When something goes wrong in the hip joint, there are a lot of possible culprits: bones, muscles, tendons, ligaments, and more. Just as with low back pain, the source of hip pain can be difficult to pinpoint.

One common pain, two different problems

Two likely causes of hip pain are osteoarthritis and bursitis. They have similar symptoms, but very different reasons for causing pain.

  1. Hip osteoarthritis occurs when the slippery, protective cartilage in the hip joint thins or disappears. When the cartilage is damaged, there can be painful friction between the bones that make up the hip’s ball-and-socket. Bone spurs may form as the cartilage degenerates, which can make the bone-on-bone friction worse.

    See What Is Hip Osteoarthritis?

  2. Hip bursitis occurs when the bursa in the hip become inflamed. Throughout the body, bursae provide cushion and reduce friction between bones and the soft tissues that run over them during joint movement. In the hip, the bursa most likely to become inflamed is the trochanteric bursa.

    Inflammation of the trochanteric bursa typically occurs alongside inflammation in the hip’s abductor tendons (called tendonitis). 1 Redmond JM, Chen AW, Domb BG. Greater Trochanteric Pain Syndrome. J Am Acad Orthop Surg. 2016 Apr;24(4):231-40. doi: 10.5435/JAAOS-D-14-00406. Review. PubMed PMID: 26990713. Both the trochanteric bursa and abductor tendons are located at the bony knob near the top of the thighbone (medically known as the femur bone’s greater trochanter), near the outward curve of the upper thigh.

    See Hip (Trochanteric) Bursitis

Because of its tendency to share symptoms with hip osteoarthritis and other hip conditions, hip bursitis is sometimes called “the great mimicker.”


Comparing arthritis and bursitis symptoms

Is your hip pain caused by osteoarthritis, bursitis, or something else? A closer look at the symptoms of osteoarthritis and bursitis may provide you clues.

Symptoms that suggest hip osteoarthritis include:

  • Pain that originates from the inside of the hip joint and may also be felt in the groin and thigh, and occasionally the buttock
  • Increased hip joint stiffness and/or decreased range-of-motion
  • Grating or creaking sensations, known as crepitus
  • Referred pain in the knee

Read more about Hip Osteoarthritis Symptoms

Symptoms that suggest hip bursitis include:

  • Hip pain that is felt on the outside of the lower hip
  • Pain and tenderness that increases when pressure is put on the affected hip, such as when lying on your side

Read more about Hip Bursitis Symptoms

Keep in mind that it’s possible to have hip osteoarthritis and hip bursitis at the same time. It is also possible to have hip osteoarthritis or hip bursitis alongside another condition, such as a tight IT band, a hip labrum tear, or low back arthritis. A doctor can provide you with a definitive diagnosis and recommend treatment.


Luckily, the pain and symptoms of both hip bursitis and hip osteoarthritis can be treated. Common nonsurgical treatments for both conditions include ice or heat therapy, anti-inflammatory medications, therapeutic injections, and physical therapy. Occasionally, severe cases are treated with surgery.

See Hip Osteoarthritis Treatment and Hip Bursitis Treatment

Learn more:

What’s Causing My Hip Pain?

Hip Bursitis Causes

  • 1 Redmond JM, Chen AW, Domb BG. Greater Trochanteric Pain Syndrome. J Am Acad Orthop Surg. 2016 Apr;24(4):231-40. doi: 10.5435/JAAOS-D-14-00406. Review. PubMed PMID: 26990713.

Dr. J. Stuart Melvin is an orthopedic surgeon specializing in orthopedic trauma and joint replacement surgery. He practices at Washington Orthopaedics and Sports Medicine. Dr. Melvin is a reviewer for the Journal of Arthroplasty, has contributed chapters to several medical textbooks, and has had numerous scientific papers published in academic journals.