Greater Trochanter Pain Syndrome (GTPS)

The greater trochanter is a bony prominence of the upper thigh bone which can be felt on the lateral aspect of the hip. It is the attachment site for a number of muscles that originate from the pelvis, namely the gluteal muscles. It is thought to affect 1.8 per 1000 patients annually.

GTPS is the development of pain on the outer part of the thigh around this bony prominence, which can either occur on one or both sides. Typically these symptoms can develop as a result of direct trauma onto the area, however more commonly is associate with a sudden increase in activity (and therefore can be common in runners). 

Those who are experiencing GTPS usually report a combination of the following symptoms:

• Pain when touching the outer part of the hip

• Pain when laying on the affected side (but when symptoms are severe people can experience symptoms laying on the unaffected side))

• Pain with weight bearing activities such as walking, climbing stairs.

• Pain when sitting crossed legged.

• Pain with prolonged positions

• Pain which is episodic in nature but will become more persistent if symptoms continue to be aggravated.

After listening to the history and nature of your symptoms a more detailed physical examination will take place. This includes excluding pain that is being referred from the hip joint, small joints from the lower back or meralgia paraesthesica. As well as assessing your aggravating activities, provocation following a combination of tests such as a single leg stance, de-rotation test and jump sign will allow further suspicion of GTPS

Following a positive diagnosis of GTPS, there is good evidence that supports the use of physiotherapy to help settle symptoms and increase tissue tolerance. Since interventions may include:

• Advice and education around pacing, pain relief etc

• Advice to avoid certain positions such as sitting cross legged, hinging on one hip and laying on the symptomatic side to allow things to settle

• Home exercise programme

• Electrotherapy

• Shockwave Therapy

• Acupuncture