Hip pain can make everyday activities uncomfortable, from walking and climbing stairs to getting a good night’s sleep. But not all hip pain comes from the same source. Two common causes are hip bursitis and hip arthritis, and understanding the difference can help you take the right steps toward relief.
At Orthopedic Specialists of Southwest Florida (OSSWF), our orthopedic team helps patients throughout Fort Myers and Southwest Florida identify the underlying causes of hip pain and explore personalized treatment options.
Whether you’re experiencing a dull ache, sharp discomfort, or stiffness that limits your movement, knowing what your symptoms may indicate is the first step toward getting back to the activities you enjoy.
Understanding Hip Pain: Why the Cause Matters
The hip is one of the body’s largest weight-bearing joints. It supports your body during walking, standing, bending, and countless daily movements.
Because the hip is surrounded by muscles, tendons, ligaments, bursae, and other structures, discomfort in this area can originate from several different sources.
Two frequently discussed conditions are:
- Hip bursitis: Inflammation or irritation involving a fluid-filled sac that cushions tissues around the hip.
- Hip arthritis: Damage or inflammation affecting the joint itself, often involving the cartilage that helps the bones move smoothly.
Although both conditions can cause pain and interfere with mobility, they affect different structures and may require different treatment approaches.
Understanding where your pain occurs, what makes it worse, and whether you’re experiencing stiffness or tenderness can provide important clues.
However, symptoms alone cannot always distinguish one condition from the other. A professional orthopedic evaluation is often the best way to determine what’s causing persistent hip discomfort.
What Is Hip Bursitis?
Hip bursitis occurs when a bursa becomes irritated or inflamed.
Bursae are small, fluid-filled sacs that help reduce friction between bones, tendons, muscles, and other tissues.
Several bursae are located around the hip, but one of the most commonly affected areas is the outside of the hip near a bony prominence called the greater trochanter.
Pain in this area is often described as greater trochanteric pain syndrome, or GTPS.
Although GTPS is frequently called hip bursitis, the condition can also involve irritation or damage to the gluteal tendons. This distinction matters because not every case of outer hip pain is caused primarily by an inflamed bursa.
Common Symptoms of Hip Bursitis
Patients experiencing lateral hip pain associated with bursitis or GTPS may notice:
- Pain or tenderness along the outside of the hip
- Discomfort when lying on the affected side
- Pain when climbing stairs or walking uphill
- Increased discomfort after prolonged walking or standing
- Tenderness when pressing on the outer hip
- Pain that occasionally extends down the outside of the thigh
One of the most recognizable symptoms is difficulty sleeping on the affected side.
For some patients, even the pressure of lying in bed can aggravate the irritated tissues.
What Causes Hip Bursitis?
Several factors may contribute to bursitis or greater trochanteric pain syndrome, including repetitive activity, changes in exercise routines, tendon problems, or direct pressure on the hip.
Potential contributing factors include:
- Repetitive walking, running, or stair climbing
- Sudden increases in physical activity
- Weakness or imbalance in the muscles surrounding the hip
- Prolonged pressure on the outside of the hip
- Previous hip injuries
- Changes in walking mechanics
Hip bursitis and GTPS are particularly relevant for active adults who participate in activities such as golf, pickleball, walking, and recreational fitness.
While staying active is important, persistent outer hip pain shouldn’t be ignored.
What Is Hip Arthritis?
Hip arthritis affects the hip joint itself.
The hip is a ball-and-socket joint, where the rounded head of the thighbone fits into a socket in the pelvis.
Healthy cartilage covers the joint surfaces, allowing the bones to move smoothly while absorbing stress during movement.
With hip osteoarthritis, cartilage gradually deteriorates and changes occur in the underlying bone and surrounding joint structures.
As the condition progresses, the joint may become painful, stiff, or less mobile.
Osteoarthritis is one of the most common forms of hip arthritis, particularly among middle-aged and older adults.
Other inflammatory conditions, including rheumatoid arthritis, can also affect the hip joint, although their underlying causes differ.
Common Symptoms of Hip Arthritis
Hip arthritis can produce several symptoms that may be different from those associated with bursitis.
