Hip assessment: trochanteric bursitis, hip arthritis, gluteal tendinopathy and referred pain.
Hip arthritis slowing your walks?
'Hip pain' covers more ground than most patients realise.
Pain in the outer hip, the groin, the buttock and the upper thigh all get filed under the same label, but they have different drivers, different treatments and very different outlooks. Working out which is in play is the most important step.
At the Skin & Joint Injection Clinic in Bebington, Wirral, we assess hip pain in person, with careful examination and ultrasound where it helps. Trochanteric bursitis is far more common than people think; many patients arrive expecting an 'arthritis' answer and leave with a more accurate, more treatable diagnosis.
When it hurts, and where you feel it, often point towards the cause. These are three we hear about often.
NightOuter-hip pain that makes lying on the affected side painful and breaks up sleep. Lying on the other side can hurt too, as the affected hip drops and stretches the inflamed tissue.
Often seen with Trochanteric bursitis →
MorningDeep groin or buttock pain, and a hip that won't rotate far enough to reach your feet easily. Stairs and getting out of the car can be harder too.
Often seen with Hip osteoarthritis →
AfternoonPain that builds with weight-bearing can cut the usual walk short. Where you feel it matters: the groin and buttock point one way, the outer hip and thigh another.
See the common causes →These are the patterns of hip pain we most commonly assess. The list isn't diagnostic: your consultation works out which (if any) fits your symptoms.
Hover or tap the points on the circle to explore each pattern.
The hip joint sits deep, surrounded by major blood vessels and nerves, while the bursa and gluteal tendons lie on the outside of the hip. Ultrasound shows us which structure we are treating.
Trochanteric bursitis and gluteal tendinopathy sit here, on the outside of the hip. Steroid injections here are £400, the same as any hip injection.
Osteoarthritis affects the cartilage of the femoral head and the socket. Injections into the joint itself are guided carefully by ultrasound because the joint lies deep.
Pain felt in the hip can start in the lower back. We screen for this carefully, because the right treatment is different.
Engraving for orientation, not to scale.
Patterns of pain matter as much as imaging. Below are the routes we most often discuss for hip problems. Final recommendation always follows in-person assessment.
Outer-hip pain disturbing sleep, painful to lie on the affected side, no significant groin pain.
Targeted into the trochanteric bursa under ultrasound guidance. Often a turning point in trochanteric pain that hasn't settled with physiotherapy and load management.
Read more about steroid injection →Deep groin pain on weight-bearing with reduced hip rotation: hip osteoarthritis without inflammatory flare.
A non-steroid route for hip osteoarthritis where supporting joint lubrication is the goal. Ultrasound-guided into the femoroacetabular joint.
Read more about Ostenil Plus →Hip osteoarthritis where a longer-acting single injection is preferred and a non-steroid route is desired.
Durolane is most commonly used in the knee, but is considered for the hip in selected cases where a cross-linked, longer-acting single shot fits the goals.
Read more about Durolane →Chronic gluteal tendinopathy that has plateaued despite physiotherapy and load management.
An autologous regenerative option for chronic gluteal tendon problems where steroid injection has not helped or repeated injections are not appropriate.
Read more about PRF →Treatments are considered after clinical assessment. We do not offer or recommend injection therapy without first confirming the diagnosis and screening for contraindications.
Treatment fees include consultation, examination, ultrasound guidance where appropriate, the procedure and aftercare guidance. The final price is confirmed after assessment.
About hip injection fees →An injection can open a window of easier movement. The strengthening done in that window is what helps keep a hip working, and not every hip needs an injection at all.
Calming an inflamed bursa, irritated gluteal tendons or an arthritic joint can ease pain, including the night pain of lying on the sore side.
With pain quieter, the work that protects a hip becomes possible: gluteal strengthening, load management and walks that build tolerance step by step.
Stronger hip muscles support the joint and the tendons. Many patients find walking, stairs, socks and sleep easier, though responses vary.
We know it can feel difficult to book a procedure when you are not sure what will happen next. Your clinician will explain suitability, risks, recovery and aftercare before treatment goes ahead.
The questions patients most often raise in clinic when they're not sure which next step is right.
They feel quite different on careful assessment. Trochanteric bursitis causes outer-hip pain, painful to lie on that side at night, with the hip itself often comfortable to rotate. Hip osteoarthritis causes deeper groin or buttock pain on weight-bearing with restricted internal rotation. Many patients arrive convinced they have 'hip arthritis' when it's actually trochanteric bursitis, which is good news, because it usually responds well to a targeted injection.
This is the classic pattern of trochanteric bursitis or gluteal tendinopathy: both involve structures on the outside of the hip that get compressed when you lie on that side. Sometimes it's worse on the unaffected side too, because the affected hip drops downwards and stretches the inflamed tissue. It's a frequent reason for fragmented sleep and reduced quality of life.
No. For trochanteric bursitis, examination is usually enough to plan a treatment. For hip osteoarthritis, an X-ray is helpful but not always essential. MRI is occasionally needed when the diagnosis is unclear, when there's concern about a femoral neck or labral problem, or when surgery is on the agenda. We discuss imaging case by case rather than ordering it routinely.
A steroid hip injection is £400, whether it goes into the hip joint itself or around the outside of the hip (the trochanteric bursa or gluteal tendons). Hip injections are more involved than most other joints because the structures lie deep and need careful ultrasound guidance.
Our GP-led clinic in Higher Bebington serves patients from across Merseyside: Liverpool, Birkenhead, Heswall and Chester. We assess in person before any treatment is offered, and refer onward when it's the right call.
