Greater Trochanter Pain Syndrome (GTPS) is a common but often misunderstood cause of persistent pain on the outside of the hip. It can affect people of all ages but is particularly prevalent in middle-aged adults, runners, and those who spend long periods sitting or standing. While it was once referred to as “trochanteric bursitis,” modern research shows the condition is usually more complex than simple inflammation.
Understanding what GTPS is, how it develops, and how it differs from other hip conditions is an important first step toward effective treatment and long-term relief.
Understanding the Anatomy Behind GTPS
The greater trochanter is a prominent bony point on the outside of the femur (thigh bone). It acts as an attachment site for key hip muscles, particularly the gluteus medius and gluteus minimus, which are essential for pelvic stability and walking.
Between these tendons and the bone sit small fluid-filled sacs called bursae. These bursae help reduce friction as the muscles move. When the tendons, bursae, or surrounding tissues become overloaded or irritated, pain can develop along the outer hip — this cluster of issues is now known as Greater Trochanter Pain Syndrome.
Rather than being a single diagnosis, GTPS is an umbrella term that can include:
- Gluteal tendinopathy (degeneration or irritation of the gluteal tendons)
- Bursal irritation
- Muscle overload and altered hip mechanics
Common Symptoms of Greater Trochanter Pain Syndrome
GTPS typically presents with very specific and recognisable symptoms. These may include:
- Pain on the outside of the hip, often described as sharp or aching
- Pain that worsens when lying on the affected side
- Discomfort during walking, climbing stairs, or standing on one leg
- Pain when getting out of a car or rising from a seated position
- Tenderness when pressing over the bony point of the hip
In some cases, the pain may radiate down the outside of the thigh, which can lead people to mistakenly believe the issue is coming from the lower back or sciatic nerve.
What Causes GTPS?
GTPS is rarely caused by a single event – instead, it tends to develop gradually due to repeated strain or biomechanical overload. Common contributing factors include:
- Weakness or poor endurance of the gluteal muscles
- Sudden increases in walking, running, or exercise volume
- Prolonged sitting with poor hip positioning
- Hip or pelvic alignment issues
- Previous hip or lower back injury
- Poor load management during rehabilitation or training
Women are statistically more likely to develop GTPS, partly due to differences in pelvic structure and biomechanics, although the condition affects men as well.
GTPS vs Trochanteric Bursitis: What’s the Difference?
For many years, lateral hip pain was routinely labelled as trochanteric bursitis. While bursae can be involved, current imaging and research show that the gluteal tendons are more often the primary source of pain. This distinction matters because tendon-related pain responds best to structured strengthening and load management, rather than rest alone or repeated injections. Treating GTPS as a tendon condition rather than a purely inflammatory one often leads to better long-term outcomes.
How is Greater Trochanter Pain Syndrome Diagnosed?
Diagnosis is usually based on a detailed clinical assessment. A qualified health professional will consider:
- Location and behaviour of the pain
- Movement patterns and hip strength
- Functional activities that aggravate symptoms
Imaging such as ultrasound or MRI may be used in some cases, particularly if symptoms persist, but many people can be accurately diagnosed without scans.
Why Early Management Matters
Left unaddressed, GTPS can become a chronic condition that significantly limits daily activities and sleep quality. Early identification allows for targeted intervention, including strength-based rehabilitation, movement retraining, and education around posture and activity modification. It’s worth noting that simply “pushing through” the pain or relying solely on rest can often prolong recovery – a structured, progressive approach that addresses the underlying cause is key.
Greater Trochanter Pain Syndrome is a common source of outer hip pain, but it doesn’t have to be a long-term problem
By understanding what GTPS is (and maybe more importantly, what it isn’t), people can make more informed decisions about treatment and recovery. If you’re experiencing persistent pain on the outside of your hip, seeking professional guidance early can help restore comfort, function, and confidence in movement.