Greater trochanteric pain syndrome (GTPS) is a common cause of pain on the outer hip, usually related to gluteal tendinopathy. It is often aggravated by lying on the affected side and typically responds to load management and rehabilitation.

Greater trochanteric pain syndrome (GTPS) is the current term for pain on the outer hip that was once loosely called “bursitis”. In most cases the underlying problem is gluteal tendinopathy — load-related changes in the tendons that attach to the outer hip.

Management centres on a targeted gluteal strengthening program and load management, including avoiding positions and activities that compress the tendons. This is the best-evidenced approach and resolves symptoms for many people over time.

Where pain persists despite good rehabilitation, additional options such as shockwave therapy may be considered, as it has been studied for gluteal tendinopathy. We assess your hip carefully, distinguish GTPS from other causes of hip pain, and recommend the approach best matched to your diagnosis.

Common symptoms

  • Pain over the outer hip, sometimes radiating down the outer thigh
  • Pain when lying on the affected side at night
  • Pain with prolonged standing, walking or climbing stairs
  • Tenderness over the bony point of the hip
Evidence-informed treatment summary

How our treatment options may fit for Greater Trochanteric Pain Syndrome (Hip)

The options below include the treatments offered at The Back Pain Doctor. Listing a treatment does not mean it is recommended for this condition. The evidence, likely benefit and role of each option are considered against the diagnosis, examination findings, imaging where appropriate, patient goals, risks, cost and alternatives.

Foundation

Diagnosis, education and progressive rehabilitation

This is the starting point for most musculoskeletal conditions.

The priority is to identify the likely pain generator, explain the condition clearly, modify aggravating load and build a realistic plan to restore strength, movement and confidence.

Best supported when the diagnosis is a suitable tendinopathy or plantar heel pain presentation.

Shockwave may be clinically relevant when symptoms persist despite appropriate load management and rehabilitation. It remains an adjunct, not a substitute for progressive loading and diagnosis-specific care.

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Evidence varies substantially by condition, tissue and preparation method.

PRP may be discussed in selected tendon or joint presentations. It should not be presented as a guaranteed regenerative treatment, and uncertainty, cost and alternatives should be discussed.

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May provide symptom relief when the pain generator is a joint, bursa, tendon sheath or other defined irritable structure.

Injection treatment may be discussed when pain is limiting sleep, function or rehabilitation. The expected benefit is usually symptom control, not tissue regeneration.

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Clinical evidence is still developing and guideline support is limited.

EMTT may be discussed as an adjunct in selected presentations, but should be presented with clear uncertainty and never as a replacement for diagnosis, load management or rehabilitation.

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Selected cases

Prolotherapy

Evidence is condition-specific and generally less established than exercise-based care.

Prolotherapy may be considered in carefully selected chronic ligament, tendon or joint-related pain presentations, but it is not a first-line treatment.

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Most relevant when focal myofascial pain is a clear contributor.

Trigger point treatment may reduce pain from focal muscle spasm or myofascial tenderness. It should be paired with movement restoration, strength work and recurrence prevention.

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Relevant only when the history and examination support nerve irritation or entrapment.

Nerve-focused treatment may be discussed when there is a plausible peripheral nerve pain generator. Progressive weakness, major neurological deficit or red flags require a different pathway.

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This is general information only. Suitability is assessed individually. Treatments with limited or condition-dependent evidence may still be discussed, but only with clear explanation of uncertainty, expected benefit, risks, cost and alternatives. Red flags, progressive neurological symptoms or suspected serious pathology require a different pathway.

Frequently asked questions

Why does it hurt to lie on that side?
Lying on the affected hip compresses the gluteal tendons, which is why night pain when lying on that side is a classic feature. Adjusting sleeping position and using a pillow between the knees can help.
What helps GTPS the most?
A targeted gluteal strengthening program combined with load management is the best-evidenced approach. Avoiding positions that compress the tendon is also helpful.
Are injections useful?
Some injection treatments are considered for persistent cases, and shockwave therapy has been studied for gluteal tendinopathy. We discuss what is reasonable for your situation rather than defaulting to injections.

Ready for a clearer plan for your back or musculoskeletal pain?

Book an assessment with Dr Joshua Hatch.

Your assessment focuses on understanding the likely source of your pain and the most appropriate non-surgical options for your diagnosis, with the aim of reducing pain and improving function.

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