A senior UK physiotherapist explains what your GP probably missed about your hip pain

One in four women over 50 are told they have "arthritis" or "wear and tear" in their hip. Most of them have neither — and that's the reason nothing has worked.

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Dr. Helen Shaw, MSc Physiotherapy, women's health specialist · May 2026

I'm going to say something that won't make me popular with a fair few GPs I trained alongside.

But I've stopped caring.

After twenty-two years treating women with chronic hip pain — eleven inside the NHS, the rest in private clinic — I'm done watching women in their fifties be told it's just their age.

Done watching them sent home with paracetamol.

Done watching them put on cortisone every six months while the tendons get weaker.

Done watching them blame themselves for not "losing the weight" when weight was never the problem.

Because in roughly seven out of ten cases I see, the diagnosis they've been given is wrong.

Not slightly wrong. Wrong condition. Wrong tissue. Wrong treatment plan.

And the result is exactly what you'd expect.

The pain gets worse.

The painkillers stop working.

The cortisone helps for a fortnight, then fades.

The NHS physio waiting list is nine months long.

When they finally get in, they're handed a sheet of exercises that make everything ache more.

If you're reading this on your phone at 2am — on the side that doesn't hurt, because you can't sleep on the side that does — keep reading.

The next five minutes might be the most useful you spend this year.

My name is Dr. Helen Shaw

I've been a chartered physiotherapist for twenty-two years.

I trained at University of Birmingham.

I spent eleven years inside the NHS musculoskeletal service.

For the last decade I've run a private practice specialising in women's pelvic and hip health.

In that time, I've assessed roughly four thousand women between forty-five and sixty-five with chronic outer hip pain.

And I've watched something happen so consistently it stopped being a coincidence years ago.

The pattern nobody is telling you about

It starts somewhere between forty-five and fifty-five.

Usually after the first signs of perimenopause. Hot flushes. Sleep changes. The periods getting irregular.

Then the hip starts aching.

Not in the groin. On the outside.

The side you lie on at night.

The spot that nags when you sit too long.

The bit that's tender when you press it.

You go to your GP.

You're told it's wear and tear. Maybe arthritis. Maybe bursitis.

You're handed a leaflet. Prescribed ibuprofen. Told to lose a bit of weight and walk more.

You try. The walking makes it worse.

A few months later, you go back. This time you get a referral for a scan.

The scan comes back clear. Or shows "mild age-related changes".

Your GP says nothing significant. Tells you to keep doing what you're doing.

You try physiotherapy on the NHS. Nine-month wait. When you finally get in, you're given strengthening exercises.

They make it worse, not better.

You try a private physio at sixty pounds a session. Slightly better. The pain comes back within a week of stopping.

You try cortisone. Each injection helps for six weeks.

Each one stops working faster than the last.

You're now eighteen months in. Possibly three years in. Possibly five.

And nobody has actually told you what's wrong with you.

Here's what's actually happening

The condition you almost certainly have is called gluteal tendinopathy.

It's the breakdown of the tendons that anchor the muscles of your buttock to the side of your hip bone.

Those tendons sit on the outside of the hip.

Exactly where your pain is.

It's been documented in NHS clinical guidance for over a decade.

Cambridge University Hospitals' own patient leaflet states it has been "traditionally referred to as 'trochanteric bursitis'".

In other words: routinely mislabelled.

The condition is invisible on a standard X-ray. Because tendons are soft tissue. And soft tissue doesn't show up on imaging unless you specifically ask for an ultrasound or a soft-tissue MRI.

Which most women with this pain are never offered.

So here's what's gone wrong in your case.

Your GP looked at a clear X-ray. Concluded "nothing significant".

That was technically correct.

But the absence of arthritis on a scan is not the same as the absence of a problem.

A clear scan is diagnostic information. It points somewhere specific.

It's pointing at the tendons.

Not the joint.

And here's the part nobody connects

The reason this is happening to women between forty-five and sixty-five — and not men, and not younger women, and not older women — is hormonal.

Oestrogen has a job most people don't know about.

It's the primary signal your body uses to tell your tendons to produce collagen.

Collagen is the structural protein that keeps tendons strong and capable of repairing themselves from daily wear.

When you go through perimenopause and menopause, your oestrogen levels drop.

Research from teams in Sweden, Australia and the UK has now confirmed that collagen production in tendons can drop by as much as a third in the years immediately after the menopause.

