Greater trochanteric pain syndrome

This information is useful for those who have been diagnosed with greater trochanteric pain syndrome (GTPS). People who are experiencing new or ongoing symptoms should contact a healthcare professional for assessment and diagnosis.

What is greater trochanteric pain syndrome?

Greater trochanteric pain syndrome (GTPS), also known as lateral hip pain or trochanteric bursitis, is a common and painful condition which affects the outer side of the hip and thigh. It occurs when the tissues which lie over the outside of the hip bone (greater trochanter) become irritated.

The soft tissues that attach to the outside of the hip include tendons and bursa. When these become overloaded they are the primary sources of pain caused by GTPS.

It's more common in females and in those aged between 40 and 60 years old but can affect any age.

Signs and Symptoms of GTPS

These can vary from person to person.

People may experience some or all of these symptoms including:

Pain in the hip/thigh/buttock area.
Worse pain when lying on your side or with direct pressure.
Pain increasing with exercise such as periods of walking, standing or running.
Tenderness to touch.
Pain sitting with your legs crossed.
Pain when standing on the affected leg (sometimes called hanging on the hip)
Pain when climbing stairs
Pain when lifting legs in/out a car or bed

What causes GTPS

Often it can occur for no apparent reason but these are some factors which appear to contribute to it:

a sudden increased load on your hip
a change to your activity levels such as increased walking distances or pace
increased pressure to your hip area through sitting or standing in one position for too long or weight bearing on one leg
reduced strength and flexibility of the muscles around the hip and buttock
having a sedentary, inactive lifestyle or being overweight
an injury such as a fall on to the side of your hip area
hormone changes may also influence this condition
this can also be related to osteoarthritis of the hips and knees or low back pain

How can GTPS be managed?

An important step in your recovery is identifying which activities are causing or increasing your pain. Modifying those activities can help to reduce symptoms.

The key to success is slow progressive loading of the soft tissues through exercise that strengthen the muscles involved.

Over time it is important to gradually increase the exercises to help the tendons and muscles become stronger, less painful and more able to cope with your normal activity levels.

Other ways to help improve symptoms include:

spreading your weight evenly across both feet and not leaning on just one leg.
avoiding low chairs.
avoid sitting with your legs crossed.
avoid sleeping on the painful side. Try lying on your back with a pillow under your knees or lie on your good side with a pillow between your legs to keep them in line with your hip joints.
try to keep active and stay at work even if you have to modify your duties.
losing weight if you are overweight.

This condition can often take 6 to 12 months of rehabilitation to settle, but this will depend on the cause.

It is normal to have flare ups during this time. If this happens, then it may be best to reduce the repetitions or rest for a few days before starting again.

Managing pain

Pain medication can help you move more comfortably, which can help your recovery.

More about taking painkillers

Corticosteroid injections

If painkillers aren't helping to control the pain, your healthcare professional may discuss the option of having a corticosteroid injection into the outer hip.

Corticosteroids are medicines that help reduce pain and inflammation. They may also be given with a local anaesthetic.

Injections may not cure your condition, they are used to help with the pain.

Work

A hip problem can sometimes mean you need to take some time off work to help recovery. How long you're off will depend on the nature of your condition and your role at work.

You do not need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels.

Help and support

Following this advice, you should see gradual improvements over time.

If your symptoms haven't improved within 6 weeks, or it's got worse, after following this advice, talk to a healthcare professional about your symptoms.

Find out how to access MSK services in your area.

When dealing with any health condition it's important to also look after your mental wellbeing as this can impact your recovery.