Why Lateral Hip Pain Shows Up Differently in Women
Lateral hip pain is a common and frustrating problem for many women, especially in midlife and beyond. While men can also experience pain on the outside of the hip, women are much more likely to report this issue, and they often feel it most when sitting. What makes this pain show up differently for women? And why does something as simple as sitting in a chair trigger so much discomfort? As a physical therapist in Austin, these are questions we hear often.
The outside of the hip is home to important structures like the gluteus medius and gluteus minimus tendons. These tendons help stabilize the hip and connect muscles to the bone. Right under them is a fluid-filled sac called the bursa, which acts like a cushion to reduce friction. Together, these structures allow the hip to move smoothly and support the body during walking, standing, and yes, sitting. But when these tissues become irritated, inflamed, or overloaded, pain can develop. This is often called Greater Trochanteric Pain Syndrome, or GTPS.
Many women with GTPS don’t know the name for what they’re feeling, but they know how it starts. It often begins as a dull ache after sitting for a while during a long meeting, a car ride, or an evening on the couch. Over time, that ache may turn into a sharper pain. Standing up can become painful. Shifting in the chair might bring brief relief, but the discomfort always comes back. Eventually, everyday tasks like driving, relaxing, or working at a desk become sources of discomfort.
So why are women more affected than men? There are several reasons, and it starts with the shape of the body. Women typically have wider pelvises than men. This changes the angle at which the hip tendons pull, putting more strain on them. That extra strain can lead to tiny tears and inflammation. Women also tend to have less muscle mass around the hips, which means their tendons do more of the heavy lifting when it comes to stabilizing the joint. Over time, this imbalance can lead to overuse and pain. This sets the stage for problems like GTPS later in life, especially when other changes like hormonal shifts or decreased activity come into play.
How Menopause Affects Lateral Hip Pain
Menopause has a direct impact on the tissues that support the hip, and it’s a major reason why lateral hip pain often appears or worsens during this stage of life. As estrogen levels drop, tendons and other connective tissues lose some of their elasticity. Estrogen plays an important role in maintaining collagen, which gives tendons their strength and flexibility. Without enough estrogen, tendons can become weaker and more likely to develop microtears.
These small tears don’t always cause pain right away, but over time, repeated stress like the kind caused by sitting, standing, or climbing stairs can lead to inflammation and more noticeable symptoms. Once irritated, the tendons around the hip may take longer to heal in postmenopausal women. The healing process slows, and the tissues become more sensitive to compression and loading.
Menopause can also lead to changes in muscle mass and body composition. Women may experience a natural decrease in muscle strength, especially in the hips and thighs. At the same time, weight gain or a shift in fat distribution can place more pressure on the hips when sitting. With weaker muscles and more load on the joint, the tendons and bursae must absorb more stress.
Additionally, some women experience joint stiffness and general fatigue during and after menopause. These changes may make it harder to stay active or maintain good posture throughout the day, which can further increase the risk of developing GTPS. For women who sit for long periods at work or at home, these combined effects often lead to increased pain and a lower quality of life.
Why Sitting Triggers Pain
Sitting places pressure on the outside of the hip, particularly over the greater trochanter which is the bony part you can feel on the side of your upper thigh. This pressure is even greater when you sit in a low or soft chair, when your legs are crossed, or when you lean to one side. All of these positions can compress the gluteal tendons and bursa. Over time, that compression irritates. For someone with GTPS, this irritation can build up quickly.
Women often report that sitting for just 20 to 30 minutes is enough to trigger discomfort. The pain may feel like a burning ache that spreads down the outside of the thigh. When they stand up, the pain can spike sharply. It may take several minutes of walking or standing before the hip starts to feel better again. This cycle can happen multiple times a day, and it’s easy to see how it becomes exhausting.
What’s more, the postures many people adopt while sitting tend to make the problem worse. Sitting with legs crossed, leaning to one side, or slouching all increase pressure on the lateral hip. These positions are common, especially for women who are shorter or who work at desks that don’t fit their bodies well. Without even realizing it, many women are sitting in ways that stress their hips every day.
Why This Looks Different in Men
It’s important to recognize that men don’t usually experience these problems the same way. Men are more likely to develop lateral hip pain after intense activity, like running or jumping. Their pelvises are narrower, and their hip muscles are typically stronger, which provides more support for the tendons. While men can and do get GTPS, it usually takes a greater physical load to trigger their symptoms. For women, the pain often shows up during everyday activities, not just after a workout, but after sitting at work or lying on the couch.
