Lateral hip pain is usually a tendon problem rather than a bursa problem, and that one difference decides which orthobiologic is worth discussing. Cambridge University Hospitals NHS Foundation Trust gives patients the numbers. Take greater trochanteric pain syndrome, which is pain over the bony point of the outer hip. In it, 88% to 98% of patients have a tendon problem. Bursitis alone shows up in only about 2%. So start with the gluteal tendons, the stage of damage, and a loading plan. Do not start with an injection choice.
Key takeaways
- A tendon problem is present in 88% to 98% of patients with greater trochanteric pain syndrome. Bursitis alone is present in about 2%.
- The condition is far more common in women. Cambridge University Hospitals reports it in 23.5% of women and 8.5% of men between the ages of 50 and 79. It is especially common in women around and after menopause.
- A 2021 systematic review of 1,103 patients across 27 studies found good evidence for platelet-rich plasma in grades 1 and 2 tendinopathy. The evidence depends on the grade, so staging comes first.
- Orthobiologics are paired with rehab. An injection with no loading plan after it treats half the problem.
- No orthobiologic has been shown to regrow or regenerate tendon or cartilage, and we do not describe any of them that way.
- Conservative care comes first. Surgery is considered only after conservative measures have been exhausted.
What gluteal tendinopathy is, and why the diagnosis decides everything after it
What can be mistaken for hip bursitis?
Gluteal tendinopathy is wear and overload damage in the gluteus medius and minimus tendons. They attach at the greater trochanter, the bony point on the outer hip. It shows up as pain on the outside of the hip. It is usually worse on stairs, lying on that side, standing on one leg, and walking a long time. The Cambridge University Hospitals figures argue against the old habit of calling this bursitis. The label matters because it aims treatment at a different structure.
Who gets gluteal tendinopathy?
Cambridge University Hospitals patient information gives the rates by sex. Greater trochanteric pain syndrome affects 23.5% of women and 8.5% of men between the ages of 50 and 79. It is more common in women around and after menopause. That tilt is worth naming during the evaluation, because hormones and metabolism shape how much load a tendon can take and how it recovers.
How is outer hip pain diagnosed?
We use your history, an exam, and a review of your imaging. That is how we confirm whether the gluteal tendons cause the pain. It also shows how far the damage has gone. Deep hip joint problems, pain sent down from the low back, and mixed cases all look alike from the outside. Each one would send the plan somewhere different.
Does PRP work for gluteal tendinopathy?
The systematic review that anchors the discussion
A 2021 systematic review in the Orthopaedic Journal of Sports Medicine covered 1,103 patients. They came from 27 studies. The average age was 53.7 years, and women outnumbered men roughly seven to one. It matched its treatment advice to the stage. It found good evidence for platelet-rich plasma in grades 1 and 2 tendinopathy.
Why grade-dependence changes the conversation
A mildly damaged tendon is not the same as an advanced, partly torn one. The evidence splits results the same way. That is why staging comes before the injection decision here, not after it. It is also why an early-stage result should not be quoted to a late-stage patient.
PRP is not one product
Studies differ in how they make PRP. The platelet count differs. So do the white cells, the volume injected, and the exact target. When you read a PRP result, you are reading a result for that method at that target. That is one reason we describe what is planned rather than naming a category. What each option involves is set out on our orthobiologics service page.
Bone marrow aspirate concentrate and fat-derived options
Where BMAC enters the discussion
Bone marrow aspirate concentrate is an option drawn from bone marrow. We consider it when the goal, the stage, and the target tissue line up. No single protocol fits everyone. The evidence for tendons is thinner than for platelet-rich plasma. We say so rather than smoothing it over.
Lipogems and fat-derived orthobiologics
Lipogems is an option drawn from fat. It comes up for muscle, tendon, and joint problems. As with the others, we explain the reason and the target. Our goal is less pain and better function. We do not promise a structural result that has not been shown.
What none of them do
No orthobiologic has been shown to regrow or regenerate tendon or cartilage. In advanced knee osteoarthritis, trial authors frame platelet-rich plasma as a safe bridge therapy prior to joint replacement. The same restraint applies to how we talk about the hip.
Rehabilitation is not the optional half
Why does a hip tendon need exercise, not just rest?
Tendon tissue adapts to load that builds step by step. An injection does not change the mechanics that overloaded it. Every orthobiologic plan here comes with a set program of loading and body mechanics. You follow its pain-guided steps between visits.
