Hip

Greater Trochanteric Pain Syndrome

Greater trochanteric pain syndrome (GTPS) — the modern clinical term for what was historically called "trochanteric bursitis" — is one of the most common causes of lateral hip pain, affecting an estimated 1.8 per 1,000 adults per year. The condition is frequently misunderstood: in many patients, what appears to be simple bursal inflammation is actually underlying gluteus medius or minimus tendon pathology. At Maryland Orthopedic Specialists, we use advanced imaging and a targeted treatment ladder to resolve lateral hip pain reliably — from physical therapy and injections to endoscopic surgery for cases that resist conservative care.

Ready to get started?

Schedule an appointment with a specialist experienced in treating greater trochanteric pain syndrome.

Schedule Now

or call (301) 515-0900

In-network with most major insurance plans. Same-day appointments available for acute injuries.

What is greater trochanteric pain syndrome?

Greater trochanteric pain syndrome causes pain and tenderness over the bony bump on the outer hip, usually from irritation of the nearby gluteal tendons and bursa. It often worsens with walking, climbing stairs, or lying on the affected side, and is frequently mistaken for hip arthritis.

The greater trochanter is the bony prominence you can feel on the outer side of your hip. Several structures converge here:

The trochanteric bursa — fluid-filled sacs that reduce friction
The iliotibial (IT) band — a thick fascial band running from the iliac crest to the knee, which passes over the greater trochanter
The gluteus medius and minimus tendons — the hip abductor tendons that insert directly onto the trochanteric footprint

Mechanism: The IT band runs across the greater trochanter during hip flexion and extension. When the hip abductors are weak or biomechanics are altered, the IT band creates repetitive compressive and shear forces on the underlying bursa and tendon insertions, generating pain. This compression mechanism distinguishes GTPS from simple "bursitis" driven by direct trauma.

Who is affected: GTPS affects women more than men (4:1 ratio), most commonly in the 40–60-year age group. Risk factors include low back pain, knee OA, obesity, limb length discrepancy, and a wide female pelvis (increased Q-angle).

Important overlap: Gluteus medius/minimus tendon tears — the "rotator cuff of the hip" — frequently co-exist with trochanteric bursitis and must be assessed separately, as tendon tears require a different treatment approach.

Treatment options

Non-Operative Treatments

Physical therapy is the most durable long-term treatment for GTPS and is recommended as the primary initial intervention. An effective program includes: Hip abductor strengthening: Isometric side-lying abduction, clamshells, resistance band work — progressively loaded to restore abductor function and reduce IT band compression IT band stretching: Gentle lateral hip stretches and foam rolling (cautious use — aggressive IT band rolling over the greater trochanter can irritate the bursa acutely) Lumbopelvic stabilization and gait retraining: Correcting Trendelenburg gait pattern reduces repetitive trochanteric loading Load management: Avoiding hip adduction postures (standing with one hip dropped, crossing legs, sleeping with knees together without a pillow) Corticosteroid injection: Ultrasound-guided injection into the trochanteric bursa provides rapid pain relief (typically 4–12 weeks). Most effective as a bridge to PT; repeated injections (>3) may weaken tendon tissue at the insertion. PRP for tendinopathy: When GTPS is driven primarily by gluteal tendinopathy rather than bursal inflammation alone, PRP injection at the tendon insertion offers a regenerative alternative to corticosteroid. Studies show longer-lasting symptomatic benefit compared to corticosteroid at 12-month follow-up. Shockwave therapy (ESWT): Extracorporeal shockwave therapy stimulates tendon healing through mechanical and biological pathways. Evidence supports its use in tendinopathy-predominant GTPS when PT has not provided adequate relief.

Surgical Procedure

Trochanteric Bursectomy

Arthroscopic removal of the inflamed greater trochanteric bursa in patients with refractory greater trochanteric pain syndrome, combined with evaluation and treatment of any underlying gluteal abductor tendon pathology.

Click for more Surgical Procedure

Gluteus Medius / Minimus Repair

Endoscopic repair of abductor tendon tears at their footprint on the greater trochanter — a frequently missed cause of lateral hip pain and weakness — using suture anchors to restore secure attachment.

Click for more

Frequently Asked Questions

Is stretching helpful or harmful for trochanteric bursitis?

Targeted hip abductor stretches are beneficial. However, aggressive IT band stretching in positions that adduct the hip (e.g., standing lateral lean) can increase compression over the trochanter acutely. Your physical therapist will guide you through the appropriate progression.

Why does it hurt more when I sleep on my side?

Direct compression of the greater trochanter against the mattress applies sustained pressure to the bursa and tendon insertions. Using a pillow between your knees maintains hip alignment and significantly reduces nocturnal pain.

How many cortisone shots can I have?

We generally recommend no more than 2–3 corticosteroid injections in the same region per year. Repeated injections beyond this threshold may weaken tendon tissue and accelerate tendinopathy progression.

Does GTPS come back after treatment?

Recurrence is common if the underlying biomechanical drivers (abductor weakness, gait pattern) are not corrected. Patients who complete and maintain their PT program have significantly lower recurrence rates.

What activities should I avoid when I have greater trochanteric pain syndrome, and for how long?

During the acute phase of greater trochanteric pain syndrome, you should avoid activities that compress or repeatedly load the tendons over the greater trochanter — including running, climbing stairs quickly, crossing your legs, and sitting in low chairs. Side-lying on the affected hip and hip adduction stretches (crossing the leg past the midline) are particularly aggravating and should be avoided. Most patients see significant improvement within three to six months with a load-management program, targeted physiotherapy, and activity modification. Your MOS care team will guide a gradual return to full activity once the tendon has settled and strength has been restored.

Meet the specialists

John J. Christoforetti, MD

Orthopedic Surgery · Sports Medicine · Hip Preservation Surgery

Meet Dr. Christoforetti →

Related conditions

Gluteus Medius / Minimus Tendon Tears Hip Osteoarthritis

Medically reviewed by John J. Christoforetti, MD, MD, FAAOS

Last reviewed May 1, 2026

References

Fearon AM, Cook JL, Scarvell JM, Neeman T, Cormick W, Smith PN. Greater trochanteric pain syndrome negatively affects work, physical activity and quality of life: a case control study. J Arthroplasty. 2014;29(2):383–386. https://doi.org/10.1016/j.arth.2012.10.016
Mellor R, Bennell K, Grimaldi A, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. 2018;361:k1662. https://doi.org/10.1136/bmj.k1662
Lustenberger DP, Ng VY, Best TM, Ellis TJ. Efficacy of treatment of trochanteric bursitis: a systematic review. Clin J Sport Med. 2011;21(5):447–453. https://doi.org/10.1097/JSM.0b013e318221299c
Fitzpatrick J, Bulsara MK, O'Donnell J, McCrory PR, Zheng MH. The effectiveness of platelet-rich plasma injections in gluteal tendinopathy: a randomized, double-blind controlled trial comparing a single platelet-rich plasma injection with a single corticosteroid injection. Am J Sports Med. 2018;46(4):933–939. https://doi.org/10.1177/0363546517745525
Baker CL Jr, Massie RV, Hurt WG, Savory CG. Arthroscopic bursectomy for recalcitrant trochanteric bursitis. Arthroscopy. 2007;23(8):827–832. https://doi.org/10.1016/j.arthro.2007.02.015