Do you experience pain on the outside of your hip when walking, climbing stairs or lying on your side? Does the discomfort sometimes extend towards your upper thigh?

These symptoms may be associated with greater trochanteric pain syndrome, commonly known as GTPS.

Greater trochanteric pain syndrome is a condition involving structures around the outer hip, particularly the gluteal tendons and surrounding tissues. It can cause persistent discomfort and make everyday activities such as walking, standing and sleeping difficult.

The condition was traditionally referred to as trochanteric bursitis. However, gluteal tendinopathy is frequently an important contributor to symptoms.

Understanding the condition and managing the activities that aggravate it can help support recovery.

This guide explains the causes, symptoms and seven practical ways to manage greater trochanteric pain syndrome.

What Is Greater Trochanteric Pain Syndrome?

Greater trochanteric pain syndrome is a condition characterised by pain around the outer side of the hip, near a bony prominence called the greater trochanter.

This area contains several important structures, including:

• Gluteus medius tendon.

• Gluteus minimus tendon.

• Trochanteric bursae.

• Iliotibial band.

• Surrounding muscles and soft tissues.

The gluteus medius and gluteus minimus muscles help stabilise the pelvis during walking, standing and other lower-limb activities.

Their tendons attach near the greater trochanter.

When these structures become irritated or overloaded, pain may develop around the outer hip.

GTPS can involve gluteal tendinopathy, bursal irritation or a combination of these problems.

Common Causes and Risk Factors of Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome can develop gradually due to changes in activity, repeated loading or reduced capacity of the muscles and tendons around the hip.

1. Repetitive Hip Loading

Activities involving repeated walking, running, climbing stairs or standing may increase the demands placed on the gluteal tendons.

A sudden increase in these activities can sometimes contribute to symptoms.

2. Prolonged Pressure on the Outer Hip

Direct pressure over the affected hip may aggravate symptoms.

Examples include:

• Sleeping on the painful side.

• Sitting with crossed legs.

• Standing while leaning on one hip.

• Remaining in positions that compress the outer hip.

3. Weakness in the Hip Muscles

The gluteal muscles help control pelvic movement and stabilise the hip.

Reduced strength or capacity in these muscles may affect how the hip manages everyday physical demands.

4. Sudden Changes in Exercise Routine

Increasing walking distance, starting a new exercise programme or returning to sports after a period of inactivity may place additional demands on the hip.

Gradual increases in activity can help the body adapt to changing exercise requirements.

5. Age-Related Tendon Changes

Tendon structure and load tolerance can change with age.

GTPS is commonly seen in middle-aged and older adults, although younger active individuals can also experience it.

6. Previous Hip or Lower-Limb Problems

Previous injuries or conditions affecting the hip, pelvis and lower back may influence movement patterns and physical loading.

7. Individual Anatomical and Lifestyle Factors

Other contributing factors may include:

• Prolonged standing.

• Repetitive single-leg activities.

• Changes in body weight.

• Reduced physical conditioning.

• Certain movement patterns.

Not everyone with these risk factors develops GTPS, and the underlying causes can differ between individuals.

Common Symptoms of Greater Trochanteric Pain Syndrome

The most common symptom is pain around the outer hip, near the greater trochanter.

Symptoms may include:

• Outer hip pain: Aching or sharp discomfort on the side of the hip.

• Pain while sleeping: Discomfort when lying directly on the affected side.

• Stair-climbing pain: Increased symptoms when walking upstairs or uphill.

• Pain during walking: Discomfort after prolonged walking or standing.

• Tenderness: Sensitivity when pressing the outer hip.

• Pain when standing on one leg: Symptoms may increase during single-leg activities.

• Thigh discomfort: Pain may extend towards the outer upper thigh.

Some people experience mild discomfort initially, while others develop persistent pain that interferes with sleep and daily activities.

7 Effective Ways to Manage Greater Trochanteric Pain Syndrome

Managing greater trochanteric pain syndrome involves reducing aggravating pressure, improving hip strength and gradually increasing the ability of the surrounding tissues to tolerate activity.

The following strategies may help.

1. Avoid Sleeping Directly on the Painful Side

Direct pressure on the outer hip can increase discomfort.

If sleeping on your side aggravates your symptoms, consider:

• Sleeping on your back when comfortable.

• Sleeping on the unaffected side.

• Placing a pillow between your knees.

• Keeping your hips comfortably aligned.

• Avoiding positions that create pressure around the painful area.

These adjustments may help reduce compression around the gluteal tendons.

