Conditions

Greater trochanteric pain syndrome (GTPS)

It happens when the tendons and other soft tissues around the greater trochanter (the bony point on the side of your hip) become irritated. Small fluid-filled sacs called bursae may also become irritated, which is why the condition is sometimes called hip bursitis.

GTPS

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What are the symptoms of GTPS?

You may notice:

Pain on the outside of your hip
Pain that gets worse when lying on that side
Discomfort when walking, climbing stairs, or standing for a long time
Pain when pressing on the side of the hip

What causes GTPS?

GTPS can develop for many reasons, including:

Overuse or repetitive movements
Weak hip muscles
A fall or bump to the hip
Being overweight
Smoking – linked to slower healing and poorer tendon health
Women aged 40-60 are affected more commonly

GTPS usually improves with time, activity modification and the right exercises. Gradually increasing activity, avoiding positions that aggravate symptoms and following a strengthening programme gives most people the best chance of recovery.

Steps to take to recovery

Self-Management

Activity Modification

If your symptoms have recently flared up, temporarily reduce activities that significantly increase your pain while keeping as active as possible. Finding a balance between activity and rest usually helps symptoms settle. Pacing walking and standing activities can also be helpful.

Useful tips:

Avoid lying directly on the painful hip
Try sleeping with a pillow between your knees if lying on your side
Avoid sitting with your legs crossed

Pain Relief

Over-the-counter medicines: Over-the-counter pain relief may help you stay active. Always follow the advice provided with the medicine.

Topical creams: Some people find topical creams or gels helpful for short-term relief of pain and stiffness.

It is important to check whether you can take these medicines. If you are unsure whether you can take these medicines, speak to a pharmacist or another healthcare professional.

Exercises

Gradually strengthening the hip muscles is one of the most effective treatments for GTPS. Exercises should be progressed gradually and some discomfort during exercise is acceptable provided it settles afterwards. The Arthritis UK hip exercise programme may help.

Weight Management

If you are carrying extra weight, even a modest amount of weight loss can reduce the load through the hip and improve symptoms. You can calculate your BMI using the NHS BMI calculator.

Further Treatment

Physiotherapy

If your symptoms aren't improving or you feel you need more help, then please refer yourself to physiotherapy. We will assess your symptoms and work with you to develop a treatment plan. You can have one-to-one physiotherapy and have access to our gym classes. We can also refer you to other services to access other treatments listed if appropriate.

Steroid Injections

Corticosteroid injections can sometimes reduce pain in the short term, particularly if pain is limiting rehabilitation. They are not suitable for everyone and are usually considered alongside an exercise programme rather than instead of one. It is not an appropriate option for everyone.

Surgery (very rare)

Considered only if symptoms are severe or do not improve with other treatments. It is rare for this condition to require surgery.

Lifestyle factors that influence health

GTPS is influenced by how the tendons are loaded, the body's ability to recover and overall health. Smoking, carrying extra weight, diabetes, poor sleep, and long-term stress levels are known to negatively affect tendon health and healing. Staying active, gradually strengthening the hip muscles, and addressing lifestyle factors can help reduce pain and improve function. More support with health and lifestyle factors can be found on our Your Musculoskeletal Health page.

When to seek further advice

Some symptoms require urgent medical assessment rather than physiotherapy. Please seek urgent medical advice if you have any of the following:

Sudden severe hip pain after a fall or injury, particularly if you are unable to stand, bear weight or move your hip normally
Signs of infection, such as increasing redness, warmth, swelling, fever or feeling generally unwell
Pain travelling down the leg accompanied by new problems controlling your bladder or bowels, numbness around the genitals or back passage ("saddle area"), or changes in sexual function. These symptoms require immediate assessment in A&E. These symptoms can be a sign of cauda equina syndrome. Our cauda equina syndrome webpage provides further information.

If any of the other symptoms above apply to you, contact NHS 111 for advice.