Pain on the outside of your hip can make everyday activities surprisingly difficult. Whether you’re walking the dog, climbing stairs, getting out of the car or trying to sleep on your side, Greater Trochanteric Pain Syndrome (GTPS) can have a significant impact on your quality of life.
Often referred to as trochanteric bursitis, we now know that GTPS usually involves irritation of the tendons around the hip, the bursa, or both. The good news is that most people recover well with the right combination of physiotherapy, progressive exercise and expert guidance. At Great Northern Physiotherapy, we’ll identify what’s driving your symptoms and create a personalised, evidence-based rehabilitation plan to help you move comfortably and confidently again.
Symptoms
GTPS typically causes pain over the bony point on the outside of your hip. Symptoms often develop gradually and may become increasingly noticeable during everyday activities.
Common symptoms include:
- Pain on the outside of the hip
- Tenderness when pressing over the hip bone
- Pain when walking for longer distances
- Discomfort climbing stairs or walking uphill
- Pain when getting up from a chair
- Difficulty standing on one leg
- Pain during running or sporting activities
- Pain when lying on the affected side
- Disturbed sleep because of hip pain
- Stiffness after periods of rest
Causes
Greater Trochanteric Pain Syndrome develops when the tissues on the outside of the hip become overloaded. Rather than being caused by inflammation alone, current research suggests the condition often involves changes within the gluteal tendons, irritation of the bursa, or a combination of both.
Several factors can contribute to GTPS, including:
- Sudden increases in walking or running
- Weakness in the hip muscles
- Reduced pelvic stability
- Repetitive stair climbing
- Prolonged standing on one leg
- Changes in training volume
- Previous hip or lower back problems
- Altered walking patterns
- Age-related tendon changes
The condition is more common in women over 40, runners and people whose jobs involve prolonged standing or walking.
Diagnosis
A detailed physiotherapy assessment is usually all that’s needed to diagnose Greater Trochanteric Pain Syndrome.
During your appointment, we’ll discuss:
- Where your pain is located
- Activities that aggravate your symptoms
- Your exercise and activity levels
- Previous injuries
- Your work and lifestyle
- How the pain affects your sleep and daily activities
We’ll then assess:
- Hip movement
- Gluteal muscle strength
- Walking and movement patterns
- Balance and single-leg control
- Pelvic stability
- Tenderness around the greater trochanter
- Lower back function where appropriate
Most cases can be diagnosed clinically without the need for imaging.
If your symptoms aren’t responding as expected or another condition is suspected, diagnostic ultrasound or MRI may be recommended.
Treatment Options
Comprehensive Physiotherapy Assessment
Successful treatment begins with identifying why your hip has become overloaded.
Rather than simply treating the painful area, we assess how your hips, pelvis, lower back and legs work together. This helps us address the underlying causes of your symptoms and reduce the likelihood of them returning.
Hands-on Physiotherapy
Manual therapy can help reduce pain, improve movement and make rehabilitation exercises more comfortable.
Treatment may include:
- Soft tissue massage
- Hip joint mobilisation
- Muscle release techniques
- Movement re-education
- Flexibility work
Hands-on treatment is always combined with active rehabilitation for the best long-term results.
Progressive Rehabilitation
Exercise is the most effective long-term treatment for GTPS.
Your personalised programme may include:
- Gluteal strengthening
- Hip stability exercises
- Core strengthening
- Balance training
- Functional movement retraining
- Walking progression
- Return-to-running rehabilitation
- Strength training tailored to your goals
The exercises are progressed gradually to improve tendon capacity without unnecessarily aggravating your symptoms.
Shockwave Therapy
For persistent tendon-related pain that hasn’t responded fully to exercise alone, Shockwave Therapy may be recommended.
This evidence-based treatment stimulates healing within the tendon and is often used alongside rehabilitation exercises to improve long-term outcomes.
Injection Therapy
If conservative treatment hasn’t provided sufficient relief, ultrasound-guided injection therapy may be appropriate in selected cases.
Steroid or hyaluronic acid injections can help reduce pain within the bursa, making rehabilitation exercises easier to perform. They are generally used to support recovery rather than replace exercise-based treatment.
Self-management
There are several things you can do to help settle symptoms while your hip recovers.
We often recommend:
- Avoid lying directly on the painful hip
- Place a pillow between your knees when sleeping on your side
- Reduce activities that significantly increase pain
- Build walking distances gradually
- Complete your strengthening exercises consistently
- Avoid standing on one leg for prolonged periods
- Maintain general fitness within comfortable limits
Consistency is key. Tendons respond well to gradual, progressive loading rather than complete rest.
Recovery Timelines
Recovery depends on how long your symptoms have been present and how irritated the tendons have become.
Typical recovery times include:
- Mild symptoms: 6–8 weeks
- Moderate tendon irritation: 2–4 months
- Long-standing cases: Several months with progressive rehabilitation
Many people notice improvements in pain within the first few weeks, while strength and function continue to improve over several months.
When to Seek Help
- Hip pain is affecting your sleep
- Walking has become uncomfortable
- Pain has persisted for more than a few weeks
- Symptoms are limiting exercise or work
- Self-management isn’t improving your symptoms
Seek medical advice promptly if:
- You develop severe pain after a fall or injury
- You’re unable to bear weight
- The hip becomes hot, swollen or red
- You develop unexplained fever or feel generally unwell
These symptoms may indicate another condition that requires urgent assessment.
Clinically Reviewed By
Phil Williams
Director and Consultant Physiotherapist
Get Back to Walking, Sleeping and Moving Comfortably
Outer hip pain can make even simple activities feel challenging, but it doesn’t have to become a long-term problem. With an accurate diagnosis, progressive rehabilitation and evidence-based treatment, most people achieve an excellent recovery.
Our experienced physiotherapists will help you understand your symptoms, rebuild strength and confidence, and support your recovery every step of the way.
Book your initial assessment today and take the first step towards pain-free movement.
GTPS & HIP PAIN FREQUENTLY ASKED QUESTIONS
Not exactly. GTPS is an umbrella term that includes irritation of the gluteal tendons, the bursa or both. While bursitis can occur, tendon overload is now thought to be the most common cause.
Lying directly on the affected hip increases pressure on the irritated tissues. Using a pillow between your knees or avoiding sleeping on the painful side can often help.
Usually not. Walking is encouraged, but you may need to temporarily reduce your distance or pace while your hip settles.
Most people recover very well with a structured rehabilitation programme that improves hip strength, movement and tendon resilience.
Injections may be considered if pain is preventing progress with rehabilitation or symptoms haven’t improved despite appropriate physiotherapy. They work best when combined with an exercise programme.
Related PHYSIO SERVICES
To support your recovery, your physiotherapist may recommend one or more of our related services:
Book your initial assessment and take the first step toward pain-free movement.