What we ask you to track
We ask for specific markers, not a general pain score. How far can you walk before pain starts? Can you lie on that side? How do you handle stairs? Those measures show whether the loading program is working.
When more than one area is involved
Hip plus spine
Many patients have more than one pain source. Pain sent down from the low back can mimic or join outer hip pain. When the evaluation supports it, we treat spine causes on their own terms. We do not fold them into the hip plan.
Hip plus knee
We keep knee and hip questions apart, even when they show up together. What fits a worn knee joint is not what fits a gluteal tendon. Mixing the two is how expectations get set wrong.
What to expect at Regen.MD
Physician-led evaluation, conservative first
Dr. Gurpreet Singh Padda, MD, MBA, MHP directs Regen.MD and leads the Clinical Evaluation. He is a surgeon, and the practice does provide surgery when conservative measures have been exhausted. That is exactly why we take the conservative path seriously and never treat it as a formality.
Where we are
The office is at 4477 Woodson Rd, Suite 103, St. Louis, MO 63134, next to St. Louis Lambert International Airport. Directions and parking are on our St. Louis location page.
Find out what is actually driving your lateral hip pain
Regen.MD begins with a physician-led Clinical Evaluation — a review of your history, imaging, and metabolic data, and a written terrain roadmap. Evaluation is contingent upon review of your data.
Questions? Call or text us.
Frequently asked questions
Is my lateral hip pain bursitis or tendinopathy?
Cambridge University Hospitals NHS Foundation Trust patient information gives the numbers. In greater trochanteric pain syndrome, 88% to 98% of patients have a tendon problem. Bursitis alone shows up in about 2%. So we start by assuming the tendon and confirm it on exam. We do not assume it from a scan. You can see how we sort this out across the conditions we evaluate.
Is platelet-rich plasma actually supported for gluteal tendinopathy?
For part of the condition, yes. A 2021 systematic review in the Orthopaedic Journal of Sports Medicine covered 1,103 patients across 27 studies. It found good evidence for platelet-rich plasma in grades 1 and 2 tendinopathy. Because results depend on grade, staging comes before any injection decision, as set out in our approach to care.
Will an injection fix it without rehabilitation?
No. Orthobiologics are paired with a loading and rehab plan, because the mechanical causes of tendon overload do not change on their own. The real goals are less pain and better tolerance of building load, not a structural repair. Our patient education library explains how we set those expectations.
Are peptides sold as part of this?
No. At Regen.MD, we talk about peptides as topics for care and teaching. We do not sell them. If your questions lean toward metabolism and recovery, start with our physician-directed peptide therapy education. Keep it separate from the tendon decision.
Who performs the evaluation, and what should I bring?
A physician leads the Clinical Evaluation. Bring your imaging, your past treatments, and a clear account of which activities set off the pain. You can read the background of Dr. Gurpreet Singh Padda, MD, MBA, MHP before requesting one.
What are the symptoms of hip bursitis and gluteal tendinopathy?
Pain on the outside of the hip is the main sign. It is usually worse on stairs, lying on that side, standing on one leg, and after long walks. People often call this bursitis. But in 88% to 98% of cases the gluteal tendons are the problem. It is far more common in women, especially around and after menopause.
How do you treat hip bursitis?
Start with the right structure. The gluteal tendons are usually the source. So we build treatment around a loading program the tendon adapts to. You track progress by walking distance, side-lying comfort and stairs. Platelet-rich plasma has good evidence in grade 1 and 2 tendinopathy. It always comes with that program. Surgery is considered only after conservative care has been exhausted.
Sources
- Ladurner A, Fitzpatrick J, O’Donnell JM. Treatment of Gluteal Tendinopathy: A Systematic Review and Stage-Adjusted Treatment Recommendation. Orthopaedic Journal of Sports Medicine, 2021. https://pmc.ncbi.nlm.nih.gov/articles/PMC8330465/ — referenced for the 1,103 patients across 27 studies, the mean age of 53.7 years and female predominance, and the conclusion of good evidence for platelet-rich plasma in grades 1 and 2 tendinopathy.
- Cambridge University Hospitals NHS Foundation Trust. Gluteal tendinopathy. Patient information, accessed August 2026. https://www.cuh.nhs.uk/patient-information/gluteal-tendinopathy/ — referenced for tendon pathology in 88% to 98% of patients versus isolated bursitis in about 2%, and for the prevalence of 23.5% in women and 8.5% in men between the ages of 50 and 79 with higher frequency in peri- and post-menopausal women.