I-70 EAST TO I-270
From O’Fallon, PRP and orthobiologic care is around twenty-four minutes east on I-70 and I-270, at our clinic on Natural Bridge Road. Lateral (outer) hip pain that hurts when you lie on it is almost never bursitis. Treating it as bursitis is why it has not gone away.
Getting here from O’Fallon
I-70 east to I-270 north, then east to Natural Bridge Road. It takes around twenty-four minutes outside the afternoon rush. Parking is at the door.
What can be mistaken for hip bursitis?
Pain on the outside of the hip gets called trochanteric bursitis almost automatically. It is worse lying on that side and worse climbing stairs. But imaging and surgical studies have shown for years that the bursa (a small fluid sac) is often not involved.
What is actually breaking down is the gluteal tendon where it attaches to the greater trochanter (the bony point of the hip). It is a tendinopathy, not an inflamed sac. That is why repeated cortisone into the bursa does less each time. It is also why the problem outlasts it.
Gluteal tendinopathy covers the anatomy and how to tell the two apart.
Why the commute makes it worse
A long daily drive holds the hip in one position for a long time. The leg is angled inward, and the tendon is squeezed against the bone. Add a desk at the other end, and the tissue spends most of the day in the position that irritates it.
That is worth naming because it changes the advice. Crossing the legs, sleeping on the painful side, and sitting low all squeeze the same structure. Changing those does more early on than most treatments.
Do cortisone shots help hip bursitis?
A steroid injection here often helps for a few weeks. Repeated, it has a measurable harmful effect on tendon tissue. That is the very structure that is already failing.
So the honest framing is that cortisone buys time instead of repairing anything. And each round buys less. PRP versus cortisone sets out what the evidence actually supports for each.
Should you sleep on the side that hurts?
The single most effective early change for lateral (outer) hip pain is usually not a treatment. It is a pillow between the knees and, where possible, not sleeping on the painful side. That is because lying on your side squeezes the tendon against the bone for hours.
People brush it off because it sounds trivial. It is often the difference between a tendon that is irritated for eight hours a night and one that is not.
Is it hip pain or back pain?
Lateral (outer) hip pain and pain referred from the lower spine overlap. Some of what gets treated as hip pain is coming from the back. An exam can tell the two apart.
Hip or back? covers how that is worked out. It is worth settling before anything is injected into either.
Does strengthening help outer hip pain?
Weak abductors (the outer hip muscles) both cause gluteal tendinopathy and result from it, and the loop closes fast. A program that loads the tendon step by step is what changes the tissue. Everything else manages symptoms.
It is slower than an injection. And it is the part that decides whether the result lasts past six months.
When to stop and reassess
Some signs belong in a different conversation. Night pain that does not depend on position, pain that keeps getting worse instead of coming and going, or any fever should not be managed as tendinopathy.
Those are uncommon, and they are worth stating, because a confident wrong diagnosis is more dangerous than an uncertain right one.
If both hips hurt
Lateral (outer) hip pain on both sides shifts the question toward load, gait and sometimes the spine. It is less likely to be two tendon problems by coincidence.
It also raises inflammatory and metabolic causes. That is a different workup, and one worth doing before injecting either side.
What the plan looks like
Load management first. Then a structured strengthening program for the abductors. Then injection, only where that program has truly been run and stalled.
The recovery timeline sets out how long each stage should take. That way a normal plateau is not mistaken for failure.
What we do instead
Confirm the structure and load it properly. Where a repair response is worth sparking, use an orthobiologic preparation suited to tendon, not to joint.
The loading part is not optional. It is the part patients most often skip, because it is slower and less dramatic than an injection. Without it, the injection is treating tissue that will be asked to do exactly what failed it before.
Hip pain in a younger patient is usually a different diagnosis
The hip discussion on this page assumes degenerative change. In patients under about forty, a different picture is common. Groin pain with clicking, catching or a sharp limit when bending the hip up more often points to femoroacetabular impingement and the labral injury (a tear in the socket’s rim) that comes with it.
The cause is a shape mismatch, not wear. There may be extra bone on the femoral neck, a deeper-than-usual socket, or both. So the two surfaces collide at the end of range instead of clearing each other. Repeated collision damages the labrum and the cartilage next to it.
The tells are specific. Pain comes back when the hip is bent up, angled inward and turned in. Sitting for long periods is hard. And there is often a history of a sport with repeated deep hip bending.
It matters here for two reasons. The treatment order is different. And the surgical option truly works in selected patients, unlike much of what is offered for degenerative hips. Getting the diagnosis right early, before more cartilage damage builds up, changes what is available later.
What O’Fallon patients ask
I was told it is bursitis. Is that wrong?
Usually, yes. The bursa is often not involved, and the tendon is the structure that has broken down: gluteal tendinopathy.
Why did my cortisone injection stop working?
Because it suppresses inflammation without repairing tendon. And repeat exposure has a cost to the tissue: the comparison.
Can I keep driving to work?
Yes, with changes: seat height, avoiding crossed legs, and breaking up the position. Those change the load the tendon is under all day.
How far is it from O’Fallon?
About twenty-four minutes via I-70 and I-270, with free parking outside.
How do you cure bursitis of the hip?
Most outer hip pain labeled bursitis is a gluteal tendon problem, so the plan treats the tendon. Load management comes first. Use a pillow between the knees, do not sleep on the painful side, and avoid crossed legs and low seats. Then comes a structured strengthening program for the abductors. An orthobiologic injection suited to tendon is considered only when that program has truly been run and stalled.
How can I tell if hip pain is bursitis?
Pain on the outside of the hip that is worse lying on that side and worse climbing stairs gets called bursitis almost automatically. But the bursa is often not involved. The usual cause is the gluteal tendon where it attaches to the bone. Pain referred from the lower back overlaps with it. An exam can tell the two apart, and that is worth settling before anything is injected.
Does hip bursitis ever go away?
It often lingers because it is treated as bursitis when the real problem is a breaking-down tendon. And cortisone into the bursa buys less time with each round. What changes the tissue is taking pressure off the tendon and loading it step by step. That strengthening work is slower than an injection. It decides whether the result lasts past six months.
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12174 Natural Bridge Rd, Suite 303
St. Louis, MO 63044