Greater trochanteric pain syndrome (GTPS) is a common cause of hip pain. It can often be treated conservatively but sometimes requires medical intervention or even surgery.

Greater trochanteric pain syndrome (GTPS) is most common in people ages 40 to 60 who were assigned female at birth. It affects as many as 1.8 per 1,000 adults per year.

The main cause of GTPS was originally thought to be trochanteric bursitis — inflammation of a fluid-filled sac on the outer part of your hip called the greater trochanteric bursa. But imaging studies now suggest that GTPS pain comes mostly from injury to the tendons that connect your gluteus medius and gluteus minimus muscles to the top of your femur.

Read on to learn more about how GTPS is treated, including home remedies, medications, and medical options.

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Greater trochanteric pain syndrome. Illustration by Wenzdai Figueroa.

Conservative treatment is effective in more than 90% of GTPS cases. Several home remedies and exercises may help speed up recovery.

Home remedies

You may be able to manage your symptoms at home by:

  • applying ice to the injured area for 10 to 15 minutes at a time to reduce inflammation
  • applying heat for 15 to 20 minutes at a time to reduce stiffness
  • taking over-the-counter pain medications, such as ibuprofen, to relieve pain
  • exercising the muscles around your outer hip to strengthen them
  • stretching your IT band to relieve tightness
  • reducing your current training volume if you’re active (runners may benefit from reducing weekly mileage)
  • losing weight to reduce stress on your muscles and skeleton if you have a high body weight and your doctor recommends this

Exercises

Exercise plays an important role in rehabilitation. A physical therapist can help you build a custom workout plan to strengthen weak areas and stretch tight muscles.

Experts often recommend:

  • quadriceps strengthening
  • IT band stretching with a foam roller
  • stretching and strengthening of the hip abductors, the muscles on the outer part of your hips

A 2018 study found that a physical therapy-led education and exercise plan had a 78.6% success rate in treating gluteal tendon pain after 1 year. For comparison, the success rate was 51.9% in people who received no specific treatment.

Strengthening the muscles around the hip through “eccentric exercise” is considered superior to general exercise. Eccentric exercise involves resisting your body weight or an external weight against gravity, such as during the downward portion of a squat.

Here are a few exercise ideas to help strengthen your hips:

Learn more about exercises to strengthen your hip muscles.

Doctors often recommend a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs) to help manage symptoms.

Benefits

NSAIDs such as ibuprofen or naproxen may help reduce pain and inflammation.

Side effects and risks

NSAID side effects can include headaches, gastrointestinal problems, and dizziness. Side effects become more common if you:

  • take high doses
  • are older or not in generally good health
  • take NSAIDs for long periods

NSAIDs may not be appropriate for some people, such as those who are taking blood thinners or are at risk of gastrointestinal bleeding.

If your condition does not respond to conservative treatments, your doctor may recommend:

Benefits

Corticosteroid injections may help reduce inflammation within the bursa, but there’s mixed evidence of their effectiveness.

In a 2018 review, researchers found evidence that shockwave therapy, exercise, and corticosteroids could help manage GTPS but that the effects of corticosteroid injections were short-lived.

They found good evidence to support the use of platelet-rich plasma injections for minor to moderate tendon injuries.

Side effects and risks

Corticosteroid injections are considered safe but have some possible complications, including:

  • pain
  • bleeding
  • infection
  • allergic reactions
  • injury to nearby structures

Shockwave therapy is considered safe but can cause:

  • mild bruising
  • swelling
  • tingling or numbness
  • pain

Side effects of platelet-rich plasma therapy can include:

  • bleeding
  • nerve or other tissue damage
  • infection

Typically, doctors will consider surgery only if you’ve had pain for 6 to 12 months and it has not improved with conservative treatment.

Doctors may consider many types of surgery, depending on the underlying cause of your pain. Surgery may involve:

  • removing your inflamed bursa
  • repairing damaged tendons
  • releasing tension in your IT band

Benefits

In a small 2019 case series, researchers found that endoscopic bursa removal and IT band release could be safe and effective when more conservative treatments have failed.

Studies have also found good results after tendon repair.

Side effects and risks

Not every person is a good candidate for surgery. If you have unmanaged diabetes or are not in generally good health, you may not be eligible.

Side effects of surgery can include:

  • loss of range of motion
  • tendon or other tissue injury
  • infection
  • scarring

Here are some frequent questions people have about treating GTPS and trochanteric bursitis.

What aggravates trochanteric bursitis?

Repetitive friction between a part of your femur called your greater trochanter and your IT band can irritate your trochanteric bursa. Repetitive movements of your upper leg or sudden impacts, such as falling on your hip, can also irritate your bursa.

Additionally, some people develop trochanteric bursitis after a total hip replacement. This can happen if a surgeon increases the tension of the muscles too much and causes the trochanter — a bony growth that attaches muscles to the upper part of the thigh bone — to impinge on the IT band.

What is the best treatment for greater trochanteric pain syndrome?

GTPS is almost always treated nonsurgically with some combination of physical therapy, NSAIDs, and injections. Surgery may be an option if these treatments fail.

How long does it take to heal greater trochanteric pain syndrome?

GTPS can take 2 to 3 months or longer to resolve completely with conservative treatment. If you don’t see improvement in that time frame, your doctor may recommend other treatments.

GTPS is a group of conditions that cause pain around your outer hip. It can usually be treated conservatively with home remedies, injections, or other nonsurgical treatments.

Surgery is usually a last resort for treating GTPS. It may be effective when all other treatments fail.