Focused shockwave therapy for Greater trochanteric pain.
Greater trochanteric pain syndrome is a common cause of pain around the outside of the hip. Here is what to look out for, how it is diagnosed, and the treatment options available — including focused shockwave therapy.
What is greater trochanteric pain?
Greater trochanteric pain syndrome (GTPS) is a common condition that causes pain around the outside of the hip. It most commonly involves the gluteal tendons that attach around the greater trochanter, although other tissues in the area can also contribute to symptoms.
GTPS is sometimes referred to as trochanteric bursitis, although the condition is not necessarily caused by inflammation of the bursa.
Symptoms
Common symptoms of greater trochanteric pain syndrome include:
- Pain on the outside of the hip or upper thigh
- Tenderness when pressing over the side of the hip
- Pain when lying on the affected side
- Pain when walking, running or climbing stairs
- Discomfort when standing on one leg
- Pain when getting up from a chair or getting in and out of a car
- Stiffness or aching around the hip
- Pain that may become worse after prolonged activity
Symptoms can vary between individuals and may affect one or both hips.
Causes
Greater trochanteric pain syndrome is often associated with increased or repeated loading of the tissues around the outside of the hip.
Factors that may contribute include:
- A sudden increase in walking, running or other physical activity
- Repetitive activities that place load through the hip
- Reduced strength of the hip and gluteal muscles
- Changes in training volume or intensity
- Returning to exercise too quickly after a period of reduced activity
- Prolonged standing or walking
- Activities or positions that repeatedly compress the tissues around the outside of the hip
- Previous hip or lower-limb problems
GTPS does not necessarily result from a single injury. It can develop gradually as the tissues become less tolerant of repeated loading.
Diagnosis
Greater trochanteric pain syndrome is usually diagnosed through a clinical assessment.
During a consultation, your clinician will discuss your symptoms, activity levels and medical history before assessing your hip and lower limb.
They may assess:
- The location and nature of your pain
- Tenderness around the greater trochanter
- Hip movement and flexibility
- Hip and gluteal muscle strength
- Your walking and movement patterns
- Your ability to perform activities such as standing on one leg or climbing stairs
- How your symptoms respond to different types of loading
Imaging is not always necessary. However, an ultrasound, X-ray or other form of imaging may sometimes be recommended if the diagnosis is unclear or another condition needs to be ruled out.
If you're experiencing persistent pain on the outside of your hip, you can arrange a consultation with our Advanced Clinical Pharmacist to discuss your symptoms and have the affected area assessed.
Your Advanced Clinical Pharmacist can help identify the likely cause of your symptoms and discuss appropriate treatment options with you.
Treatment
Treatment for greater trochanteric pain syndrome depends on your symptoms, how long you have experienced them and the demands you place on your hip.
Treatment may include:
- Activity modification: temporarily reducing or adapting activities that aggravate your symptoms
- Strengthening exercises: progressive strengthening of the hip and gluteal muscles can help improve the capacity of the affected tissues
- Rehabilitation: a structured programme can help you gradually return to your normal activities
- Physiotherapy: an individualised rehabilitation programme can help manage symptoms and improve hip function
- Movement modification: adapting certain activities or positions may help reduce irritation and excessive compression around the hip
- Pain relief: appropriate pain-relieving medication may help with symptoms; speak to a pharmacist or healthcare professional if you're unsure what is suitable for you
- Focused Shockwave Therapy: may be considered for some people with persistent symptoms as part of a broader treatment plan
Focused Shockwave Therapy uses targeted acoustic waves to deliver treatment to the affected area. It may be considered for people with persistent greater trochanteric pain, depending on their individual assessment and treatment needs.
Prevention
While greater trochanteric pain syndrome cannot always be prevented, you can reduce your risk by managing how quickly you increase the load placed on your hip.
Helpful measures include:
- Increase walking, running and sporting activity gradually
- Avoid sudden increases in training volume or intensity
- Strengthen your hip and gluteal muscles regularly
- Allow adequate recovery between demanding activities
- Build up gradually when returning to exercise after a break or injury
- Pay attention to persistent pain rather than repeatedly training through it
- Avoid prolonged positions that consistently aggravate your symptoms
- Maintain appropriate hip and lower-limb strength and mobility
If you have persistent, severe or worsening hip pain, seek assessment from a qualified healthcare professional.
Book your shockwave assessment.
Start with a £55 initial specialist assessment, or book treatment directly if you already have a confirmed diagnosis.
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