Greater trochanteric pain syndrome: lateral hip pain from gluteal tendinopathy

myBackPain Assessment

Outer hip pain that is worse at night or when walking — could it be GTPS?

The myBackPain assessment identifies the GTPS pattern and distinguishes it from hip OA and spinal nerve root pain — conditions it is frequently confused with. Results in minutes.

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Women

over 40 are most commonly affected — GTPS is 3–4 times more common in women

Often

misdiagnosed as hip OA or sciatica — it is neither, and needs different management

Responds

well to tendon rehabilitation — the most evidence-based treatment

What is greater trochanteric pain syndrome?

Greater trochanteric pain syndrome (GTPS) — previously called trochanteric bursitis — is pain over the outer hip at the greater trochanter (the bony prominence on the outer upper thigh). It is caused primarily by gluteal tendinopathy: degeneration and irritation of the tendons of the gluteal muscles where they attach to the greater trochanter. It is extremely common, particularly in women over 40, and is frequently misdiagnosed as hip osteoarthritis or lumbar nerve root pain.

What does it feel like?

Pain over the outer hip, often severely worse when lying on that side at night
Pain with walking, particularly up slopes or stairs
Pain with sustained standing on one leg
Tenderness directly over the greater trochanter on palpation
Pain with crossing legs (adduction of the hip reproduces symptoms)
Often radiates down the outer thigh — can mimic L5 nerve root pain

Why GTPS is commonly misdiagnosed

The pain can extend down the outer thigh and even to the knee, mimicking L5 nerve root pain from the spine. Unlike true radiculopathy, there are no neurological changes — no weakness, no reflex change, no dermatomal sensory loss. The key distinguishing feature is that compression of the lateral hip (lying on it, crossing legs) reproduces the pain, whereas spinal nerve root pain is reproduced by dural tension tests.

What helps?

Load management — the first step

Avoiding compressive loading of the greater trochanter is essential initially: no crossing legs, no sitting with legs adducted, sleeping with a pillow between the knees, avoiding hip adduction during walking. This is not rest — it is specific load management.

Tendon rehabilitation

Progressive loading of the gluteal tendons through isometric and then isotonic exercises. This is the most evidence-based treatment for GTPS. A physiotherapist or osteopath can guide a specific programme. It takes time — 3–6 months for significant improvement.

Corticosteroid injection

Provides short-term pain relief but does not address the underlying tendinopathy. Best used to reduce pain enough to allow commencement of rehabilitation, not as a standalone treatment.

Shockwave therapy

Extracorporeal shockwave therapy has good evidence for gluteal tendinopathy. Available from physiotherapy and sports medicine clinics. Particularly useful for cases that have not responded to load management and rehabilitation alone.

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Download the Greater Trochanteric Pain Syndrome Fact SheetPDF — printable summary to share with your GP or practitioner