{"id":25884,"date":"2025-12-12T13:14:14","date_gmt":"2025-12-12T13:14:14","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=25884"},"modified":"2025-12-12T13:14:15","modified_gmt":"2025-12-12T13:14:15","slug":"greater-trochanteric-pain-syndrome","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/greater-trochanteric-pain-syndrome\/","title":{"rendered":"Greater Trochanteric Pain Syndrome"},"content":{"rendered":"\n<p><strong>Fact Sheet &amp; Advice for GPs and referrers to use with patients<\/strong> (<a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/GTPS-FACT-SHEET-for-Ref-help-1.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/GTPS-FACT-SHEET-for-Ref-help-1.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Download pdf<\/a>)<\/p>\n\n\n\n<p>&#8211;<em>usually no requirement for Orthopaedic referral<\/em><\/p>\n\n\n\n<p>GTPS\/lateral hip pain is a common presentation &#8211; most patients do not need an Orthopaedic consultation\/intervention to treat the problem.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The most common CAUSE of lateral hip pain is tendinopathy of the abductor muscles (specifically gluteus medius and gluteus minimus)<\/li>\n\n\n\n<li>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<br><br><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>DIAGNOSIS <\/strong>can be confidently made with:\n<ul class=\"wp-block-list\">\n<li>Pain on palpation of the greater trochanter<\/li>\n\n\n\n<li><strong>Plus<\/strong>: Pain on resisted abduction<\/li>\n\n\n\n<li><strong>Plus<\/strong>: Pain on 30 sec single leg stance<br><br><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>PATHOLOGY<\/strong> is commonly seen in asymptomatic individuals and MRI findings are a <em>poor<\/em> predictor of symptoms, and as such are <em>not<\/em> helpful in general.<br><br><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>EXERCISES\/TREATMENTS:<\/strong><\/li>\n<\/ul>\n\n\n\n<div class=\"wp-block-media-text has-media-on-the-right is-stacked-on-mobile\"><div class=\"wp-block-media-text__content\">\n<ul class=\"wp-block-list\">\n<li>Early treatment with <em>exercise<\/em> and <em>education<\/em> is indicated to prevent chronicity \u2013 referral to physiotherapy is indicated.<\/li>\n\n\n\n<li>Weightbearing exercises are recommended.&nbsp; (The clam exercise may be provocative due to friction and compression forces across the greater trochanter)<\/li>\n\n\n\n<li>Stretching of the ITB is NOT likely to help and more likely to provoke pain due to compression forces.<\/li>\n\n\n\n<li>Exercise and education provide superior short &amp; long term relief than corticosteroid injections.\u00a0 Injections should be avoided as first line intervention, and <em>only<\/em> used to facilitate rehabilitation exercises.<\/li>\n<\/ul>\n<\/div><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"325\" height=\"217\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/GTPS-Image.jpg\" alt=\"GTPS Image\" class=\"wp-image-25905 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/GTPS-Image.jpg 325w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/GTPS-Image-300x200.jpg 300w\" sizes=\"auto, (max-width: 325px) 100vw, 325px\" \/><\/figure><\/div>\n\n\n\n<p class=\"has-text-align-right\"><em><strong>Image Courtesy &#8211; NHS Lothian Medical Photography Services<\/strong><\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Over 90% of people recover with non-operative treatments<\/li>\n\n\n\n<li>Surgery is <em>rarely, if ever<\/em> needed <em>even<\/em> in the presence of significant full thickness tears.<br><br><\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>RECOMMENDATION FOR MANAGEMENT:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>Refer to Physiotherapy via SCI Gateway for gluteal muscle strengthening and management advice<\/strong>.<br><br><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n\n\n\n<p>Juliet Gold, Extended Scope Practitioner<\/p>\n\n\n\n<p>Iain Murray, Consultant Orthopaedic Surgeon, RIE <\/p>\n\n\n\n<p>Gavin MacPherson, Consultant Orthopaedic Surgeon, RIE<\/p>\n\n\n\n<p>December 2025<\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Fact Sheet &amp; Advice for GPs and referrers to use with patients (Download pdf) &ndash;usually no requirement for Orthopaedic referral GTPS\/lateral hip pain is a common presentation &ndash; most patients do not need an Orthopaedic consultation\/intervention to treat the problem. Image Courtesy &ndash; NHS Lothian Medical Photography Services Juliet Gold, Extended Scope Practitioner Iain Murray,<\/p>\n","protected":false},"author":7,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"class_list":["post-25884","page","type-page","status-publish","hentry"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"aparnaamanna","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/aparnaamanna\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"Fact Sheet &amp; Advice for GPs and referrers to use with patients (Download pdf) &ndash;usually no requirement for Orthopaedic referral GTPS\/lateral hip pain is a common presentation &ndash; most patients do not need an Orthopaedic consultation\/intervention to treat the problem. Image Courtesy &ndash; NHS Lothian Medical Photography Services Juliet Gold, Extended Scope Practitioner Iain Murray,","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25884","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=25884"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25884\/revisions"}],"predecessor-version":[{"id":25907,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/25884\/revisions\/25907"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=25884"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=25884"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}