2. Avoid Crossing Your Legs

Crossing your legs can place the hip in a position that increases compression around the outer hip.

Try to:

• Sit with both feet supported.

• Keep your knees comfortably apart.

• Avoid standing while leaning heavily on one hip.

• Distribute your body weight evenly between both legs.

• Change positions regularly.

Small changes in daily posture may help reduce unnecessary irritation.

3. Modify Activities That Increase Hip Pain

Some activities may temporarily aggravate symptoms, particularly when they involve repeated hip loading.

Consider modifying:

• Long-distance walking.

• Repeated stair climbing.

• Uphill walking.

• Deep squatting.

• Prolonged standing.

• High-impact exercise.

You do not necessarily need to stop all physical activity.

The aim is to find a manageable activity level and gradually increase it as your symptoms and strength improve.

4. Strengthen Your Gluteal Muscles

The gluteal muscles play an important role in stabilising the pelvis and controlling hip movement.

A physiotherapist may recommend suitable strengthening exercises such as:

• Glute bridges.

• Supported standing hip abduction.

• Isometric hip abduction.

• Controlled sit-to-stand exercises.

• Progressive resistance-band exercises.

Exercise selection and intensity should depend on your symptoms and current strength.

Start with manageable resistance and progress gradually rather than immediately attempting demanding exercises.

5. Improve Hip and Pelvic Control

The hip and pelvis work together during walking, standing and stair climbing.

Poor movement control may increase the demands placed on the surrounding tissues.

A rehabilitation programme may include:

• Controlled weight-shifting exercises.

• Supported single-leg standing.

• Step-up exercises.

• Functional movement training.

• Pelvic stability exercises.

These activities can help develop better movement control as your strength improves.

6. Gradually Increase Your Physical Activity

Avoid returning immediately to your previous exercise routine if it significantly aggravates your symptoms.

Instead:

• Begin with manageable activities.

• Monitor discomfort during exercise.

• Observe how symptoms respond afterwards.

• Increase exercise demands gradually.

• Allow appropriate recovery between demanding sessions.

Some discomfort may occur during rehabilitation, but exercises should not cause a sustained worsening of symptoms.

A physiotherapist can help determine suitable progression.

7. Seek Physiotherapy for a Personalised Rehabilitation Plan

Persistent outer hip pain may require an assessment to identify the structures involved and the factors contributing to your symptoms.

A physiotherapist can assess:

• Hip strength.

• Hip movement.

• Gluteal muscle function.

• Pelvic control.

• Walking pattern.

• Single-leg balance.

• Activities that reproduce your pain.

Based on the assessment, a rehabilitation programme can be developed to improve strength, movement and everyday function.

How Is Greater Trochanteric Pain Syndrome Diagnosed?

Diagnosis generally involves reviewing your symptoms, medical history and physical examination findings.

A healthcare professional may ask:

• Where exactly do you experience hip pain?

• Does lying on the affected side increase discomfort?

• Do you experience pain while climbing stairs?

• How long have you had the symptoms?

• Have you recently changed your exercise routine?

• Does walking or standing aggravate the pain?

Physical Examination

The examination may include:

• Checking tenderness around the greater trochanter.

• Assessing hip movement.

• Testing hip abductor strength.

• Performing resisted hip movements.

• Evaluating single-leg standing.

• Observing walking and functional movements.

The assessment also helps determine whether symptoms may be coming from the hip joint, lower back or another structure.

Imaging Tests

Imaging is not always required, but it may be considered when symptoms are persistent or the diagnosis is uncertain.

Possible investigations include:

Ultrasound: May help assess gluteal tendons, bursae and surrounding soft tissues.

MRI: May provide detailed information about tendon changes, tears and other structures around the hip.

X-ray: May be used to investigate other possible causes of hip pain, including certain joint or bone conditions.

Imaging findings should always be interpreted alongside clinical symptoms and examination results.

How Can Physiotherapy Help With Greater Trochanteric Pain Syndrome?

Physiotherapy is an important part of managing many cases of greater trochanteric pain syndrome.

Treatment generally focuses on reducing aggravating loads and progressively improving the strength and function of the muscles around the hip.

1. Reducing Painful Compression

A physiotherapist can identify daily positions and activities that increase pressure around the outer hip.

Suitable modifications may help reduce irritation.

2. Improving Gluteal Strength

Progressive strengthening can improve the ability of the hip muscles to tolerate everyday activities.

Exercises may begin with lower-load movements and gradually progress to more demanding exercises.

3. Improving Pelvic Stability

Exercises targeting hip and trunk control may help improve movement during walking, standing and stair climbing.