Common signs include:
- Deep pain in the groin or front of the hip
- Stiffness after sitting or resting
- Difficulty putting on shoes or socks
- Reduced range of motion
- Pain when standing up from a chair
- Discomfort during prolonged walking
- Difficulty rotating the hip or getting in and out of a vehicle
Some patients also experience pain in the buttock, thigh, or even the knee.
Because hip arthritis can produce discomfort outside the immediate hip joint, identifying the source of pain isn’t always straightforward.
What Causes Hip Arthritis?
Hip osteoarthritis develops through a combination of factors rather than a single cause.
Potential risk factors include:
- Increasing age
- Previous hip injuries
- Family history of osteoarthritis
- Structural differences in the hip joint
- Repetitive or excessive joint loading
- Higher body weight
- Certain underlying joint conditions
Although arthritis becomes more common with age, it is not an inevitable part of getting older.
Many people with hip arthritis remain active and manage their symptoms successfully with appropriate treatment.
Hip Bursitis vs. Hip Arthritis: What’s the Difference?
While both conditions can make walking, exercising, and sleeping uncomfortable, the location and characteristics of your symptoms may offer clues.
| Symptom | Hip Bursitis / GTPS | Hip Arthritis |
|---|---|---|
| Typical pain location | Outside of the hip | Groin, front of hip, or deep within the joint |
| Pain when lying on the affected side | Common | Possible, but less characteristic |
| Morning stiffness | May occur | Common, especially after inactivity |
| Tenderness when pressing the outer hip | Common | Less characteristic |
| Difficulty putting on shoes and socks | Less typical | Common with reduced hip mobility |
| Pain with stairs | Common | Common |
| Reduced hip range of motion | May occur | Often present |
| Pain extending into the thigh | Possible | Possible |
Important: These are general patterns, not diagnostic rules. Hip bursitis, tendon conditions, arthritis, and referred pain from the lower back can overlap. Some patients may have more than one condition at the same time.
7 Clues That May Help Explain Your Hip Pain
1. Your Hip Hurts When You Sleep on Your Side
If you notice discomfort primarily when lying on one side, particularly when pressure is placed directly on the outside of your hip, bursitis or GTPS may be contributing to your symptoms.
This pain can interfere with sleep and may become more noticeable after an active day.
Changing sleeping positions or placing a pillow between your knees may help reduce discomfort temporarily, but recurring pain deserves further evaluation.
2. You Feel Pain Deep in Your Groin
Pain deep within the groin or front of the hip is commonly associated with conditions affecting the hip joint, including arthritis.
Patients may describe a dull ache, pressure, or discomfort when walking or rotating the leg.
Groin pain can have several causes, however, and should not automatically be attributed to arthritis.
3. Your Hip Feels Stiff After Sitting
Do you find yourself taking several uncomfortable steps after getting out of a chair?
Hip arthritis frequently causes stiffness after periods of inactivity.
This may be particularly noticeable first thing in the morning or after a long car ride.
The stiffness may improve somewhat as you begin moving, although prolonged activity can also aggravate symptoms.
4. Pressing on the Outside of Your Hip Causes Pain
Tenderness directly over the bony area on the outside of your hip is a common finding in greater trochanteric pain syndrome.
You may notice discomfort when leaning against a countertop, lying on your side, or touching the area.
While tenderness is an important clue, it does not identify which specific structure is irritated.
5. Putting on Shoes or Socks Has Become Difficult
Hip arthritis can gradually reduce joint mobility.
Tasks that require bending or rotating the hip, such as putting on socks, tying shoes, or getting into a vehicle, may become more challenging.
If these activities are becoming increasingly difficult, restricted hip motion may be contributing to your symptoms.
6. Walking or Climbing Stairs Makes the Pain Worse
Both hip bursitis and arthritis can cause pain during walking and stair climbing.
With GTPS, symptoms may be related to the forces placed on the tendons and other tissues along the outside of the hip.
With arthritis, discomfort may result from loading the affected joint.
The location of pain, associated stiffness, and findings during a physical examination can help your orthopedic provider distinguish between potential causes.
