Greater Trochanteric Pain Syndrome

Fact Sheet & Advice for GPs and referrers to use with patients (Download pdf)

–usually no requirement for Orthopaedic referral

GTPS/lateral hip pain is a common presentation – most patients do not need an Orthopaedic consultation/intervention to treat the problem.

The most common CAUSE of lateral hip pain is tendinopathy of the abductor muscles (specifically gluteus medius and gluteus minimus)
The most common AGE GROUP is post -menopausal females but can occur in males, younger post-partum females, especially runners, those with hip dysplasia (a pelvic A-P XR is useful) and following hip replacement

DIAGNOSIS can be confidently made with:
- Pain on palpation of the greater trochanter
- Plus: Pain on resisted abduction
- Plus: Pain on 30 sec single leg stance

PATHOLOGY is commonly seen in asymptomatic individuals and MRI findings are a poor predictor of symptoms, and as such are not helpful in general.

Early treatment with exercise and education is indicated to prevent chronicity – referral to physiotherapy is indicated.
Weightbearing exercises are recommended. (The clam exercise may be provocative due to friction and compression forces across the greater trochanter)
Stretching of the ITB is NOT likely to help and more likely to provoke pain due to compression forces.
Exercise and education provide superior short & long term relief than corticosteroid injections. Injections should be avoided as first line intervention, and only used to facilitate rehabilitation exercises.

Image Courtesy – NHS Lothian Medical Photography Services

Over 90% of people recover with non-operative treatments
Surgery is rarely, if ever needed even in the presence of significant full thickness tears.