Hip Bursitis Treatment in Sydney CBD

Outer hip pain that’s worse at night, on stairs, or when lying on your side. It sounds simple. It’s frequently mismanaged. And rest alone almost never fixes it.

City Physio & Pilates treats hip bursitis at our Sydney CBD clinic at 25 Martin Place. If you’ve been told to rest and ice and it keeps coming back, there’s a reason — and it’s fixable.

What Is Hip Bursitis?

Hip bursitis — more accurately called greater trochanteric pain syndrome (GTPS) — is irritation or inflammation of the bursa sitting on the outer aspect of the hip at the greater trochanter. The bursa is a fluid-filled sac whose job is to reduce friction between the gluteal tendons and the underlying bone. When it becomes irritated — through compression, overload, or altered movement mechanics — it produces the characteristic sharp, aching pain on the outside of the hip.

What’s important to understand is that in most cases, the bursa is not the primary problem. It’s reacting to something else — usually gluteal tendon overload, hip abductor weakness, or altered movement patterns that increase compressive load on the outer hip. Treating only the bursa without addressing those drivers is why so many people with hip bursitis improve temporarily and then relapse.

Symptoms of Hip Bursitis

Pain on the outer hip, sometimes radiating into the outer thigh
Aching at night, particularly when lying on the affected side
Pain climbing stairs, getting up from a low chair, or walking uphill
Tenderness directly over the greater trochanter (the bony prominence on the outer hip)
Pain sitting with legs crossed or in low chairs
Discomfort walking for extended periods

Hip bursitis is more common in women, particularly in the perimenopausal years, and in runners and walkers — though it occurs across all populations and activity levels.

What Causes Hip Bursitis?

The most common drivers include:

Gluteal tendon overload — the gluteus medius and minimus tendons attach at the greater trochanter alongside the bursa. Tendon overload — from increased training load, changes in activity, or biomechanical inefficiency — increases compressive forces on the bursa.

Hip abductor weakness — weakness in the gluteal muscles alters how load is distributed through the outer hip, increasing bursal compression during single-leg activities like walking, running, and stairs.

Movement pattern faults — habitual hip adduction (the thigh crossing the midline during walking or running) dramatically increases compression at the greater trochanter.

Posture and leg length — prolonged hip adduction postures, leg length discrepancy, and altered lumbopelvic mechanics all contribute.

Sudden load increase — a rapid increase in running volume, walking, or step-based activity is a common trigger.

How Is Hip Bursitis Treated?

Effective treatment targets the underlying load drivers — not just the bursa.

At City Physio & Pilates, treatment typically includes:

Load management — identifying and modifying the activities compressing the bursa while maintaining as much function as possible. Complete rest is rarely the answer and often makes things worse by allowing further deconditioning.

Manual therapy — to address hip joint mobility, lumbar spine contribution, and soft tissue restrictions around the hip and pelvis.

Progressive strength training — a structured gluteal and hip abductor strengthening programme is the cornerstone of long-term resolution. This is where most bursitis treatment falls short — the exercises need to be the right exercises, at the right load, progressed correctly.

Movement retraining — correcting hip adduction patterns in walking, running, and daily activities to reduce compressive load at the greater trochanter.

Dry needling — for gluteal muscle trigger points and referred pain contributing to symptoms.

Clinical Pilates — particularly useful for integrating hip stability and load tolerance into functional movement patterns once the acute phase has settled.

Corticosteroid injections are sometimes recommended by GPs for hip bursitis. They can provide short-term pain relief but do not address the underlying cause and have a poor long-term track record as a standalone treatment. Physiotherapy that targets the load drivers produces significantly better long-term outcomes.

Frequently Asked Questions

How long does hip bursitis take to resolve? With appropriate physiotherapy and load management, most presentations improve meaningfully within 6–8 weeks. Full resolution of a long-standing case can take 3–4 months of progressive rehabilitation. The longer it has been present, the longer structured rehab takes — which is a good reason to get it assessed early.

Is walking good or bad for hip bursitis? It depends on the presentation. Short, flat walks at a comfortable pace are generally fine. Long walks, hills, and stairs tend to aggravate it. Your physiotherapist will give you specific guidance based on your assessment findings.

Do I need a scan? Not usually for initial diagnosis — hip bursitis is a clinical diagnosis made through examination. Ultrasound or MRI can confirm bursal inflammation or associated tendon pathology if the presentation is unclear or not responding as expected.

Can hip bursitis come back? Yes, if the underlying drivers — weakness, movement patterns, load — aren’t fully addressed. That’s why a structured strengthening programme matters more than short-term symptom management.

Book a Hip Bursitis Assessment

City Physio & Pilates | 25 Martin Place, Sydney CBD | Steps from Martin Place Metro and Wynyard

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