Greater Trochanteric Pain Syndrome: Causes, Symptoms, and How We Can Help
- staystrongtherapy
- Jun 30
- 4 min read
All information in this blog is supported by peer-reviewed research. There is currently no dedicated NICE guideline for this condition, so current evidence is used throughout. Reference numbers appear throughout, with the full list at the bottom of the page.
What Is Greater Trochanteric Pain Syndrome?
Greater trochanteric pain syndrome (GTPS) is the modern, accurate term for what was historically called "trochanteric bursitis." This older label turns out to be largely misleading. MRI research found true bursal distention in only 8.3% of people with this presentation, while gluteal tendon tears and tendinitis were far more common findings, at 45.8% and 62.5% respectively. ¹ A separate ultrasound study of 877 people with lateral hip pain found no signs of bursitis at all in nearly 80% of cases. ¹
GTPS is now understood as a broader, more accurate umbrella term, encompassing trochanteric bursitis, gluteal tendinopathy or tearing, and external snapping hip syndrome together. ²
Common Signs and Symptoms
Pain and tenderness over the outer (lateral) side of the hip
Pain often worse lying on the affected side at night
Pain with walking, climbing stairs, or standing on one leg
Occasionally a snapping or catching sensation at the hip
Risk Factors
Female sex, GTPS shows a clear female predominance of around 2 to 3 to 1 ³
Age, most common between the 40s and 60s ³
Pelvic biomechanics and hormonal factors, thought to contribute to the female predominance ⁴
Femoroacetabular impingement (FAI), people with FAI have a higher risk of developing chronic GTPS, with one study finding 7% prevalence ⁵
What to Look Out For
Please seek medical assessment if you experience:
Sudden, severe hip pain following a fall or trauma
Fever, redness, or warmth around the hip
Significant, unexplained weight loss alongside hip pain
Inability to weight-bear on the affected leg
How Is It Diagnosed?
Diagnosis is primarily clinical. Imaging is often used to rule out other causes of lateral hip pain, such as osteoarthritis or FAI, rather than to confirm GTPS itself. ³ Plain X-rays are valuable for excluding other diagnoses, allowing appropriate treatment to begin without unnecessary advanced imaging. ⁶
How We Can Help
Research has found that targeted physiotherapy offers superior long-term outcomes compared to corticosteroid injections, with around 60% of patients achieving symptom resolution at 15 months. ⁷ Combining physiotherapy with an injection can be more effective for managing acute symptoms specifically than physiotherapy alone, but exercise-based treatment remains central to lasting improvement. ⁷
Osteopathic manual techniques and manual therapy: used to address restriction and tension around the hip and surrounding muscles, supporting overall function.
Deep tissue and sports massage: targeted soft tissue work for the gluteal muscles and iliotibial band, the structures most consistently implicated in GTPS.
Medical acupuncture: used alongside exercise-based treatment to support pain management.
Exercise: The Cornerstone of Recovery
Given how strongly GTPS is linked to gluteal tendinopathy rather than simple bursal inflammation, targeted gluteal strengthening is genuinely central to treatment.
Gluteal strengthening exercises: progressively loading the gluteus medius and minimus tendons.
Activity and load modification: temporarily reducing aggravating positions, such as lying directly on the affected side or prolonged standing on one leg.
Graded return to activity: a structured progression back to walking, stairs, and exercise as symptoms improve.
Your practitioner will guide a programme tailored to your specific presentation.
What to Expect at Your First Appointment
We will take a thorough history and carry out a hands-on assessment to confirm GTPS and rule out other sources of hip pain, such as osteoarthritis or referral from the lower back. We will explain clearly what we find, using current, accurate terminology, and build an evidence-based treatment plan.
Frequently Asked Questions
Do I have bursitis? Possibly, but current evidence shows true bursitis is actually one of the least common findings in this presentation. Gluteal tendon problems are far more frequently the genuine cause.
Will I need a steroid injection? Not necessarily as a first step. Targeted physiotherapy has shown better long-term outcomes than injections alone.
How long will it take to improve? Recovery varies, but research shows around 60% of people achieve symptom resolution within 15 months with appropriate physiotherapy-based treatment.
Recognise these symptoms? Get in touch using the contact form and we will assess and build the right treatment plan for you.
References
The 2022 International Society for Hip Preservation (ISHA) physiotherapy agreement on assessment and treatment of greater trochanteric pain syndrome (GTPS): an international consensus statement. Journal of Hip Preservation Surgery. 2023. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234389/
The 2022 International Society for Hip Preservation (ISHA) physiotherapy agreement on assessment and treatment of greater trochanteric pain syndrome (GTPS): an international consensus statement. Journal of Hip Preservation Surgery. Available at: https://academic.oup.com/jhps/article/10/1/48/6967092
Management of Greater Trochanteric Pain Syndrome: A Narrative Review. PMC. 2025. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC12255468/
Greater Trochanteric Pain Syndrome (Greater Trochanteric Bursitis). StatPearls Publishing. Updated February 2024. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557433/
Greater Trochanteric Pain Syndrome (Greater Trochanteric Bursitis). StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557433/
Greater Trochanteric Pain Syndrome (Greater Trochanteric Bursitis). StatPearls Publishing. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557433/
Management of Greater Trochanteric Pain Syndrome: A Narrative Review. PubMed. 2025. Available at: https://pubmed.ncbi.nlm.nih.gov/40656316/
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