Why It’s Often Misdiagnosed
Unfortunately, lateral hip pain is often missed or misdiagnosed in women. Because it doesn’t always show up on X-rays and the pain may feel similar to back or sciatic nerve issues, it’s sometimes written off as age-related or simply “bursitis.” But women deserve more than a quick label. The truth is, this kind of pain has a physical cause. It’s not in your head. It’s not just part of getting older. It’s a real condition, and it often starts with how the body responds to everyday positions like sitting.
How This Pain Affects Sleep and Daily Life
In some cases, the pain can even affect sleep. Many women report that lying on the painful side is unbearable. But lying on the opposite side, with the top leg falling forward, can also pull on the sore tissues. Finding a comfortable sleeping position becomes nearly impossible. This loss of rest adds to the problem, making pain feel worse and recovery harder.
Lateral hip pain doesn’t just affect the body, it affects the way women live. It can change how you move, sit, sleep, and even how confident you feel in your own skin. Some women start avoiding certain movements or positions. Others become less active, which leads to muscle loss and stiffness. All of these things make the condition harder to overcome, especially if it’s not recognized early.
A 2007 study by Segal and colleagues backs up what many women experience. It found that GTPS is significantly more common in women than men. The study also found links between GTPS and body weight, low back pain, and activities like sitting or lying on the side. The findings suggest that everyday positions, not just injuries, can lead to lasting pain in the soft tissues around the hip.
What Early Symptoms Should Women Watch For?
Lateral hip pain doesn’t usually start suddenly. For most women, the signs creep in slowly and may be easy to dismiss at first. But recognizing these early symptoms can make a big difference. The sooner you identify what’s happening, the easier it is to manage before it becomes a constant, daily problem.
In the beginning, the discomfort might not even register as hip pain. Many women describe it more as a vague ache on the outside of the thigh or buttock. It might only happen after a long day at work or after sitting in the same position for too long. You might feel like you need to stretch or shift positions more often than usual. Some women even think it’s just from “getting older” or being stiff from sitting.
One of the first red flags is sensitivity to certain sitting positions. You might notice that sitting with your legs crossed starts to feel uncomfortable. Chairs with firm edges or hard surfaces may leave a lingering soreness after just 20 or 30 minutes. You may start shifting around a lot in your seat, trying to take pressure off one side of your body. That need to constantly readjust is often your body’s way of protecting irritated tissues around the hip.
Another early symptom is tenderness on the outside of the hip, right over the greater trochanter. This bony bump is where the gluteus medius and minimus tendons attach. When these tendons are inflamed or starting to wear down, even light pressure can cause discomfort. You may notice that lying on your side in bed becomes bothersome on a firm mattress. What used to be a comfortable sleep position now wakes you up or forces you to roll over more frequently during the night.
Early on, the pain is usually mild. It might feel like a dull burn or a tight, pulling sensation rather than a sharp stab. But it’s persistent. And it tends to show up in patterns after sitting, after sleeping on one side, or after walking up a long flight of stairs. You may not even connect all of these symptoms at first because they seem minor or scattered. But together, they point to the early stages of lateral hip irritation.
Sometimes, the pain starts to radiate slightly. It doesn’t usually go past the knee, but it can spread down the outer thigh. It may feel like heaviness in the leg or a deep ache, especially after standing up from a seated position. You may catch yourself limping slightly without realizing it, or avoiding putting full weight on the affected side.
The earlier you recognize these patterns, the better. Pain that starts as an occasional annoyance can become chronic and harder to treat if left alone. If you’re starting to notice these symptoms come on more often, or start affecting your sleep or daily movement, it’s worth getting evaluated. You may be catching the problem at just the right time to stop it from progressing.
Sitting might seem like a harmless activity, but for many women, it’s the moment when pain begins. And because it builds slowly, it’s easy to ignore until it becomes impossible to live with.
If this sounds familiar to you, know that you’re not alone. Many women live with this kind of pain for months or even years before understanding what’s happening. Lateral hip pain is common. It’s real. And it often starts with something as simple as sitting.
If you have started to notice your hip bothering you, reach out to our team at Move Empower Concierge Physical Therapy for a FREE discovery session.