Greater Trochanteric Pain Syndrome
Greater trochanteric pain syndrome (GTPS) is a common cause of outer hip pain, most often related to irritation or tendinopathy of the gluteal tendons where they attach near the bony point of the hip (the greater trochanter). It's frequently worse lying on the affected side at night and with walking. A medical evaluation confirms the diagnosis and rules out other sources of hip pain.
Common Symptoms
- Aching or sharp pain over the outside point of the hip
- Pain that's worse lying on the affected side, especially at night
- Pain with walking, climbing stairs, or standing from a seated position
- Pain that may radiate down the outside of the thigh
- Tenderness when pressing directly on the outer hip bone
Why It Happens
GTPS was once attributed mainly to bursitis (inflammation of the fluid-filled sac over the hip), but current understanding is that gluteal tendinopathy — irritation and disorganized tissue changes in the gluteus medius/minimus tendons — is the primary driver in most cases, sometimes with bursitis as a secondary feature.
Why It Can Become Persistent
The gluteal tendons are compressed against the greater trochanter with common daily positions — including standing with hip "hitched" to one side, crossing the legs, and side-lying — so ordinary daily habits can keep reirritating the area without a person realizing it.
Who Commonly Gets It
GTPS is substantially more common in women, particularly in midlife and beyond, and is also seen in runners and other athletes. It's one of the most common causes of hip pain evaluated in primary care and sports medicine settings.
How It Is Usually Diagnosed
Diagnosis is typically clinical: tenderness directly over the greater trochanter, pain with specific resisted hip movements, and a pain pattern consistent with GTPS rather than a joint-related (arthritis) or lower-back-related source. Ultrasound or MRI can confirm gluteal tendinopathy or bursitis when needed.
Traditional Treatment Options
- Activity and position modification: Avoiding prolonged compression of the tendons (side-lying on the affected hip, standing "hip-hitched") is a key first step.
- Physical therapy: Targeted hip and gluteal strengthening, often including isometric-to-progressive loading similar to other tendinopathies.
- NSAIDs: Sometimes used short-term for symptom control.
- Corticosteroid injection: Can offer short-term relief for some patients, particularly when bursitis is a significant component.
Why Someone Might Start Looking for Another Option
GTPS can be surprisingly stubborn — many patients try rest, NSAIDs, and even an injection and still have lingering outer hip pain, especially at night. This is a common point where patients start researching other non-invasive options.
Where Shockwave Therapy May Fit
Shockwave therapy has a growing body of randomized trial evidence specifically for greater trochanteric pain syndrome, generally showing short- to medium-term pain improvement, with some studies directly comparing it to corticosteroid injection and exercise therapy.
How Shockwave Treatment Works for This Area
Acoustic pressure waves are directed at the tender area over the outer hip/greater trochanter. See What Research Says below for the specific trial evidence in GTPS and its limitations.
What the Treatment Feels Like
Most patients describe a firm tapping or pressure sensation over the outer hip, with some tenderness directly over the sore spot. Sessions are brief and most patients resume normal activity the same day per your provider's guidance.
What Happens During Your First Visit
Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.
New Patient Offer
New Patient Exam + First Treatment — $99
First treatment provided when clinically appropriate following your examination.
Who May Not Be Appropriate
- Hip joint (osteoarthritis) or lower-back-related pain masquerading as GTPS, which needs its own evaluation and treatment approach
- Active infection, open wounds, or certain bone conditions at the treatment site
- Certain circulatory, neurological, or bleeding-related conditions, per your provider's screening
This list is not exhaustive. Your provider will screen for contraindications during your evaluation.
Frequently Asked Questions
They're related but not identical. "Bursitis" was long used as a catch-all term for outer hip pain, but current evidence points to gluteal tendinopathy as the primary driver in most cases, with the bursa sometimes also involved. GTPS is now the preferred umbrella term.
A 2024 systematic review with meta-analysis of randomized trials found that shockwave therapy produced significantly lower pain scores than comparison treatments at 2 to 4 months for GTPS, though the review authors cautioned about risk of bias in some included trials. A clinical evaluation determines whether it's appropriate for your case.
What Research Says
Selected sources relevant to hip pain (gtps). See the full Research Center for our complete source registry and methodology.
JBJS Reviews · 2024 · Rhim, Shin, Beling, et al.
Three weekly sessions of shockwave therapy produced significantly lower pain scores than comparison treatments at 2 to 4 months in greater trochanteric pain syndrome, with focused shockwave outperforming radial shockwave in the pooled analysis.
Limitations: The review authors cautioned that results should be interpreted carefully because of high risk of bias in several included trials and meaningful heterogeneity across study protocols; functional gains at 6 months, while present, did not consistently reach a clinically meaningful threshold.
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First treatment provided when clinically appropriate following your examination.
