Outer Hip Pain Explained: Greater Trochanteric Pain Syndrome

Do you struggle with nagging pain on the outside of your hip? Many people assume it’s just “hip bursitis,” but often the real issue is something called Greater Trochanteric Pain Syndrome (GTPS). This condition is one of the most common causes of hip pain on the side of the hip, and the good news is: most people improve without surgery when they get the right treatment.

What Is Greater Trochanteric Pain Syndrome (GTPS)?

GTPS is an umbrella term for pain around the bony point on the outside of your hip (the greater trochanter).

It was once thought to be caused only by bursitis (inflammation of a small fluid-filled sac), but research shows it’s usually a mix of:

  • Hip tendon problems (gluteus medius and minimus tendinopathy — sometimes called “hip tendonitis”)
  • Bursal irritation (trochanteric bursitis)
  • Pressure or friction from the iliotibial band (ITB) running down the thigh

Anatomy In Simple Terms

Your hip is like a ball-and-socket joint. On the outside of the thigh bone, there’s a bony lump (the greater trochanter) where important glute muscles attach. These muscles help with balance, walking, and climbing stairs.

If the tendons become weak, overused, or compressed, they get irritated and sore — leading to GTPS.

Greater Trochanteric Pain Syndrome Anatomy

Common Signs & Symptoms Of GTPS

  • Outer hip pain, sometimes radiating down the thigh
  • Tenderness when pressing the side of the hip
  • Pain when lying on the affected side (disturbs sleep)
  • Pain with walking, climbing stairs, or standing up
  • Sometimes a limp if the pain is severe

Causes Of Outer Hip Pain

GTPS usually develops when the hip tendons or bursa are overloaded. Common causes include:

  • Overuse from running, hiking, or stair climbing
  • Weakness in the glute muscles
  • Tightness in the ITB (outer thigh band) and poor hip joint mobility
  • A fall onto the side of the hip
  • Poor posture 
  • Not following a graded return to exercise protocol 

Who Is At Higher Risk?

GTPS (or “hip bursitis”) is most common in:

  • Women aged 40–60 (especially around menopause)
  • Runners and active people who load their hips repetitively
  • People with knee or low back pain, since this changes walking mechanics
  • People with higher body weight or sedentary lifestyle

Treatment Options: Physio & Chiro Management

Most cases of GTPS get better with conservative care — no surgery required.

Physiotherapy & Chiropractic Care May Include:

  • Strengthening exercises (especially glute muscles)
  • Activity modification (avoid crossing legs, side sleeping without support, or standing with hip popped out)
  • Manual therapy (massage therapy, soft tissue release, joint mobilisation, dry needling)
  • Shockwave therapy (for persistent tendon pain)
  • Patient education (load management and posture strategies)

Self-care tips:

  • Sleep with a pillow between your knees
  • Avoid lying directly on the sore side
  • Ease back into exercise with guided progression

Shockwave therapy

Imaging & Scans For GTPS

Most people don’t need scans right away. Diagnosis is usually clinical.

  • Ultrasound — can show bursitis or tendon changes
  • MRI — best for checking glute tendon damage if symptoms don’t improve
  • X-ray — used mainly to rule out hip arthritis

Specialist Referral & Injection Options

If pain doesn’t improve after a good trial of physio or chiro care, your doctor may consider:

  • Corticosteroid injections — reduce pain and inflammation short-term

  • Platelet-rich plasma (PRP) injections — newer option to encourage tendon healing

  • Surgery — very rare, reserved for severe tendon tears or long-standing cases

FAQs: Hip Bursitis & GTPS

Is GTPS the same as hip arthritis?
 No. Arthritis affects the hip joint itself, while GTPS affects the tendons and bursa outside the joint.

How long does recovery take?
 With the right care, most people improve in 6–12 weeks. Tougher cases can take a few months.

Can it go away without treatment?
 Sometimes mild cases settle, but without strengthening, pain often comes back.

Can I keep exercising with GTPS?
 Yes — low-impact options like cycling or swimming are usually fine, and strengthening the hip is essential.

Get The Right Treatment With Spinal & Sports Care

Greater Trochanteric Pain Syndrome (often called hip bursitis or hip tendonitis) is the most common cause of pain on the outside of the hip. The main issue is tendon overload rather than just bursitis. Most people recover with strengthening exercises, lifestyle changes, and hands-on care from a physio or chiropractor. Injections and scans are only needed for stubborn cases.

At Spinal and Sports Care, our multidisciplinary team is here to help with expert assessment, imaging referrals, and a tailored treatment plan to relieve pain, restore function, and get you moving again safely and confidently. Reach out to our team today for a personalised treatment plan tailored to your needs.

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