Greater Trochanteric Pain Syndrome
What is Greater Trochanteric Pain Syndrome?
Greater trochanteric pain syndrome (GTPS) is a common cause of pain over the outer aspect of the hip. It was traditionally called “trochanteric bursitis”, but we now understand that the underlying problem in most patients is tendinopathy or tearing of the gluteus medius and gluteus minimus tendons as they insert into the greater trochanter, with secondary inflammation of the adjacent bursae.
GTPS is most common in women between 40 and 60 years of age, patients with low back pain, patients with knee or hip arthritis, runners and patients with leg length discrepancy.
Symptoms of Greater Trochanteric Pain Syndrome
Typical symptoms include:
Treatment options
Treatment might include nonsurgical and surgical treatments:
Non-surgical treatment: is successful in the majority of patients and includes activity modification, weight loss, a structured physiotherapy program focused on gluteal tendon loading and hip stability, anti-inflammatory medications, shockwave therapy and image-guided injections (corticosteroid or platelet-rich plasma).
Surgery: is reserved for patients who fail a prolonged course of non-operative treatment and have confirmed gluteal tendon tears on imaging. Surgical options include open or endoscopic repair of the torn gluteal tendons. In cases of chronic, massive, irreparable tears, tendon transfer procedures may be considered.
Frequently Asked Questions (FAQ)
Hip arthritis usually develops over time rather than from a single cause. The most common reason is gradual wear of the joint cartilage with age. However, many people develop it earlier due to subtle issues with the shape of the hip, when the ball and socket don’t fit perfectly, it creates uneven pressure that slowly damages the joint. Previous injuries, such as fractures or dislocations, can also speed up this process. In some cases, genetics, inflammation, or increased load on the joint (including higher body weight or repetitive stress) contribute.
