Six months I could not sleep on that side

THE 30-SECOND VERSION

Pain on the outside of the hip is often not arthritis in the joint at all. It is usually a tendon, and tendons respond to exercise. That is far better news.

FEEL-GOOD FRIDAY

Not the joint after all

We close hip week with the mix-up that sends people to the wrong conclusion about their own hip.

For about six months I could not sleep on my right side. There was a sore spot on the outside of that hip, right on the bony bump, and rolling onto it at two in the morning would wake me every time. Stairs bothered it. So did standing on that leg to pull on a sock.

I had it all worked out in my head. Sixty-seven years old, hip hurts, that is arthritis setting in, and arthritis is a one-way street. I braced myself for the long decline and told nobody, which is a habit I am trying to break.

I had jumped to the wrong conclusion. Pain in that exact spot usually is not the joint at all, and what it usually is happens to respond rather well to work. Let me explain.

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A sore spot on the outside of the hip, tender to press and worst lying on it. What is usually behind it?

Tap your guess. A ready-to-send reply opens. Just press send and we’ll tell you if you got it right.

A tendon on the outside of the hip

Arthritis inside the joint

A pinched nerve

THE MYTH

Outer hip pain is usually not arthritis

Start with where it hurts, because location tells you a great deal. Arthritis in the hip joint itself usually shows up in the groin, at the front, and it complains when you turn the leg. The joint sits deep inside you, closer to your groin than to your pocket.

Pain on the outside is a different animal. That bony bump you can feel on the side of your hip is where the tendons of the buttock muscles attach. Tendons are the cords that tie muscle to bone. When those particular tendons get irritated and worn, doctors call it gluteal tendinopathy. It is sore to press, and it hates being lain on.

It is far more common than people realize. It is the second most frequent hip complaint after arthritis, and around one in four women over 50 will get it. For years it was called bursitis, after a small fluid sac in the area. Then better imaging showed the tendon was usually the real problem, and the name changed.

Here is why this matters so much. If you decide it is arthritis, you conclude the joint is wearing out and nothing will help. If it is a tendon, the picture changes completely. Tendons answer to careful loading, which is a fancy way of saying they get better when you strengthen them properly.

The treatment is Monday’s exercise

This is the part that made me laugh. The best-tested program for this condition is a graded strengthening of the hip abductors, the very muscles we worked on Monday with the side-lying leg raise. Not rest. Not an injection first. Steady, progressive loading of the muscles on the outside of the hip, taught properly and built up over weeks.

One thing I will not do

I am not going to tell you which one you have. I cannot, and neither can a newsletter. The two can overlap, and other things cause outer hip pain too. What I will say is this: do not assume the worst from the word arthritis, and do get it looked at properly. Knowing which one you are dealing with changes the whole plan.

⚠ GET IT PROPERLY CHECKED

Do not diagnose yourself from an email

A short exam can tell these apart, and it is worth having. See a doctor promptly if:

● Pain shoots down the leg, or you have new numbness, tingling, or weakness in the leg or foot.

● The hip pain began after a fall, or you cannot put weight on the leg.

● The joint is hot, red, and swollen, or you have a fever alongside the pain.

When in doubt, get it checked. PainFree adds to your doctor’s care. It never replaces it.

THIS WEEK’S QUICK WINS

Three ways to carry hip week forward

📌 Note where it actually hurts

Point to it with one finger. Groin and front, or the bony bump on the side? Write that down and take it to your doctor. That single detail steers the whole assessment.

One minute • Worth more than a guess

🛏 Stop squashing the sore spot at night

Sleep on the other side with a pillow between your knees, so the top leg does not drop across and pull on the tender tendon. This is what finally gave me my nights back.

Nightly • One pillow, real relief

🧘 Keep Monday’s leg raises going

Strengthening the outer hip is the best-tested treatment for this problem, and good insurance either way. Ten slow lifts a side, most days, and build up gradually rather than rushing.

Daily • Slow and steady wins here

RESEARCH BRIEF

Exercise beat the injection, and kept beating it

An Australian trial known as LEAP compared three approaches for this outer hip tendon problem. One group had education about managing load plus a guided exercise program over eight weeks. One group had a steroid injection. One group waited and saw. The exercise group came out ahead on pain and on how much better people felt, both at eight weeks and again a full year later. That last part matters. Injections can settle things briefly, but at 52 weeks the exercise group was still in front. The sobering side: left alone, about one in three people still have symptoms years on. This is not a problem that reliably fades by itself.

52 wks

exercise still ahead of injection a year later

2nd

most common hip complaint, after arthritis itself

1 in 3

still have symptoms years later if it is left alone

Waiting it out is the weakest of the three options. Guided strengthening of the outer hip is the one that held up over a year.

WORTH KNOWING

1 in 4

Around a quarter of women over 50 experience this outer hip tendon problem. If that sore spot on the side of your hip has been keeping you off that shoulder at night, you are in very common company, and it is not the joint giving up.

From reported prevalence of gluteal tendinopathy.

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