7. Your Hip Pain Is Interfering With Your Daily Routine
Regardless of whether your pain originates from bursitis, arthritis, or another condition, symptoms that interfere with everyday activities deserve attention.
Warning signs include:
- Avoiding walks because of discomfort
- Waking up repeatedly due to hip pain
- Difficulty completing household tasks
- Limiting exercise or recreational activities
- Increasing reliance on over-the-counter pain medication
- Experiencing persistent or worsening symptoms
You don’t have to wait until hip pain becomes severe to seek an orthopedic evaluation.
Can You Have Hip Bursitis and Hip Arthritis at the Same Time?
Yes.
Hip bursitis or GTPS and hip arthritis can occur together.
For example, arthritis may change the way a person walks, potentially increasing stress on surrounding muscles and tendons.
At the same time, someone with outer hip pain may also have underlying joint degeneration.
This is one reason why identifying the precise cause of hip discomfort is important.
Treating only one source of pain may not fully address symptoms when multiple structures are involved.
An orthopedic specialist can assess your joint mobility, walking mechanics, strength, and pain patterns to help determine which conditions may be contributing.
How Is Hip Pain Diagnosed?
At Orthopedic Specialists of Southwest Florida, determining the source of hip pain begins with a comprehensive evaluation.
Your orthopedic provider may ask questions about when your symptoms began, where the pain is located, what activities aggravate it, and how it affects your daily routine.
Physical Examination
A physical examination may include assessing:
- Hip range of motion
- Tenderness around the joint
- Muscle strength
- Walking patterns
- Balance and functional movement
- Pain during specific movements
These findings help distinguish between joint-related problems, tendon conditions, and other potential sources of discomfort.
Diagnostic Imaging
Depending on your symptoms and examination, imaging may be recommended.
X-rays can help identify joint-space narrowing, bone changes, and other findings associated with arthritis.
MRI may be useful when additional information is needed about tendons, muscles, cartilage, or other soft tissues.
Ultrasound can sometimes help evaluate structures around the outside of the hip and may be used to guide certain injections.
Not every patient needs advanced imaging. Your provider can recommend appropriate testing based on your individual situation.
Treatment Options for Hip Bursitis
Many patients with hip bursitis or greater trochanteric pain syndrome improve with nonsurgical treatment.
The appropriate approach depends on the underlying cause, severity of symptoms, and individual health considerations.
Physical Therapy
Physical therapy often plays an important role in managing outer hip pain.
A personalized program may focus on strengthening the hip abductor muscles, improving movement mechanics, and gradually increasing tolerance for activity.
Activity Modification
Temporarily adjusting activities that aggravate symptoms may help reduce irritation.
This doesn’t necessarily mean avoiding exercise altogether.
Instead, your provider may recommend modifying walking distances, stair climbing, sleeping positions, or other activities while symptoms improve.
Medication
Certain over-the-counter anti-inflammatory medications may help manage pain when appropriate.
However, these medications aren’t suitable for everyone, particularly patients with certain kidney, gastrointestinal, cardiovascular, or medication-related risks.
Always discuss medication use with your healthcare provider.
Corticosteroid Injections
In selected cases, a corticosteroid injection may provide short-term symptom relief.
However, injections aren’t appropriate for every patient, and repeated injections may carry risks, particularly when tendon problems are involved.
Your orthopedic provider can help determine whether an injection is appropriate.
Treatment Options for Hip Arthritis
Treatment for hip arthritis depends on the severity of joint changes, the degree of pain, and how much the condition affects daily activities.
Physical Therapy and Exercise
Targeted exercises can help maintain mobility, improve muscle support, and reduce functional limitations.
Low-impact activities such as swimming, stationary cycling, and appropriately paced walking may be useful for many patients.
Lifestyle Modifications
Changes in activity, movement patterns, and weight management when appropriate can help reduce stress on the hip joint.
Supportive devices, such as a cane, may also help selected patients improve comfort and mobility.
Pain Management
Treatment may include topical or oral medications when medically appropriate.
In some circumstances, an image-guided corticosteroid injection into the hip joint may provide temporary relief.
