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Health condition

Lateral hip pain, GTPS, gluteal tendinopathy - and a ladder that actually works.

Pain on the outside of the hip is common, treatable and rarely from the joint itself. A structured loading plan - with imaging and injections in reserve - fixes most people.

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A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against NICE, BOA, BASK and the LEAP trial evidence you can see at the end.

  • 03

    Current for 2026

    Reflects modern UK musculoskeletal practice - gluteal loading, image-guided injection and shockwave.

Key facts

Lateral hip pain at a glance.

The essentials, in plain English - what it is, who gets it and how it is treated in the UK today.

  • What it is

    Pain over the outer hip - the greater trochanter - usually from tendon and bursal irritation, not the hip joint itself.

  • Most common cause

    Greater trochanteric pain syndrome (GTPS) - a spectrum of gluteal tendinopathy, trochanteric bursitis and ITB friction.

  • Who gets it

    Most often women in their 40s to 60s, runners and walkers, and people after a change in load or footwear.

  • The tell-tale sign

    Tender greater trochanter, pain lying on the affected side and pain on stairs or single-leg loading.

  • First-line treatment

    Load management and structured gluteal strengthening - the LEAP trial evidence backs education plus exercise.

  • When to escalate

    Persistent pain despite 12 weeks of physiotherapy - consider imaging, image-guided injection or shockwave.

Why this guide matters

A loading plan, not a lifetime of injections.

Lateral hip pain is one of the most common musculoskeletal problems in midlife, and one of the most misunderstood. The three points below shape everything else on this page.

  • Gluteal loading is the treatment

    The LEAP trial evidence is clear - education plus a structured gluteal strengthening programme outperforms rest or injection alone.

  • Injections work best as a bridge

    An image-guided steroid injection can settle a flare so rehabilitation actually happens - but on its own it rarely gives a lasting fix.

  • The hip joint is usually innocent

    True hip osteoarthritis causes groin pain and stiff internal rotation. Pain over the outer bony point is almost always tendon and bursa, not joint.

How the diagnosis is made

From first twinge to a clear plan.

The steps a UK GP, sports physician or musculoskeletal specialist will normally follow, in order - so you know what to expect and why.

  1. 01

    Assessing

    Focused history

    Location, sleep disturbance, stairs, sit-to-stand and any change in running mileage, walking or footwear.

  2. 02

    Assessing

    Red-flag screen

    Night pain unrelated to position, weight loss, fever, cancer history or trauma - each changes the pathway.

  3. 03

    Assessing

    Clinical examination

    Palpation of the greater trochanter, Trendelenburg test, resisted hip abduction, FABER and FADIR to separate lateral from joint pain.

  4. 04

    Confirming

    Ultrasound - selective

    A focused musculoskeletal ultrasound scan looks at the gluteal tendons and bursa when pain is not settling.

  5. 05

    Confirming

    MRI - selective

    Reserved for suspected gluteal tendon tear, stress fracture or a picture that does not fit GTPS.

  6. 06

    Planning

    Specialist musculoskeletal review

    A sports and exercise medicine or musculoskeletal consultant confirms the diagnosis and shapes the plan.

  7. 07

    Planning

    Physiotherapy referral

    A structured 12-week gluteal loading programme following LEAP-style principles is the treatment backbone.

Typical timeline: from a first visit to a clear plan in one to two weeks.

Symptoms

What lateral hip pain actually feels like.

A classic pattern - tender greater trochanter, pain lying on the side and pain on stairs - with a handful of features that mean it is time to look further.

  • Point tenderness

    A sore, well-localised spot over the bony outer hip - the greater trochanter - reproduced by direct pressure.

  • Pain lying on the side

    Waking at night when rolling onto the affected side is a classic feature of gluteal tendinopathy and bursitis.

  • Stairs and single-leg load

    Climbing stairs, standing on one leg or getting up from a low chair reliably provokes the pain.

  • Radiation down the outer thigh

    A vague ache spreading toward the outer knee - not below - suggests a lateral hip source rather than the back.

  • A snapping or clicking sensation

    External snapping hip - the iliotibial band flicking over the greater trochanter with hip flexion or rotation.

  • Weakness on single-leg stance

    A dropped pelvis on the unsupported side - a positive Trendelenburg sign - points to gluteus medius or minimus.

  • Numb, burning patch on the outer thigh

    A sharply demarcated area of altered sensation suggests meralgia paraesthetica, not tendon pain.

  • Red flag - sudden loss of function

    A sudden pop, marked weakness or an inability to abduct against gravity may indicate a gluteal tendon tear.

Treatment

How lateral hip pain is treated in the UK.

Load management and structured physiotherapy first, image-guided injection and shockwave next - and surgery reserved for the refractory few.

  • Lifestyle and load management

    The first step - modify triggers, avoid crossing legs, cushion the side you sleep on, and reduce hills or running mileage temporarily.

  • Structured physiotherapy

    A LEAP-style gluteal loading programme with a specialist musculoskeletal physiotherapist - the best-evidenced treatment for GTPS. See our guide to spinal physiotherapy for the model of care.

  • Simple analgesia and NSAIDs

    Paracetamol and a short course of an NSAID (if suitable) can settle a flare while the exercise programme takes effect.

  • Image-guided steroid injection

    A targeted, ultrasound-guided steroid injection into the bursa can bridge the first weeks of rehab in a stubborn flare.

  • Shockwave therapy

    Extracorporeal shockwave therapy - a specialist musculoskeletal option with growing evidence in refractory gluteal tendinopathy.

  • PRP - specialist selective

    Platelet-rich plasma is offered selectively in some specialist musculoskeletal clinics where standard treatment has plateaued.

