Side Hip Pain: Why Your MRI Might Sound Nasty But Isn’t the Full Story (And How Most People Get 70–90% Better Without Surgery or Injections)

Pain on the side of your hip when you walk, climb stairs, get out of the car, or even just lie on that side at night can be incredibly draining. It turns simple daily things into a struggle and it often keeps people awake or avoiding thinks like walking.

People come in frustrated, exhausted, and often carrying an MRI report that’s left them feeling defeated. That reaction is completely valid. When the report mentions “torn tendon,”“moderate or severe degeneration,” “bursitis,” or “significant changes,” it’s easy to think the worst, that you need a new hip. Scans can trigger real fear and anxiety and that fear can make everything feel worse.

But here’s the reassuring truth from brand-new 2025 research: Those dramatic-looking MRI changes often have no meaningful connection to how much pain you’re actually in or how well you can move.

What the Latest Research (Grimaldi et al. 2025. PMCID: PMC12179227  ) Actually Found

A secondary analysis from the large LEAP clinical trial looked at 204 people with clinically diagnosed gluteal tendinopathy (the medical term for most side-of-hip pain). Experienced radiologists scored the MRI findings with things like tendon tears, degeneration, and bursitis, without knowing the patients’ symptoms.

The Key Result

There was no correlation between the severity of the MRI changes and:

• Pain levels

• Function

• Disability scores

The average MRI pathology score was 5.6 out of a possible higher range, yet this score had zero meaningful link to how much people were suffering or what they could do (Pearson correlation coefficients ranged from -0.4 to 0.3, with p-values all above 0.6).

In plain terms: A “bad-looking” scan doesn’t mean you’ll have bad pain or poor recovery. Many people with quite dramatic tendon changes on imaging still function well, while others with milder findings can feel significant pain.

This matches what we see in clinic every week — the picture on the scan is just one piece of the puzzle, not the whole story. Words like “torn” or “severe” in reports can open the pain gate wider (see our earlier blog on Gate Control Theory) and feed straight into fear-avoidance patterns (our fear-avoidance blog), making you guard the area, move less, and feel more sensitive. The good news is we can interrupt that cycle.

The Really Hopeful Part: Most People Improve Dramatically

High-quality trials, including the original LEAP study that this analysis came from, show that around 8 out of 10 people achieve 70–90% improvement (and often much more) with a thoughtful, progressive loading program. No injections, no surgery, and no endless rest required.

Progressive loading works because it gently re-trains the tendons and muscles to handle load again. The tendon isn’t “torn” in the way a muscle might tear — it’s more like a worn rope that needs smart strengthening to rebuild resilience. Rest alone often makes things stiffer and more sensitive, while the right kind of movement helps calm irritation, improve blood flow and restore confidence.

How We Put This Into Practice

If side hip pain (often called gluteal tendinopathy or greater trochanteric pain syndrome) is weighing you down, our approach is built around the same evidence-based principles:

Education & mindset shift first


We sit down with you and your scan, explain what the findings really mean and reframe the language so it feels less threatening. Pain is protective and very real, it’s your body’s alarm system but it’s often more about current sensitivity and load tolerance than permanent damage.

Progressive loading program


We start gently and build in clear stages (always goal-driven, not pain-limited):

• 
Isometrics (gentle holds to reduce pain quickly)

• 
Eccentrics (controlled lengthening to build tendon strength)

• 
Functional movements (step-ups, single-leg balance, walking progressions)


This helps the tissues adapt safely and reduces sensitivity over time.

Hands-on care to support the process
:

• Remedial massage and soft-tissue work to release tight glute and hip muscles

• gentle mobilisations or adjustments to improve hip and pelvic mechanics

• dry needling (when appropriate) to calm trigger points and ease guarding

Additional lifestyle support


• practical advice on sleep positions and other modifications

• stress management (which affects tendon healing)

• walking patterns and simple home strategies to keep progressing between sessions.

Monitoring and when to escalate


• We track your progress closely. Most people notice meaningful relief within weeks and big functional gains over 3–6 months

• If symptoms are severe or there’s no improvement after consistent effort, we’ll refer for specialist review — but that’s not the usual path.

• While most people see significant improvement without surgery or injections, a smaller group may need more advanced options or ongoing management. That doesn’t mean hope is lost — it means finding the approach that fits your body and circumstances.

You’re Not Defined by Your MRI

Many patients leave our sessions feeling lighter: “I thought this was going to be forever, but now I understand it’s manageable.” The inflammation settles, the fear fades and normal movement returns.

If side hip pain is limiting your walking, stairs, sleep, or daily life, you don’t have to put up with it. Book a session so we can assess what’s the going on, look at your scan together if you have one, and start a plan that actually works.

You’ve got this — evidence shows most people recover really well with the right approach.

Check the original Reel for the quick hit: https://www.instagram.com/reel/DRN4p6wky9h/

Disclaimer

These are general insights based on common patterns in research and clinic experience. Everyone’s body and situation is unique — some recover quickly, others take longer or need different paths. If your pain is persistent or worsening, always seek personalised guidance. This article is general information only — it is not a substitute for personalized medical advice.