Greater Trochanteric Bursitis (GTB)
Greater trochanteric bursitis, most commonly known as GTB and also now known as greater trochanteric pain syndrome (GTPS), is one of the most common causes of pain over the outside of the hip that I see. The bursa and the soft tissues that sit over the bony point of the hip become irritated and painful. It can disturb your sleep and limit your walking, but it usually settles with the right load management, sensible advice and a progressive strengthening programme.
What greater trochanteric bursitis typically feels like
Pain over the outer hip, thigh or buttock.
Worse when lying on the affected side, so night pain is common.
Pain with activity: climbing stairs, standing, walking.
Tenderness to touch over the greater trochanter.
Pain standing on the affected leg, or sitting with legs crossed.
Pain that travels below the knee, or comes with numbness, tingling or weakness, makes me think about the lower back and nerves as well.
What greater trochanteric bursitis (gtb) is
Greater trochanteric bursitis, also known as lateral hip pain or greater trochanteric pain syndrome (GTPS), is a common and painful condition affecting the outer side of the hip and thigh. It happens when the tissues lying over the outside of the hip bone, the greater trochanter, become irritated. The soft tissues attaching there include the bursa and the tendons, and when they are overloaded they become the primary source of pain. It is more common in women and in people aged between 40 and 60, but it can affect any age.
Symptoms to look out for
Pain in the hip, thigh or buttock area.
Worse pain when lying on your side, or with direct pressure over the outer hip.
Pain increasing with exercise, such as periods of walking, standing or running.
Tenderness to touch over the bony point on the outside of the hip.
Pain sitting with your legs crossed.
Pain when standing on the affected leg, sometimes called hanging on the hip.
Pain when climbing stairs.
Pain when lifting your legs in or out of a car or bed.
Why this matters to a rheumatologist
Outer hip pain is easy to label and easy to mislabel. Part of my job is to confirm that the pain is coming from the bursa and soft tissues over the greater trochanter, and not from the hip joint itself, the lower back or a nerve, and to make sure I am not missing a fracture, an infection or an inflammatory cause. In patients with inflammatory arthritis, pain at the tendon attachments can also be a sign of enthesitis, which changes the treatment plan entirely. Once I am confident of the diagnosis, most of the recovery comes from load management and a properly progressed strengthening programme rather than from repeated injections.
Signs I would like you to seek care for
For emergency symptoms please seek urgent or emergency care first rather than waiting for a WhatsApp reply.
A significant fall or injury after which you cannot bear weight on the leg, which needs urgent assessment for a fracture.
A hot, swollen hip, fever, chills or feeling generally unwell, which needs urgent review to exclude infection.
Rapidly worsening severe pain, or pain that is now constant and unrelieved at rest.
Marked new weakness, numbness, pins and needles down the leg, or difficulty controlling your bladder or bowels.
What a specialist review looks like
I start by listening to how the pain behaves, then examine the hip, the lower back and your walking pattern, and test the muscles that hold the pelvis level. This is usually a clinical diagnosis, so I do not scan everyone. I arrange imaging when the story is unclear, when symptoms persist despite sensible treatment, or when I suspect a different diagnosis such as hip joint disease, a stress or fragility fracture, or referred pain from the spine. Treatment then focuses on education, temporary changes to load and sleeping position, and a progressive hip and buttock strengthening programme with a physiotherapist. Simple analgesia is used only if it suits you and your other conditions. A clinician-led injection into the bursa is an option for selected cases where pain is limiting rehabilitation, and surgery is uncommon.
Questions my patients often ask me
Speak with me
If you have pain over the outside of your hip that is disturbing your sleep or limiting your walking, message my clinic. We can work out where the pain is really coming from and put a clear plan in place.
Other conditions I treat
This page is for general education only and does not replace medical advice. Please consult a qualified healthcare professional for diagnosis and treatment.
What causes greater trochanteric bursitis
Often it occurs for no apparent reason, but these are the factors that appear to contribute to it.
- A sudden increase in load on your hip.
- A change to your activity levels, such as increased walking distance or pace.
- Increased pressure on the hip area from sitting or standing in one position for too long, or weight bearing on one leg.
- Reduced strength and flexibility of the muscles around the hip and buttock.
- A sedentary, inactive lifestyle, or carrying extra weight.
- An injury such as a fall onto the side of the hip.
- Hormone changes, which may also influence this condition.
- Osteoarthritis of the hips or knees, or low back pain, which often sit alongside it.