Greater Trochanteric Pain Syndrome/Hip Bursitis

Greater Trochanteric Pain Syndrome (GTPS) is associated with pain on the outside of the hip at its most bony prominence. It includes trochanteric bursitis as well as gluteal tendinopathy and a diagnostic process should be used as treatment will be slightly different for each. It is also important to rule out the lumbar spine and hip osteoarthritis.

Lateral hip pain is typically worse with prolonged sitting, stairs, walking, aggressive physical activity, lying directly on that side or stretching the hip across the body and up to the chest. If pain is due to bursitis, an injection may be beneficial but if it is due to gluteal tendinopathy, progressive load will be required

In the acute phase, the goal is to decrease pain with rest, ice, NSAIDs, soft tissue mobilization and pain-free gentle stretching. Education on positions for sitting/sleeping is helpful: do not sleep on involved side; if sleeping on opposite side, place pillow between knees; do not sit cross-legged; do not sit with knees above the hips in low chairs. PT should also address other impairments including core stability/strength, general LE strength and flexibility deficits and especially hip joint mobility as arthritic-type changes or capsular mobility deficits are also commonly present. It is important to understand that tendinopathy does take time to improve and ups and downs throughout the rehab process are common, though with the right treatment, they have a good prognosis to improve.