phase. Over time, patients will work with physical therapists to progress back to their desired activities.

In rare instances, surgery may be needed if pain and functional limitations persist after a trial of non-surgical management depending on the underlying cause of the pain.