Hip Replacement Surgery
For patients with advanced arthritis who continue to experience significant pain and functional limitations despite appropriate nonsurgical treatment, hip replacement surgery may be considered.
Hip replacement involves replacing damaged joint surfaces with artificial components designed to improve joint function and reduce pain.
Surgery is not the first step for every patient with arthritis.
The decision should be based on symptoms, imaging findings, overall health, personal goals, and a discussion of potential benefits and risks with an orthopedic surgeon.
When Should You See an Orthopedic Specialist for Hip Pain?
Occasional mild soreness after activity may improve with rest and appropriate self-care.
However, persistent hip pain should not be ignored, especially when it begins to affect your mobility or quality of life.
Consider scheduling an orthopedic evaluation if:
- Hip pain persists or continues returning
- Symptoms interfere with sleep
- You experience increasing stiffness
- Walking or climbing stairs becomes difficult
- You notice reduced mobility
- Pain prevents you from participating in activities you enjoy
- Previous treatments haven’t provided adequate relief
Seek urgent medical attention for severe hip pain after a fall or injury, inability to bear weight, a visibly deformed hip, or hip pain accompanied by fever, significant warmth, or redness. These symptoms may indicate a fracture, infection, or another condition requiring prompt care.
Frequently Asked Questions About Hip Bursitis and Hip Arthritis
Can hip bursitis feel like arthritis?
Yes. Both conditions can cause pain with walking, standing, and certain movements. However, bursitis or GTPS more commonly produces tenderness along the outside of the hip, while arthritis often causes deeper groin pain and joint stiffness. An examination is necessary to confirm the cause.
Does hip bursitis go away on its own?
Some mild cases improve with activity modification and time. However, persistent symptoms, particularly those involving the gluteal tendons, may require physical therapy or additional treatment.
Is walking good for hip arthritis?
Walking can be a beneficial low-impact activity for many people with hip arthritis. The appropriate amount depends on symptoms and physical ability. If walking consistently worsens pain, an orthopedic provider or physical therapist can help modify your activity plan.
Can an X-ray show hip bursitis?
Standard X-rays generally do not show inflammation of a bursa directly. They are more useful for evaluating bones and joint changes, including arthritis. Ultrasound or MRI may be considered when further soft-tissue evaluation is needed.
Is hip bursitis more painful than hip arthritis?
Pain severity varies significantly from person to person. Either condition can produce substantial discomfort. The intensity of pain alone cannot reliably distinguish between bursitis and arthritis.
Do I need surgery for hip bursitis or arthritis?
Most patients with bursitis or GTPS are treated without surgery. Many patients with hip arthritis can also manage symptoms nonsurgically. Surgery may be considered for certain persistent tendon problems or advanced arthritis when appropriate treatments have not provided sufficient relief.
Don’t Let Hip Pain Keep You on the Sidelines
Whether you’re enjoying a morning walk, playing a round of golf, staying active with pickleball, or simply trying to move comfortably throughout your day, your hips play an essential role in your quality of life.
When hip pain begins to interfere with those activities, finding the underlying cause matters.
Hip bursitis and hip arthritis may share similar symptoms, but they aren’t the same condition, and effective treatment begins with an accurate diagnosis.
At Orthopedic Specialists of Southwest Florida, our orthopedic team is dedicated to helping patients understand their symptoms, explore appropriate treatment options, and work toward improved mobility and comfort.
From orthopedic evaluations and physical therapy to nonsurgical treatment and advanced surgical care when indicated, OSSWF provides coordinated orthopedic services designed around your individual needs.
Take the First Step Toward Hip Pain Relief
You don’t have to keep guessing what’s causing your hip pain or adjusting your life around the discomfort.
If you’re experiencing persistent hip pain, stiffness, difficulty walking, or discomfort that interrupts your sleep, now is the time to seek answers.
Schedule an appointment with Orthopedic Specialists of Southwest Florida to receive a personalized evaluation and discuss the next steps toward getting back to the activities you love.
Visit www.osswf.com to request an appointment and take the first step toward better movement, greater comfort, and a more active life.
