Condition guide · Hip

Hip bursitis & GTPS, explained

That stubborn pain on the outside of your hip usually isn't "just bursitis." Understanding what it really is explains why steroid shots stop working.

It's usually more than a bursa

The common term is "hip bursitis," but doctors increasingly use a broader, more accurate name: greater trochanteric pain syndrome (GTPS). The greater trochanter is the bony bump on the outer side of your upper thigh. For years the pain was blamed on an inflamed bursa (a small cushioning sac), but we now know it usually involves irritated or degenerating gluteal tendons and inflamed soft tissue too. That's why treatments aimed only at the bursa often fall short.

GTPS is usually the irritated tendon and inflamed tissue — not just the bursa. That's why bursa-only treatments fall short.

Why steroid shots stop working

Cortisone can quiet inflammation for a while, and many people feel better after the first shot or two. But it doesn't repair the underlying irritated tendon or the abnormal blood flow feeding the problem — so the relief fades, and each shot tends to help a little less. Doctors are also cautious about repeated steroids, which over time can weaken nearby tendon tissue.

The overlooked driver: abnormal blood flow

In chronic GTPS, the irritated tissue develops abnormal, extra blood vessels (neovascularity) that feed ongoing inflammation and travel with pain-sensing nerves. Part of what keeps the pain going is this abnormal blood supply — which is exactly what embolization targets.

✔Pain on the outer hip, often worse lying on that side or on stairs
✔Relief from shots that fades faster each time
✔Physical therapy that helps but doesn't fully resolve it

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General education, not medical advice. A specialist can confirm whether your pain is GTPS and whether embolization is a reasonable option.