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Greater trochanteric pain syndrome
Understanding greater trochanteric pain syndrome
Pain on the outside bony part of your thigh could indicate a soft tissue problem and is known as greater trochanteric pain syndrome (GTPS).
GTPS describes pain at the side of the hip, often felt on side-lying or when climbing stairs, which originates in the soft-tissues of the hip including muscles, tendons and bursa. A bursa is a small fluid-filled sac that allows tendons to glide over bone.
In the majority of cases, pain is usually a consequence of overloading the gluteus medius and/or gluteus minimus muscles and/or compression of their tendons in certain postures. It can occasionally be accompanied by an inflamed bursa (a bursitis). Tendons can be overloaded either with a significant change in physical activity (type or volume) or most commonly with a loss of strength in these muscles.
How is GTPS managed?
Exercises that target the strengthening of these muscles, together with avoiding stretches and provocative postures (in standing, lying or sitting) that place the tendons under compression have proven effective in improving symptoms within 8 to 10 weeks.
Postural advice
Avoid any position that allows your affected leg to cross the centre-line of your body. For example, do not sit with crossed-legs or stand with crossed ankles. If you prefer to sleep on your side, place a pillow between your knees.
GTPS exercises
This guidance has been produced by the Dynamic Health physiotherapy service. It offers simple measures to help you manage your hip problem safely. Often the right advice and exercises are all you need to improve the problem.
This information has been made available to your GP, who may ask you to try the advice and exercises prior to consulting a physiotherapist.
If your hip pain started suddenly after a recent significant injury, for example, a slip, trip or fall, and you are unable to weight-bear, or if you have a hot, swollen hip with a high temperature and fever, please seek urgent medical advice from A&E, minor injuries or NHS 111.
How much exercise should I do?
Exercise every other day
Allowing enough rest is important to let soft tissues recover and develop.
Choose 3 or 4 exercises
Choose exercises that are challenging but manageable.
Repeat the exercise
Perform 3 to 5 repetitions of each exercise.
Rest
Rest for up to 1 to 2 minutes between each set.
Once an exercise is easy, progress it
Increase the number of repetitions (you could aim to increase it by 2 to 5 repetitions every 2 weeks). Or hold the positions for longer or move to a more challenging exercise.
How much pain is too much pain?
Before exercising
Before exercising, rate your pain at the moment on a scale of 0 to 10, where 0 is no pain and 10 is the worst pain you can imagine.
A maximum pain level
A maximum pain level of 4/10 whilst exercising is fine as long as it eases within 45 minutes of the session and does not interfere with sleep or activities the next day.
If your pain increases
If your pain increases beyond this, simplify the exercise by reducing the range of movement or number of repetitions, or try an easier exercise.
Exercises that target the strengthening of these muscles, together with avoiding stretches and provocative postures (in standing, lying or sitting) that place the tendons under compression have proven effective in improving symptoms within 8 to 10 weeks.
Need more help?
Consider self referring using the link below:
If you have a new injury or problem, please look at the self help information in our advice pages. We will often complete the same exercises and share information in clinic appointments.
If you still need some more help you can self refer into our service. Please note that the NHS is currently experiencing longer than normal waits, for more information visit our waiting times page.