  • Endoscopic bursectomy or tendon repair

    Surgical options - reserved for refractory GTPS or a confirmed gluteal tendon tear, on the advice of an orthopaedic hip specialist.

  • Meralgia paraesthetica pathway

    Weight, clothing and posture changes, a diagnostic nerve block, and rarely surgical release - assessed by a specialist neurology or musculoskeletal team.

What this guide is based on

The sources behind every claim on this page.

UK national guidance, specialist society standards and the key trial evidence, current at the time of last review.

Key references

Guidelines and trials we relied on.

A quiet reminder

This guide is for information, not medical advice.

Your GP or musculoskeletal specialist knows your history and can tell you which parts apply to you. If in doubt, get seen.

  • NICE Clinical Knowledge Summary. Greater trochanteric pain syndrome.

  • Mellor R, Bennell K, Grimaldi A et al. LEAP trial - education plus exercise for gluteal tendinopathy. BMJ, 2018.

  • British Orthopaedic Association (BOA). Standards for management of hip pain in adults.

  • British Association for Surgery of the Knee and Hip guidance on greater trochanteric pain syndrome and gluteal tendon disease.

Red flags

When lateral hip pain needs urgent attention.

Most lateral hip pain is manageable in primary care and with physiotherapy. These are the situations that are not - and where a specialist opinion or scan is needed sooner.

  • Night pain unrelated to position

    Constant, deep pain that is not eased by changing position - especially with weight loss or fever - deserves urgent review to exclude infection or bony disease.

  • History of cancer

    A new or persistent lateral hip pain in someone with a cancer history should trigger consideration of bone metastasis - imaging is warranted.

  • Recent significant trauma

    A fall onto the hip, especially in older adults or on steroids, may need X-ray to exclude a fracture of the greater trochanter or femoral neck.

  • Sudden pop and weakness

    An acute pop, bruising and marked hip-abductor weakness suggests a gluteal tendon tear - specialist orthopaedic assessment.

  • Stress fracture risk

    Long-distance runners, low body weight, disordered eating or amenorrhoea - persistent lateral hip pain with focal bony tenderness needs MRI.

  • Progressive numbness or weakness

    Numbness, tingling or leg weakness suggests lumbar radiculopathy - see our guide on herniated disk - rather than a pure lateral hip problem.

  • Bilateral or systemic joint symptoms

    Symmetrical pain, morning stiffness lasting over an hour or systemic features raise the possibility of inflammatory arthritis.

  • Post-injection infection

    Fever, redness or worsening pain after any injection needs immediate assessment - do not wait to be reviewed as routine.

  • Refractory pain despite full rehab

    Ongoing severe symptoms after 12 weeks of structured physiotherapy warrants imaging and an orthopaedic hip opinion.

Living with it

A treatable problem, with a clear ladder.

Four things that make the biggest difference day to day - manage load, fix the night pain, trust the strengthening programme and know when to step up.

A quiet reminder

Consistency beats intensity, every time.

A steady 12-week rehabilitation programme does more for lateral hip pain than any single injection or scan.

  1. 01 Load

    Manage load, do not rest completely

    Reduce the aggravating loads - hills, high mileage, prolonged standing - but keep moving. Complete rest weakens the very muscles that stabilise the hip.

  2. 02 Sleep

    Fix the night pain first

    A soft pillow between the knees, a topper on the affected side and avoiding crossed legs can transform sleep within a week.

  3. 03 Strength

    Trust the programme

    Gluteal strengthening feels slow, but the LEAP trial evidence is clear - most people improve significantly by three months if they stay with it.

  4. 04 Escalate

    Know when to step up

    If pain and function have not shifted after 12 weeks of good physiotherapy, arrange imaging, an image-guided injection or shockwave rather than more of the same.

Frequently asked

Everything we get asked about lateral hip pain.

Quick answers on GTPS, imaging, injections, shockwave and surgery.

  • What causes pain on the outside of the hip?

    Most lateral hip pain comes from greater trochanteric pain syndrome - a mix of gluteal tendinopathy, trochanteric bursitis and iliotibial band friction. Less commonly it is referred from the lumbar spine or sacroiliac joint, or from meralgia paraesthetica affecting a sensory nerve in the outer thigh.

  • How is lateral hip pain different from hip osteoarthritis?

    Hip osteoarthritis usually causes deep groin pain, restricted internal rotation and pain that eases at rest early on. Lateral hip pain is felt over the outer bony point, is worse lying on the side, and worse on stairs. See our guide to hip osteoarthritis for that pathway.

  • Do I need a scan for lateral hip pain?

    Not usually. The diagnosis is clinical in most people. A musculoskeletal ultrasound or an MRI scan is reserved for pain not settling with a proper rehabilitation programme, or where a gluteal tendon tear, stress fracture or another diagnosis is suspected.

  • Will a steroid injection cure GTPS?

    It rarely cures it, but a well-placed, image-guided steroid injection can settle a stubborn flare enough to make physiotherapy work. It is best used as a bridge to loading, not instead of it.

  • What role does shockwave therapy play?

    Extracorporeal shockwave therapy is a specialist musculoskeletal option in gluteal tendinopathy that has not responded to a full course of physiotherapy. Evidence is growing and it is offered as part of a comprehensive plan rather than as a first step.

  • When is surgery considered?

    Surgery - endoscopic bursectomy or a gluteal tendon repair - is reserved for people whose pain and function have not improved after 6 to 12 months of high-quality non-surgical care, or for confirmed gluteal tendon tears. It is decided with a specialist orthopaedic hip surgeon.

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