Understanding Greater Trochanteric Pain Syndrome: Causes, Symptoms, and Treatment Options
Many patients are told they have hip bursitis when they develop pain along the outside of the hip.
While bursitis can certainly occur, modern research has shown that many cases of persistent outer hip pain involve more than just inflammation of a bursa.
Today, physicians often use the term Greater Trochanteric Pain Syndrome (GTPS) to describe a group of conditions that can cause pain on the outside of the hip.
GTPS is one of the most common causes of lateral hip pain and frequently affects:
- Active adults
- Runners
- Walkers
- Pickleball players
- Tennis players
- Golfers
- Individuals who spend significant time on their feet
Understanding the diagnosis is often the first step toward identifying the most appropriate treatment options.
What Is Greater Trochanteric Pain Syndrome?
Greater Trochanteric Pain Syndrome refers to pain arising from structures located around the outer portion of the hip.
The greater trochanter is a bony prominence on the side of the femur where several important tendons attach.
Multiple structures in this region may contribute to symptoms, including:
- Tendons
- Bursa
- Muscles
- Soft tissues surrounding the hip
Because several structures may be involved simultaneously, the term GTPS is often more accurate than simply saying "hip bursitis."
What Causes GTPS?
Several factors may contribute to Greater Trochanteric Pain Syndrome, including:
Repetitive Stress
Repeated loading of the hip during activity.
Sports Participation
Running, pickleball, tennis, golf, and other activities may place stress on the outer hip.
Tendon Disorders
Changes involving tendons that attach near the greater trochanter.
Biomechanical Factors
Movement patterns and muscle imbalances may increase stress on the region.
Prolonged Standing Or Walking
Some individuals notice symptoms related to occupational or recreational activities.
Often, multiple factors contribute simultaneously.
Common Symptoms Of GTPS
Patients may experience:
- Pain on the outside of the hip
- Tenderness over the outer hip
- Pain while walking
- Pain during exercise
- Pain climbing stairs
- Pain lying on the affected side
- Stiffness
- Activity limitations
Symptoms may gradually worsen over time if the underlying issue is not addressed.
Why Does My Hip Hurt When I Lie On My Side?
One of the classic symptoms of GTPS is:
"I can't sleep on that side anymore."
Pressure placed directly over the affected structures may aggravate symptoms and make side sleeping uncomfortable.
This is one of the most common complaints reported by patients with lateral hip pain.
Is GTPS The Same As Hip Bursitis?
Not exactly.
Hip Bursitis
Refers specifically to irritation involving a bursa.
Greater Trochanteric Pain Syndrome
Refers to a broader category of conditions involving the outer hip.
Many patients diagnosed with "hip bursitis" actually have a combination of tendon-related and soft tissue conditions that fall under the GTPS umbrella.
GTPS vs Hip Arthritis
Patients often confuse these conditions because both may cause hip pain.
However:
Hip Arthritis
Typically causes pain within the hip joint and is often felt in the groin.
GTPS
Typically causes pain along the outside of the hip.
Although symptoms can overlap, these conditions involve different structures and often require different treatment considerations.
Who Is Most Likely To Develop GTPS?
GTPS commonly affects:
- Active adults
- Walkers
- Runners
- Pickleball players
- Tennis players
- Golfers
- Individuals who spend prolonged periods standing
Women are also commonly affected.
However, the condition can occur in individuals of all ages and activity levels.
How Is GTPS Diagnosed?
A comprehensive evaluation typically includes:
- Medical history
- Physical examination
- Functional assessment
- Movement analysis
- Review of symptoms
Diagnostic studies may include:
- X-rays
- MRI
- Ultrasound
- Additional imaging when appropriate
The goal is to identify which structures are contributing to symptoms.
Treatment Considerations
Treatment recommendations depend on:
- Symptom severity
- Functional limitations
- Activity goals
- Imaging findings
- Overall hip health
Potential treatment discussions may include:
- Physical therapy
- Strengthening programs
- Activity modifications
- Exercise progression strategies
- Interventional procedures
- Regenerative medicine discussions
- Surgical consultation when appropriate
The best treatment strategy is individualized.
Can You Continue Exercising?
Many patients remain active while managing GTPS.
The appropriate approach depends on:
- Symptom severity
- Activity type
- Functional limitations
- Individual goals
The objective is often to help patients remain active while addressing the factors contributing to symptoms.
When Should You Seek Evaluation?
You may benefit from evaluation if:
- Outer hip pain persists.
- Sleeping on your side becomes difficult.
- Walking aggravates symptoms.
- Exercise participation is limited.
- Stairs become painful.
- Previous treatment has not provided sufficient improvement.
Understanding the source of symptoms is often the first step toward improvement.
The Dr. Peaches Perspective
Dr. Peaches believes that patients deserve more than a generic diagnosis.
Not all outer hip pain is simply "bursitis."
The goal is to identify the structures involved, understand how symptoms affect daily life, and develop a treatment strategy tailored to the individual.
Whether the goal is returning to pickleball, golf, running, hiking, travel, or simply sleeping comfortably, treatment should be centered around helping patients maintain the activities they enjoy.
The mission remains:
Help people stay in the game.
Frequently Asked Questions
What is Greater Trochanteric Pain Syndrome?
GTPS is a common cause of pain on the outside of the hip involving structures around the greater trochanter.
Is GTPS the same as hip bursitis?
Not exactly.
Hip bursitis is one possible component of GTPS, but GTPS often involves additional structures as well.
Why does my hip hurt when I sleep on my side?
Pressure placed over the affected structures may aggravate symptoms and make side sleeping uncomfortable.
Can GTPS affect athletes?
Yes.
GTPS commonly affects runners, golfers, tennis players, pickleball players, and other active individuals.
Can I continue exercising?
Many patients remain active, although recommendations should be individualized.
Should I bring prior imaging to my consultation?
Yes.
Imaging studies and treatment records provide valuable information during the evaluation process.
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Request a Consultation
If outer hip pain is limiting your ability to walk, sleep, exercise, compete, or enjoy daily activities, an expert evaluation may help identify the source of your symptoms and determine which treatment pathways may be appropriate for your individual situation.
When available, prior imaging studies and treatment records can provide valuable information during the evaluation process.