Overview
Greater Trochanteric Pain Syndrome (GTPS) is an umbrella term encompassing trochanteric
bursitis, gluteal tendinopathy (gluteus medius and minimus), and iliotibial band
syndrome at the hip. It is extremely common — affecting 1.8 per 1,000 adults — with a
3:1 female-to-male predominance. The condition causes lateral hip pain that radiates
into the outer thigh, is exacerbated by side-lying, and significantly impairs walking
tolerance and quality of life.
Symptoms & Causes
Common Symptoms
- Pain over the outer hip / lateral thigh
- Tenderness to palpation directly over the greater trochanter
- Pain when lying on the affected side — disrupts sleep
- Pain climbing stairs or rising from a low chair
- Pain with prolonged walking or running
- Positive Trendelenburg sign — gluteal weakness
- Lateral hip snapping or clicking (coxa saltans externa)
Common Causes
- Gluteal tendinopathy — repetitive compressive load on tendons
- Obesity and altered biomechanics due to weight
- Leg length discrepancy
- Contralateral hip or knee pathology altering gait
- Lumbar spine pathology causing referred lateral hip pain
- Post-hip replacement anatomy changes
- High-impact activities in women — running with wide Q-angle
Conservative & First-Line Treatment
- Load management — activity modification, avoiding hip adduction postures
- Physiotherapy — gluteal tendon loading programme, hip abductor strengthening
- Avoidance of compressive postures (crossing legs, sleeping on affected side)
- Shockwave therapy (ESWT) for tendinopathy
- NSAIDs for acute flares
How Vedant Pain Management Clinic Can Help
Our interventional pain specialists offer the following evidence-based procedures, all
performed with real-time ultrasound guidance for precision and safety:
- Ultrasound-guided trochanteric bursa injection (corticosteroid + LA) — precise
delivery into the correct bursal space
- Ultrasound-guided PRP injection into gluteal tendon insertion for tendinopathy
- Hip Cooled Radiofrequency Ablation of sensory nerve branches for chronic refractory
GTPS
- Diagnostic musculoskeletal ultrasound to differentiate bursal from tendinopathic vs
combined pathology
- Referred pain from lumbar facet joints excluded with clinical assessment and if
needed, medial branch blocks
Newer Diagnostic Concepts & Advances
The paradigm shift from 'trochanteric bursitis' to 'Greater Trochanteric Pain Syndrome'
reflects that the gluteal tendons themselves are often the primary pathology, not the
bursa. Gluteus medius and minimus tendinopathy — visualised on ultrasound as anechoic
clefts, tendon thickening, or partial tears — requires a tendon loading rehabilitation
programme rather than repeated steroid injections.
