Greater Trochanteric Pain Syndrome leaflet

Greater Trochanteric Pain Syndrome (GTPS) This leaflet provides information, answers and self-help strategies regarding GTPS.

INFORMATION What is GTPS? Greater trochanteric pain syndrome (GTPS), also known as lateral hip pain or trochanteric bursitis, is a common condition where you can experience pain and tenderness on the outside of the hip and buttock region.

Sometimes it may travel down as far as the outside of the knee. GTPS is more common in people over 40 years old, and affects more women than men. It can affect both hips and can be associated with low back pain.

What causes GTPS? There are many factors that can contribute to GTPS: Inflammation of one of the bursae (a fluid filled sac that provides cushioning) Reduced strength and flexibility of the muscles around the hip Inactive lifestyle, causing weakness in the buttock muscles Being overweight Prolonged or excessive pressure to your hip area (for example, crossing legs when sitting, or lying on affected side for long periods) An injury such as a fall on to the side of your hip area.

Repetitive movements involving your hip area, such as excessive running or walking.

Signs and symptoms Pain in your outer hip and possibly thigh area. This may feel like an aching or burning pain.

The pain may be more intense when you are lying on your side, especially at night.

It may become worse with exercise and you may find you walk with a limp.

GTPS is diagnosed in clinic through taking a history and doing specific tests of the hip. Usually, scans are not required to diagnose this problem.

MANAGEMENT Helpful Tips Avoid sitting with your legs crossed as this will reduce the pressure on the painful area.

When standing, try not to push one hip out to the side or stand on one leg.

Try to avoid very low chairs.

Keep active but avoid overdoing it.

Avoid Stretching, massaging or foam-rolling the gluteal muscles.

This can irritate the tendon and make it more sensitive.

Avoid lying on the painful side or with the painful leg crossed over the other side.

Try lying on your back with a pillow under your knees, or lie on your good side with pillows between your legs to keep them parallel.

What can I do to help?

Exercises (see the back page for more information) Exercise has been shown to be very effective for GTPS. Keeping up with a gentle and graded exercise programme will help build increase tolerance to load, it can take up to 18 months to fully recover.

It is important to be persistent with your rehab and make relative modification to your daily routine. Your physiotherapist or healthcare practitioner can provide you with further guidance.

Pain Relief Simple painkillers or anti-inflammatory medication can help reduce pain in the early stages. (Always check with your GP or pharmacist before taking any new medication). You may find it useful following exercise to use some ice to help with the pain. Only apply for a maximum of 15 minutes if needed.

EXERCISES TO HELP YOUR PROBLEM Side lying hip abduction Lie on your good side, painful leg on top. Lift the painful leg a couple of centimetres off the other leg and hold this position for 20-30 seconds. Repeat three times.

Standing hip abduction Stand on your painful leg away from the wall, but keep your unaffected leg in contact with the wall for balance. If you can hold this for 20-30s without any worsening pain, gently push your unaffected foot into the wall to make this harder. Hold this position for 20-30 seconds, and repeat 3 times.

Glute Bridge ie on your back with your knees bent and feet flat on L the bed or floor. Squeeze your buttock muscles together then lift your hips up. Hold for five seconds before slowly lowering back down. Repeat 8-12 times

You may experience some discomfort doing these exercises which is normal and does not mean you are doing any harm. Your pain should be no more than a 4/10 when exercising if 0 is no pain. Ensure your pain is not worse the following day as there can sometimes be a delayed response. As a guide, start with 2-3 sets of 10 repetitions of each exercise and work through the stages as you progress.

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