Lateral hip pain is known as greater trochanteric pain syndrome or gluteal tendinopathy.

It is so called because of the location of the pain and the structures responsible for causing it. The pain is commonly felt on the lateral (outside) aspect of the hip, usually around the bony prominence of the greater trochanter (the bony part on the outside of the upper thigh).

Symptoms can also radiate down the lateral aspect of the thigh towards the knee.

Historically, lateral hip pain was thought to be caused by inflammation of the bursae (fluid-filled sacs) around the tendons of the gluteal (buttock) muscles. However, research now suggests that the tendons themselves are the main source of pain.

What causes lateral hip pain?

There is no single cause of lateral hip pain, but a number of factors are associated with it.

These include:

• gender – it is more common in females than males
• age – it is most common between 40 and 60 years of age
• hormones – it is more common in females around and after the menopause
• activities – it is common when physical activity levels are increased too quickly
• hip and pelvic posture
• movement habits
• leg length discrepancies.

Positions that take the leg across the midline of the body (adduction) compress the tendons against the bone and can aggravate pain.

How is it treated?

The initial stage of treatment may focus on reducing the compressive forces placed on the tendon. Avoiding positions of hip adduction may help to settle the pain.

Therefore:

• avoid sitting with crossed legs
• avoid sitting with your feet wider than your knees
• avoid standing with one hip pushed out to the side
• avoid lying on the unaffected hip with the opposite knee resting on the mattress.

Sitting with the knees higher than the hips can also increase compression, and prolonged low sitting should be avoided.

Try to avoid stretching the gluteal muscles, as this can also increase compression of the tendon and may lead to increased symptoms.

Exercise

It is important to exercise the muscles and tendons around the hip to encourage them to strengthen.

Exercises that engage the gluteal muscles can help reduce pain and support the return of the muscles and tendons to their normal function. Recovery often takes three to six months of progressive rehabilitation.

These exercises may be painful to begin with, but this is to be expected and will not damage the tendons or muscles.

Your physiotherapist will be able to guide you through the most appropriate exercises following your assessment.