Greater trochanteric pain syndrome (GTPS)
What Is Greater trochanteric pain syndrome?
Greater trochanteric pain syndrome is a common hip condition that causes pain. It occurs when the tissues in this area become inflamed. These tissues can include tendons, muscles or bursae (fluid filled sacks). Other names have been used to describe GTPS such as trochanteric bursitis or gluteal tendonitis but these are essentially all the same.
What are the symptoms?
Pain is often described as a dull ache or a burning sensation that is felt in the outer buttock/hip area that can often spread down the outside of the thigh towards the knee. The symptoms are often felt when walking, using the stairs, sitting with legs crossed or lying at night.
What are the causes?
It is most common in middle aged (40-60) females, but can occur in younger people, especially runners, footballers and dancers. The exact cause of GTPS is not fully understood, but there are many factors that can contribute towards it, including:
- Being over weight
- Reduced strength and flexibility of the muscle around the hip and buttock
- Inactive lifestyles, causing deconditioning of muscles and tendons around the area
- Sudden increase in a new activity that places excessive load on the tissues. This could be from exercise or heavy gardening or DIY
- Prolonged or excessive pressure to your hip area such as sitting long periods in chairs/seats that are too low, crossing legs or ankles, standing with weight through just one leg.
- Direct fall onto the outer hip
- Secondary to low back pain
- Secondary to Osteo-Arthritis of the hip
- Secondary to hip surgery
What can I do myself to help it?
- Stay positive, GTPS naturally resolves for 90% of people with some simple advice and exercise. Most people will start to improve in 6-9 months
- Try to lose weight if you are overweight. Losing even a small amount of weight can reduce the strain on the irritated tissues.
- Reduce any specific activities that aggravate your symptoms but don’t stop completely.
- Avoid standing with your weight on one leg and pushing your hip out to the side
- Don’t cross your legs or ankles
- Try sleeping on your back or the opposite side with a pillow between or under your knees.
- Avoid sitting on low chairs
- Use painkillers. They will reduce your pain, allowing you to remain active.
- Apply an ice pack to the affected area. Ensure you wrap the ice in a towel and check the skin regularly to check for ice burns.
- Self-refer yourself to see a physiotherapist.
What will physiotherapy do?
A physiotherapist with take a thorough history of your symptoms and will conduct a physical examination of the area to confirm the diagnosis.
The main aim of physiotherapy is to restore strength and function to the hip, back and thigh area. Treatment will be based on active rehabilitation, focusing on strength and flexibility.
Your physiotherapist will create an individual and progressive exercise programme to address your individual needs. We have included some gentle exercises for you to try, please see below:
Acupuncture, electrotherapy and massage have not been shown to be helpful for GTPS and therefore not offered.
Corticosteroid injections can be helpful for pain management but will not resolve the underlying cause of the problem. They should only be used after everything else has been tried. This can be discussed with your GP or physiotherapist. Due to the current coronavirus pandemic we will not be offering injections until further notice.
Symptoms to check
Click the plus sign to see a list of problems that could be a sign you may need to be checked urgently
Get advice now from 111 if:
- The hip pain was caused by a serious fall or accident
- Your leg is deformed, badly bruised or bleeding
- You are unable to move your hip or bear any weight on your leg
- You have numbness or tingling around your genitals or buttocks
- You have a change to your bladder and bowel control or difficulty peeing
- You have a raised temperature and you feel unwell
- You have a fever or a rash
- Your hip pain came on very suddenly and you have sickle cell anaemia
These problems could be a sign of something more serious and may need to be checked urgently