Common causes of GTPS

GTPS usually develops when the outer hip gets more load than it can currently handle. This can happen suddenly, or build slowly over time. Common contributors include:

• Prolonged standing on one leg (hip “hanging” posture)
• Sleeping on the painful side or with knees crossed
• Sudden increases in walking, hills, stairs, or running
• Reduced hip strength or endurance, especially hip abductors
• Changes in gait, footwear, or training surface
• Direct trauma such as a fall onto the outer hip

Symptoms of greater trochanteric pain syndrome

People with GTPS often describe:

• Localised pain over the outside of the hip
• Pain that may spread into the buttock or outer thigh
• Discomfort when lying on the affected side
• Pain with stairs, hills, prolonged walking, or standing
• Sharp pain with getting out of the car or rising from a low chair

A clear tenderness or “jump sign” over the greater trochanter is common during assessment.

People also ask: why does my hip hurt most at night?

Night pain often increases because side-lying compresses the irritated outer hip tissues. Many people sleep with the top leg drifting across the body, which adds further tendon load. A simple first step is to sleep on the other side with a pillow between your knees, or try lying on your back with pillows under your knees to reduce hip tension.

How GTPS is diagnosed

A physiotherapist assesses hip movement, strength, load tolerance, and walking pattern. They also check your pelvis and lower back to see if referred pain contributes. Imaging such as ultrasound or MRI can help when symptoms persist, when diagnosis remains unclear, or when progress stalls despite good rehab.

Conditions commonly associated with GTPS

• Gluteal tendinopathy
• Trochanteric bursitis
• Hip arthritis
• Sciatica and other referred pain patterns

Treatment options for GTPS

Physiotherapy management aims to reduce pain, improve hip load capacity, and restore confident movement. Many plans move through overlapping phases:

1. Phase 1 – Settle symptoms and reduce compression: adjust aggravating activities, change sleeping positions, and avoid long periods of “hanging” on one hip. Your physio may also use taping, targeted soft tissue techniques, and a simple starter exercise plan.
2. Phase 2 – Build strength and control: progressive hip abductor and pelvic control work, often starting with isometrics and controlled ranges, then building endurance and capacity.
3. Phase 3 – Return to walking, hills, and sport: graded exposure to stairs, hills, running, or sport-specific drills, while maintaining strength and movement quality.

If pain remains stubborn, your physio may discuss other options alongside exercise, such as shockwave therapy or guided injection pathways, depending on your presentation and goals. Education and exercise remain the usual foundation. :contentReference[oaicite:9]{index=9}

Helpful self-management tips

Small changes can reduce flare-ups while you build strength:

• Avoid crossing your legs when sitting, and avoid leaning into one hip when standing.
• Use a pillow between the knees when side-sleeping, or sleep on the other side.
• Reduce hills and stairs temporarily, then reintroduce them in a planned way.
• Keep walking short and frequent rather than long and infrequent during a flare.
• If you run, consider a short-term change to flatter routes and a gradual build, plus a running analysis if symptoms keep returning.

For general, reliable hip pain guidance, MedlinePlus also outlines common causes and when to seek help. Hip pain (MedlinePlus). :contentReference[oaicite:10]{index=10}

Returning to activity and sport

A gradual return works best. Many people improve over weeks to months when they build hip strength and increase load slowly. Your physiotherapist may recommend ongoing hip stabilisation exercises to support the tendons and reduce recurrence risk.

What to do next

If outer hip pain affects your sleep, walking, or confidence, a physiotherapy assessment can clarify the driver and map out a realistic plan. You’ll usually get the best results when you pair load changes with progressive strengthening rather than relying on rest alone.