Symptom guide
Hip pain when lying on your side: causes, red flags and when to get it checked
Pain over the bony point on the outside of the hip, worse when lying on that side at night, and sometimes when climbing stairs or standing from a chair, is most often greater trochanteric pain syndrome, once called trochanteric bursitis. It is common in middle-aged and older women and usually settles with exercise and activity changes. Hip joint problems feel different, in the groin.
Last checked: 2026-10-03
Key facts
At a glance.
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Location
Pain on the outside of the hip, tender to press, worse lying on that side, suggests tendon or bursa problems.
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Groin pain
Pain in the groin or inner thigh, with stiffness, suggests the hip joint itself, such as osteoarthritis.
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Common
Greater trochanteric pain syndrome is common, particularly in women and with gluteal tendon weakness.
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Helpful measures
Exercise-based physiotherapy, pillow support between knees and activity changes help most people.
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Who to see
GP; physiotherapy; orthopaedics if persistent or suspected hip joint disease.
What this symptom usually means
The bony prominence on the outer hip (the greater trochanter) is where the gluteal tendons attach. These tendons can become irritated or partially torn, with the bursa alongside inflamed. Lying on the sore side compresses them, so night pain is typical. Pain felt elsewhere around the hip can come from the joint or back.
Possible causes, from most to least common
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Greater trochanteric pain syndrome: gluteal tendinopathy with or without bursitis, tender over the outer hip.
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Hip osteoarthritis: groin pain, stiffness, reduced rotation and difficulty with socks and shoes.
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Referred pain from the lower back or sacroiliac joint, sometimes spreading to the buttock and thigh.
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Iliotibial band tightness and muscle strains.
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Trapped nerve (meralgia paraesthetica) causing burning on the outer thigh.
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Inflammatory arthritis, avascular necrosis, stress fracture or labral tear.
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Septic arthritis, bone infection or fracture after a fall.
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Tumour, which is uncommon but a consideration with persistent unexplained night pain.
Features that point to something more serious
Sudden severe pain after a fall, inability to bear weight, fever, groin pain with locking, constant night pain unrelieved by position, unexplained weight loss, a history of cancer, or steroid use or heavy alcohol intake suggest fracture, infection or other serious causes.
Red flags: when to seek help
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Call 999 or go to A&E: hip pain after a fall with inability to bear weight, or a shortened, rotated leg.
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Same-day GP: severe hip pain with fever or a hot, swollen joint.
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GP within days: constant night pain unrelieved by position, or hip pain with unexplained weight loss.
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Routine GP or physiotherapy: outer hip pain over several weeks, worse lying on that side.
What a doctor will ask and examine
The clinician asks where the pain is, whether it is worse lying on that side, on stairs or standing, whether you feel pain in the groin, stiffness, injury, back pain and medical history. They press over the greater trochanter, test hip movement, single-leg stance, strength of the gluteal muscles, and examine the back.
Tests that are commonly used and why
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Usually none initially; examination is diagnostic.
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Ultrasound: shows gluteal tendon changes and bursal fluid.
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X-ray: for arthritis, fracture and bone abnormalities.
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MRI: for tendon tears, avascular necrosis, labral tears or persistent pain.
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Blood tests: if inflammatory disease or infection is possible.
Self-care and the usual route
Sleep on the unaffected side with a pillow between your knees or on your back, avoid crossing your legs or sitting with the affected hip tucked under, and avoid standing with weight shifted onto one hip. Progressive gluteal strengthening with a physiotherapist is the mainstay of treatment, with load management. Weight loss helps if appropriate. Corticosteroid injection and shockwave therapy can give relief for some people.
The NHS route is a GP and physiotherapy, with orthopaedic referral for persistent pain. Private physiotherapy, ultrasound-guided injections and orthopaedic review are available directly.
Frequently asked
Questions people ask.
Quick, plain-English answers to the questions we hear most.
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Why does my hip hurt when I lie on it?
Lying on the side compresses the tendons and bursa over the outer hip, making greater trochanteric pain syndrome worse at night.
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Is it bursitis?
Often called trochanteric bursitis, but tendon problems are now thought to be the main cause, with the bursa sometimes involved.
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How do I tell hip joint from tendon pain?
Joint pain is usually in the groin with stiffness and reduced movement. Tendon pain is on the outer hip and tender to touch.
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What helps sleep?
Sleeping on the other side with a pillow between the knees, or on your back, takes pressure off the sore area.
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Do I need an injection?
Not usually at first. Exercise-based physiotherapy is first-line, and injections may give temporary relief.
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Do I need an X-ray?
If joint disease is suspected, there was a fall, or pain is persistent, an X-ray may be useful.
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How long does it last?
Most people improve over weeks to months, with longer recovery for chronic cases.
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Can it be referred from my back?
Yes, lumbar spine and sacroiliac problems can cause pain around the hip and buttock.
Where this comes from
Sources and checking.
This guide is for information, not medical advice.
Your GP or consultant knows your history and can tell you which parts apply to you. If your symptoms are severe, rapidly worsening, or come with red-flag features, seek urgent medical care. Figures and availability change, so treat them as a guide and confirm with the provider.
Published 2026-10-03, next review 2027-10-03.
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NHS: Hip pain (nhs.uk/conditions/hip-pain/)
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NICE CKS: Trochanteric bursitis (cks.nice.org.uk, topic page)
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NHS: Osteoarthritis (nhs.uk/conditions/osteoarthritis/)