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Greater Trochanteric Pain Syndrome (GTPS)

Person with hands on hips

What is Greater Trochanteric Pain Syndrome?

Greater Trochanteric Pain Syndrome (GTPS) is a condition that causes pain on the outer side of the hip, typically affecting the soft tissues around the greater trochanter, the bony prominence at the top of the thigh bone (femur). GTPS is commonly caused by inflammation or degeneration of the tendons and bursae in the hip region, often leading to persistent discomfort and limited mobility.

Causes of Greater Trochanteric Pain Syndrome

GTPS is usually the result of repetitive stress or biomechanical issues affecting the hip. Common causes include:
  • Tendon Overload or Degeneration: Repetitive activities, such as running or prolonged standing, can strain the tendons of the gluteal muscles.
  • Bursitis: Inflammation of the trochanteric bursa, a fluid-filled sac that cushions the hip joint.
  • Muscle Weakness or Imbalances: Weakness in the gluteal muscles can lead to abnormal hip mechanics, increasing strain on the tendons.
  • Sudden Increase in Activity: A rapid increase in physical activity can overload the hip structures.
  • Poor Posture or Gait Abnormalities: Conditions such as leg length discrepancies or excessive hip rotation can contribute to GTPS.
  • Trauma or Injury: A direct fall onto the hip or sudden excessive force can lead to irritation of the tendons and bursae.

Symptoms of Greater Trochanteric Pain Syndrome

GTPS symptoms can vary but typically include:
  • Pain and tenderness on the outer hip, which may radiate down the thigh.
  • Discomfort when lying on the affected side, making sleep difficult.
  • Increased pain with prolonged standing, walking, or climbing stairs.
  • Stiffness or weakness in the hip muscles.
  • Worsening pain with repetitive movements, such as running or cycling.

Risk Factors for Greater Trochanteric Pain Syndrome

Several factors can increase the likelihood of developing GTPS, including:
  • Age and Gender: More common in individuals over 40 and in women due to differences in hip biomechanics.
  • Obesity: Excess weight places additional strain on the hip tendons.
  • High-Impact Sports: Activities such as running or hiking can contribute to tendon overload.
  • Previous Hip Injury or Surgery: Can lead to altered hip mechanics and increased stress on the greater trochanter.
  • Low Back or Pelvic Issues: Conditions such as lower back pain or sacroiliac joint dysfunction can affect hip stability.

Diagnosis of Greater Trochanteric Pain Syndrome

A healthcare professional will typically diagnose GTPS through:
  • Clinical Examination: Assessing hip pain, muscle strength, and movement limitations.
  • Palpation Test: Applying pressure to the greater trochanter to identify tenderness.
  • Imaging Tests:
    • Ultrasound or MRI: To evaluate tendon degeneration, bursitis, or soft tissue damage.
    • X-rays: Used to rule out other conditions such as arthritis or fractures.

    Treatment for Greater Trochanteric Pain Syndrome

    Most cases of GTPS can be managed with conservative treatment options, including:
    Non-Surgical Treatment
    • Activity Modification: Reducing activities that worsen symptoms, such as prolonged standing or side-lying.
    • Pain Management: Over-the-counter anti-inflammatory medications (as advised by a medical professional).
    • Physical Therapy:
      • Strengthening exercises targeting the gluteal muscles and core stability.
      • Stretching to improve flexibility and reduce tendon irritation.
      • Gait and posture correction to improve biomechanics.
    • Ice Therapy: Applying ice packs to reduce inflammation and pain.
    • Shockwave Therapy: A non-invasive treatment that stimulates tissue healing in chronic cases.
    • Weight Management: Reducing excess weight can help alleviate pressure on the hip structures.

    Injection Therapy
    • Corticosteroid Injections: Used for persistent inflammation and pain relief, but should be used sparingly.
    • Platelet-Rich Plasma (PRP) Therapy: May promote tendon healing in chronic cases.

    Surgical Intervention
    Surgery is rarely needed but may be considered for severe or treatment-resistant cases. Procedures may include:
    • Tendon Repair or Release: If tendon damage is significant.
    • Bursectomy: Removal of the inflamed bursa if conservative treatments fail.

    Prevention of Greater Trochanteric Pain Syndrome

    To reduce the risk of developing GTPS, consider:
    • Maintaining Strong Hip Muscles: Regular strengthening exercises for the glutes and core.
    • Gradually Increasing Activity Levels: Avoid sudden increases in exercise intensity.
    • Using Proper Footwear: Supportive shoes can improve hip alignment.
    • Stretching and Mobility Exercises: Regular stretching to maintain flexibility and prevent stiffness.
    • Maintaining a Healthy Weight: Reducing strain on the hip joints and tendons.
    • Correcting Postural Imbalances: Addressing any underlying gait abnormalities or posture issues.

    Prognosis and Long-Term Management

    With appropriate treatment, most individuals recover from GTPS within weeks to months. Early intervention and adherence to rehabilitation exercises can prevent recurrence and improve overall hip function. If symptoms persist, seeking medical advice is crucial for long-term management and recovery.

    Further information

    Last updated07 Aug 2025
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