Trochanteric Pain Syndrome

What is Trochanteric Pain Syndrome?

Trochanteric pain syndrome is an umbrella term that is typically used to describe pain experienced on the outer (lateral) part of the hip. This is usually centered around a bony structure called the Greater Trochanter which can be found on the outside part of the upper thigh bone (femur). There are several conditions that may underly the cause of pain felt within this area. Previously, Trochanteric Bursitis, a condition where inflammation of the bursa (fluid filled sac’s around certain joints that reduce friction between bones, tendons and/or muscles) was thought to be the main source of pain causing Trochanteric Pain Syndrome. However, recent research indicates that despite fluid filling the Bursa, an underlying tendinopathy or strain of the deeper Gluteal Muscles (Gluteus Medius / Minimus) may be the primary cause of the inflammation within the area. Thus, rehabilitation is normally surrounding the management of the underlying tendinopathy if it is present.

The two bursae that are most associated with Trochanteric Pain Syndrome are the subgluteus medius and the subgluteus maximus. The causes of bursitis are numerous and include any condition that causes altered hip mechanics such as low back pain, leg length deficiencies, arthritis, surgery and neurological conditions. Altered biomechanics leads to irritation of one or more of the bursae resulting in pain and inflammation (bursitis).

The tendons of Gluteus Medius and Minimus attach onto the Greater Trochanter along with Gluteus Maximus and Tensor Fascia Lata. These are often grouped together to be called the “rotator cuff” of the hip. Due to their insertion into this area, inflammation or injury to any of these muscles can lead to the pain that often characterises Trochanteric Pain Syndrome.

Trochanteric Pain Syndrome typically presents in people aged 40-60 as localised pain over the lateral upper thigh, and less commonly pain radiating up to the lower back and/or down to the knee, with a possible limp and a history of repetitive activity. People will often experience worser pain with prolonged sitting (especially crossing legs), high impact physical activity, lying on the affected hip and climbing stairs.

Sources:

Greater trochanteric pain syndrome – physiopedia (no date) Greater Trochanteric Pain Syndrome. Available at: https://www.physiopedia.com/Greater_Trochanteric_Pain_Syndrome (Accessed: 07 July 2025).

Grimaldi, A. and Fearon, A. (2015) ‘Gluteal tendinopathy: Integrating pathomechanics and clinical features in its management’, Journal of Orthopaedic & Sports Physical Therapy, 45(11), pp. 910–922. doi:10.2519/jospt.2015.5829.

Speers, C.J. and Bhogal, G.S. (2017) Greater trochanteric pain syndrome: A review of diagnosis and management in general practice, The British journal of general practice : the journal of the Royal College of General Practitioners. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC5604828/ (Accessed: 07 July 2025).

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