First-line treatment of greater trochanteric pain syndrome
Clinical picture
Greater trochanteric pain syndrome (GTPS) presents as lateral hip pain arising from the structures around the greater trochanter. The majority of cases are amenable to structured first-line management in primary care, without the need for procedural or specialist intervention.
Treatment approach
First-line management combines oral pain relief with a structured physical therapy programme — with particular emphasis on gluteal strengthening, hip abductor control, and optimisation of lumbopelvic biomechanics. Addressing load through postural and activity modification is central to recovery.
The complete protocol specifies the full sequence, therapy components, and load-management detail — available via the link below.
References
DOI: 10.3399/bjgp17X693041
- The majority of cases of GTPS can be successfully managed in primary care with weight loss, non-steroidal anti-inflammatory drugs (NSAIDs), targeted physical therapy, load modification, and optimisation of biomechanics.
- In the acute phase, pain can be managed with rest, ice, soft tissue therapy, taping, and medications (NSAIDs and/or paracetamol).
- Exercise and load management are the cornerstone of an effective tendinopathy management.
- Physical therapy should be tailored to the individual patient and have a specific focus during the early stages on gluteal strength and control, and then, as hip control improves, muscle strengthening should target the hip abductors.
- In addition, lumbopelvic postural control is vital to optimise biomechanics.
- To reduce compressive loads on the gluteal tendons, positions of excessive hip adduction (such as crossing legs and ITB stretching exercises) should be avoided, and at night patients can sleep with one or two pillows between their legs.
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