Now think about what your hip tendons do every day.

Walking. Climbing stairs. Getting in and out of a chair. Sleeping on your side.

In a younger woman with intact collagen production, the daily micro-damage from that load is repaired overnight while she sleeps.

In a woman whose oestrogen has dropped, the overnight repair signal is no longer being sent at the same strength.

The micro-damage starts accumulating faster than it can be repaired.

After twelve to twenty-four months, the tendon tissue starts to break down.

That's gluteal tendinopathy.

And that's why it appears, almost always, within one or two years of the menopause starting.

The timing isn't a coincidence. It's exactly what the biology predicts.

Why everything you've been offered hasn't worked

Once you understand what's actually broken, the failures of every previous treatment make sense.

Painkillers and anti-inflammatories

Don't work for long because there's nothing to "anti-inflame".

The tendon isn't inflamed. That's the old framing, from when this condition was still being called bursitis.

The tendon is degenerating. Inflammation is at most a symptom.

Treating it without addressing the tissue breakdown is like mopping the floor while the tap is still running.

Cortisone injections

Work briefly because they reduce local inflammation and quiet the pain signal.

But over time, cortisone actively weakens tendon tissue.

Each repeat injection makes the tendon a little more fragile.

This is why your relief gets shorter every time.

Physiotherapy exercises

Strengthen the muscles around the hip. For many conditions, useful.

For a degenerating tendon, loading it with strength work before restoring tissue quality is asking a damaged structure to do more work it can't yet do.

That's why so many women say their physio "made it worse". It did.

Collagen supplements

Sound like the obvious answer. They don't reach the tendon.

Your digestive system breaks any oral collagen down into basic amino acids before it ever gets close to your hip.

The treatments weren't wrong in principle. They were wrong for this condition.

What the tendon actually needs

To repair a tendon that's lost its hormonal repair signal, you need to deliver the equivalent signal directly to the tissue itself.

Not through the digestive system.

Not through a needle that wears off in five weeks.

Not by loading the tissue with more work.

The signal has to reach the tendon cells. At depth. Where the damage is.

There is now a specific way to do that.

It does not involve surgery. Or drugs. Or a hospital appointment.

It takes twenty minutes a day. At home. While you're doing something else.

It uses a form of treatment called photobiomodulation — specific wavelengths of red and near-infrared light that stimulate the mitochondria inside cells.

The mitochondria are the energy factories of every cell in your body. Including the cells that build collagen.

When you stimulate them with the right wavelength of light, they produce more ATP — the energy currency cells use to do their jobs.

And one of the jobs they go back to doing is producing collagen.

This isn't fringe science.

It has over forty years of research behind it. Thousands of peer-reviewed papers. It's now used in physiotherapy clinics across the UK, the US and Australia for tendon repair, post-surgical recovery and chronic pain.

The catch — until recently — was that the equipment to deliver it properly cost two to four thousand pounds and was only available in clinic.

That has now changed.

The device I now recommend to every patient with this pattern

It's called solva.

It's a wearable wrap with an integrated therapeutic light panel that sits over the outer hip.

You put it on. You press one button. You wear it for twenty minutes.

That's it.

solva has been used by over four thousand UK women with this exact pattern. The average user reports meaningful change in the first six weeks, and continued improvement through the first three months.

You can wear it while you read. While you watch the news. While you have a cup of tea. While you do absolutely nothing.

It uses three specific wavelengths — not one — and each one targets a different stage of what a degenerating tendon needs.

The three together do what no single treatment in the conventional pathway can do.

They restart the repair process at the cellular level.

And they do it without surgery, without injections, and without a single pill.

What twenty minutes a day actually looks like

Most women who use solva follow a pattern that looks roughly like this.

Week 1

Nothing dramatic. But you might notice you're reaching for the ibuprofen less often.

Week 2 to 3

You sleep on the painful side for four hours straight. You hadn't realised that was even possible anymore.

Week 4 to 6

You get out of a chair without bracing. You climb the stairs without the inner monologue. The hip is still there, but it's quieter.

Week 8 to 12

The tendon is rebuilding. The micro-damage is being repaired faster than it accumulates. You go for a proper walk — not a careful shuffle, an actual walk — and you don't pay for it the next day.

This isn't masking the pain. It's not numbing it. It's rebuilding the tissue underneath.

Which is why, unlike cortisone or painkillers, the improvement lasts.