This article is part of the Ultimate Guide to Hip Pain Relief.

Pain around the hip is a common complaint in orthopedic patients that visit IBJI. Knowing where the pain is coming from and the cause of the pain puts the patient on the right path to treatment.

Common issues are arthritis and bursitis. These two can easily be confused if you don’t know what you’re looking for.

IBJI recently chatted with Dr. Jeremy Oryhon, board-certified orthopaedic surgeon with fellowship training in joint preservation, resurfacing and replacement. Dr. Oryhon explains the differences between arthritis and bursitis. His responses—below—have been edited and condensed for space.

Anatomic Structure of the Hip

When assessing your hip pain, it is important to understand the anatomical structure of the hip to help determine where the pain is coming from. “For hip surgeons, 'the hip' is a very specific anatomic structure (part of the body),” says Dr. Oryhon, “The hip is made up of a ball and socket joint where the top part (femoral head ball) of the thigh bone (femur) meets, attaches to and articulates with the pelvis socket.”

To figure out if your hip pain is from arthritis or is due to inflammation of the bursa (bursitis), you have to be aware of and specific with the exact location of the pain.

“Patients often think of the hip in a much broader sense. Any pain around the upper thigh, outer thigh, buttock, low back and flank are often described by patients simply as ‘hip pain.’ All of these areas are not as specific and pain in these areas is usually not coming from the hip joint itself. So, we need to first determine the area of pain to know if it is arthritis or bursitis,” says Dr. Oryhon.


“Pain coming from the hip joint is most often due to hip arthritis (osteoarthritis). If the pain seems to be in the front of the thigh, including deep in the groin area, then this is an indication of hip joint pain and probably hip arthritis.” The pain may become worse with activity or with sudden pivoting movements. The pain can also radiate down the front of the thigh to just above the knee.


“Pain or symptoms in the upper thigh, outer thigh, buttock, low back and flank may actually be coming from the back, spine, nerves, muscles, tendons or bursa.

“A Bursa is a two-layered piece of soft tissue with a little fluid in between the layers (think of a Ziploc plastic bag with a little bit water in it). These bursae are located over bony prominences on your skeleton where skin, muscles and tendon move and slide. The bursa tissue decreases the friction of the skin, muscle or tendon sliding against the bone. They are located most often around joints most notably at the back of the elbow, the shoulder, the front of the knee and at the side of the upper thigh.”

Dr. Oryhon says that, “If the pain seems to be at the outer part of the upper thigh sometimes with radiation down the outer thigh and there seems to be tenderness when pressing in this area, then it is more likely to be hip bursitis. This pain may be constant or intermittent. It is often worse at night especially when laying on the side.”

Get Relief from Your Hip Pain Today

It’s important to know exactly what area is giving you pain or symptoms as there are many more possibilities for the exact diagnosis. Be very specific about the pain and the location you are experiencing it in.

Hip pain is a common complaint that hip physicians treat. There are many structures in the hip that can cause pain and may not be either arthritis or bursitis. Your hip specialist will be able to figure out the location and cause for your hip pain and suggest the appropriate treatment.

Hip Care and Treatment at IBJI

Whether you are just starting out in your hip care journey or need a second opinion for your hip pain, IBJI’s hip surgeons are here to help provide you with the necessary care for your ailment. Get the relief you are seeking with the help of IBJI.

Schedule online with an IBJI hip surgeon to discuss treatment options and create an individualized approach to your care.

Check out IBJI’s additional online resources for hip care to learn more about conditions and read patient testimonials.

Schedule online with a Hip Doctor →

Download the Ultimate Guide to Hip Pain Relief

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