Why Gluteal Tendonitis and Hip Bursitis Are Increasingly Misdiagnosed as Sciatica in Women

Pain that starts in the hip or buttock and travels down the leg is often immediately labeled as “sciatica.” While true sciatic nerve irritation can certainly cause these symptoms, many women are actually dealing with a different condition entirely: gluteal tendonitis and greater trochanteric bursitis.

At the office of Dr. Jeffrey C. Smith, more women are presenting with this increasingly common but frequently overlooked source of hip and leg pain. Proper diagnosis is essential because treatment for gluteal tendon disorders is very different from treatment for lumbar disc-related sciatica.

What Is Gluteal Tendonitis?

The gluteal muscles—especially the gluteus medius and minimus—help stabilize the pelvis and support walking, climbing stairs, and standing on one leg. These muscles attach to the outer hip through strong tendons.

When these tendons become irritated or overloaded, inflammation and degeneration can occur, leading to gluteal tendonitis or gluteal tendinopathy. Often, irritation of the nearby bursa (a fluid-filled cushioning sac) develops as well, creating what is commonly called trochanteric bursitis.

This condition is especially common in women over 40 and is becoming increasingly recognized in both active adults and people with more sedentary lifestyles.

Why Women Are More Commonly Affected

Research has shown that women tend to develop this condition more frequently because of several anatomical and biomechanical factors, including:

• Wider pelvis structure

• Hip muscle weakness

• Changes in tendon health with aging

• Hormonal influences

• Poor walking or movement mechanics

• Prolonged sitting or side sleeping

• Repetitive stress from exercise or daily activity

Many patients notice pain after increasing walking programs, climbing stairs, exercising, or even sleeping on one side.

Why It Is Often Mistaken for Sciatica

One of the biggest reasons gluteal tendonitis is misdiagnosed is because the symptoms can closely mimic sciatic pain.

Patients commonly report:

• Pain in the buttock or outer hip

• Aching down the outside of the thigh

• Difficulty sleeping on the affected side

• Pain getting out of a chair

• Discomfort walking long distances

• Tenderness over the side of the hip

Because the pain can travel down the leg, it is often assumed to be coming from the lower back or sciatic nerve. However, many patients actually have little to no nerve involvement at all.

A key difference is that true sciatica often includes:

• Numbness or tingling

• Burning nerve pain

• Weakness into the foot or leg

• Symptoms below the knee

• Positive nerve tension testing

Gluteal tendon disorders, on the other hand, usually produce localized hip tenderness and pain with side-lying, walking, or hip movement.

The Importance of Proper Diagnosis

At the office of Dr. Jeffrey C. Smith, careful orthopedic and movement-based examination helps determine whether symptoms are truly coming from the lumbar spine, sciatic nerve, SI joint, or the gluteal tendons and hip structures.

Because several conditions can overlap, accurate diagnosis is critical. Treating presumed “sciatica” with only low back therapies may fail if the real problem is originating from the hip tendons.

How Chiropractic and Conservative Care Can Help

Treatment for gluteal tendonitis and bursitis often responds very well to conservative care when properly identified early.

Depending on the patient, treatment may include:

• Chiropractic evaluation of lumbar spine and pelvic mechanics

• Soft tissue therapy

• Targeted hip stabilization exercises

• Glute strengthening

• Movement correction

• Stretching strategies

• Activity modification recommendations

• Gait and posture assessment

One of the most important goals is reducing excessive compression and overload on the irritated tendons while improving hip stability and mechanics.

Don’t Ignore Persistent Hip or Leg Pain

If you have been told you have sciatica but continue to struggle with persistent outer hip, buttock, or leg pain, it may be worth evaluating whether the true source is actually gluteal tendonitis or bursitis.

Proper diagnosis can make a major difference in recovery and help prevent chronic pain from developing.

Dr. Jeffrey C. Smith has experience recognizing the subtle differences between lumbar nerve pain, SI joint dysfunction, and hip tendon disorders to help patients receive focused, individualized treatment aimed at restoring mobility and reducing pain naturally.