4. Restoring Functional Movement

Rehabilitation may include activities such as:

• Walking practice.

• Step-ups.

• Sit-to-stand movements.

• Controlled single-leg exercises.

• Gradual return to recreational activities.

5. Supporting Long-Term Activity Management

A physiotherapist can help develop a suitable exercise routine and explain how to manage changes in physical activity.

The goal is to improve functional capacity and reduce the likelihood of repeated symptom aggravation.

How Long Does Greater Trochanteric Pain Syndrome Take to Improve?

Recovery varies depending on symptom duration, tendon involvement, physical activity levels and the individual’s response to rehabilitation.

Some people improve gradually over several months, while longer-standing symptoms may require a more extended programme.

Factors that may influence recovery include:

• Duration of symptoms.

• Severity of tendon involvement.

• Hip muscle strength.

• Daily activity demands.

• Ability to modify aggravating positions.

• Consistency with rehabilitation.

• Other contributing hip or back conditions.

It is important to avoid rushing into high-load exercises before the hip has developed sufficient strength and tolerance.

Greater Trochanteric Pain Syndrome vs Hip Osteoarthritis: What Is the Difference?

Both conditions can cause hip discomfort, but they generally involve different structures and symptom patterns.

Both conditions can occur together.

A professional assessment can help determine which structures are contributing to your symptoms.

When Should You Seek Medical Advice?

Arrange a professional assessment if you experience:

• Persistent pain on the outside of your hip.

• Pain that interferes with sleep.

• Difficulty climbing stairs.

• Discomfort while walking or standing.

• Reduced hip strength.

• Symptoms that do not improve with activity modification.

Seek prompt medical assessment if you experience sudden severe hip pain, inability to bear weight following an injury, significant swelling or fever with a painful hip.

New unexplained hip pain accompanied by general illness or rapidly worsening symptoms should also be assessed.

Frequently Asked Questions About Greater Trochanteric Pain Syndrome

1. What is greater trochanteric pain syndrome?

Greater trochanteric pain syndrome is a condition involving structures around the outer hip, particularly the gluteal tendons and surrounding tissues. It commonly causes pain near the greater trochanter.

2. Is greater trochanteric pain syndrome the same as bursitis?

Not exactly. The term trochanteric bursitis was traditionally used, but GTPS includes several possible conditions, particularly gluteal tendinopathy and sometimes bursal irritation.

3. Why does my outer hip hurt when I sleep?

Lying directly on the affected side can place pressure on the gluteal tendons and surrounding tissues, potentially increasing discomfort.

4. Can walking make greater trochanteric pain syndrome worse?

Long periods of walking may aggravate symptoms in some people. However, completely avoiding movement is not always necessary. Activity levels should be adjusted according to symptoms and gradually progressed.

5. Are strengthening exercises good for greater trochanteric pain syndrome?

Yes. A progressive strengthening programme targeting the hip abductor and surrounding muscles is commonly recommended. Exercises should be selected according to individual tolerance.

6. Does physiotherapy help greater trochanteric pain syndrome?

Physiotherapy may help through education, activity modification, progressive strengthening and movement rehabilitation.

7. How long does greater trochanteric pain syndrome last?

Recovery varies. Some people improve over several months, while persistent cases may require a longer rehabilitation programme. Individual assessment is important for determining suitable treatment.

Physiotherapy for Greater Trochanteric Pain Syndrome in Modbury North, Adelaide

Greater trochanteric pain syndrome can make walking, climbing stairs, sleeping and participating in physical activities uncomfortable.

An appropriate rehabilitation programme can help address contributing factors, improve hip strength and support a gradual return to everyday activities.

PAX Physiotherapy provides physiotherapy and exercise rehabilitation services in Modbury North, Adelaide, South Australia.

If outer hip pain is affecting your daily routine, contact PAX Physiotherapy to enquire about an assessment and suitable rehabilitation options.

PAX Physiotherapy – Modbury North, Adelaide

Address: Unit 2, 438 Montague Road, Modbury North SA 5092

Phone: 08 8333 8333

Mobile: 0499 999 636

Email: admin@paxphysiotherapy.com.au

Website: https://paxphysiotherapy.com.au/

Medical Disclaimer

This article provides general educational information and is not a substitute for professional medical advice, diagnosis or treatment. Greater trochanteric pain syndrome can have several contributing causes, and symptoms alone cannot confirm a diagnosis. Consult a qualified healthcare professional for an appropriate assessment, particularly if pain is severe, persistent, worsening or associated with difficulty bearing weight.