Greater Trochanteric Pain Syndrome (GTPS)

Patient Information

MSK Physiotherapy Service

• Author ID:           SA
• Leaflet Ref:         Phy 081
• Version:              1
• Leaflet title:         Greater Trochanteric Pain Syndrome (GTPS)
• Date Produced:   November 2025
• Expiry Date:        November 2027

Introduction

Greater Trochanteric Pain Syndrome (GTPS) refers to discomfort to the outer side of the hip. It can also be referred to as ‘Gluteal Tendinopathy’. This leaflet includes information on what GTPS is and ways in which you can reduce and manage your symptoms. 

What is GTPS pain?

GTPS is a common condition which involves pain to the outer side of your thigh / buttock. This can occur due to progressive irritation or injury to the soft tissues that are positioned on the lateral hip.

Previously this condition was often referred to as ‘Trochanteric bursitis’ as it was thought that inflammation of the lateral hip bursa (fluid filled sac) was the main source of irritation.

Nowadays we know this is only relevant in a small number of cases and predominantly, the discomfort is related to repetitive irritation to the tendons of the buttock muscles. 

Who is most likely to develop GTPS?

• Up to 75% are female
• Aged between 40-60 years old
• Overweight - Body Mass Index (BMI) >28.5)
• 20-30% will also have lower back pain

What are the symptoms of GTPS?

Pain local to the outer side of the hip / thigh / buttock. Usually this is described as an ‘aching’ but patients can often experience ‘sharp’ sudden onset of discomfort.

This pain can be aggravated by any of the following:

• Walking
• Sitting with legs crossed
• Lying on your side
• Standing for long periods
• When standing from a seated position
• Ascending stairs or walking uphill 
• Actively moving your leg outwards against resistance

What are the causes of GTPS? 

Reasons for developing GTPS will vary from person to person. Often a combination of the following may contribute:

• Injury to the outer side of your hip
• Being overweight
• Sedentary lifestyle
• Morphology (shape) of your pelvis
• Sudden increase in physical activity levels
• Repetitive:

• Crossing legs
• Standing for long periods with weight through one leg
• Sitting in low chairs
• Physical activities, e.g. running or jumping

• Reduced strength of the muscles around your hip
• Lower back pain may contribute to developing lateral hip pain
• Oestrogen deficiency 

How to manage GTPS symptoms

Whilst lateral hip pain symptoms can persist for quite some time, a large percentage will see reduction of symptoms within 1 year. In some cases, this can be longer.

Initially, focus should centre around reducing pain and aggravation:

• Pain relief via guidance from your General Practitioner (GP) or Pharmacist
• Modifying day-to-day activities to reduce aggravation

Following this:

• Exercises to strengthen the muscles around your hip
• Maintaining a healthy body weight
• Addressing any other health conditions

In some cases which do not get better with time, other interventions such as Extracorporeal Shockwave Therapy, Corticosteroid or Platelet-Rich-Plasma injections may be recommended. This may be offered following assessment with a member of a Consultant Orthopaedic team.

Pain management

• Try to remain active however avoid activities which may aggravate your GTPS pain
• Discuss with your employer any modifications that may be required to continue your normal duties
• Heat or ice (wrapped in a towel) can help to ease your symptoms

You can find further information on medications you can use to reduce your symptoms here:

https://www.nhs.uk/medicines/paracetamol-for-adults/

https://www.nhs.uk/medicines/ibuprofen-for-adults/

How to improve sleep with GTPS

Sleeping positions can irritate your symptoms if you lie directly on the bony prominence located to the outer side of your hip.

Alternatively, you can try:

• Lying on the opposite side
• On your front or back

If you struggle to sleep without lying on your affected side, try to ensure you lie in a way which does not compress the area of discomfort. 

You can also try placing a pillow between your legs to prevent your hip crossing over which can irritate your symptoms.

Exercises

Exercise	Position	Description
Static abduction in lying     *Abduction is a movement away from the midline of the body		Lie on your back with a pillow or rolled towel under knees. Tie a strong band (or dressing gown cord) around your ankles or knees positioned to allow a neutral alignment.  Slowly begin to move your legs outwards pushing against the band. Try to keep your thigh muscles relaxed on the pillow and feel the majority of the work coming from the outer part of your hips. Hold for 30 seconds at a tolerable level and relax.   Repeat 5-8 times
Static abduction in standing		Stand with feet a hip width. Maintain a flat foot position with more weight placed through your heels.  Slowly push your legs apart as if you are going to do a splits movement. Use the friction of your feet on the floor to create this. Try to keep your thigh muscles relaxed and feel the majority of the work coming from the outer part of your hips. Hold for upto 30 seconds at a tolerable level and relax.   Repeat 5-8 times