Greater Trochanteric Pain Syndrome (GTPS) is a common cause of pain on the outer side of the hip. This condition primarily involves irritation or injury to the tendons of the gluteal muscles—specifically the gluteus medius and minimus—where they attach to the greater trochanter, the bony prominence on the side of the thigh bone. While historically this pain was often misattributed to trochanteric bursitis, modern understanding highlights gluteal tendinopathy as the main source of discomfort. Patients are typically concerned with the expected duration of symptoms and the time it will take to return to normal function.
Understanding the Typical Recovery Timeline
For an average, uncomplicated case of GTPS, recovery under conservative management typically ranges from a few weeks to several months. Many individuals experience substantial improvement within two to three months of initiating treatment. The initial phase focuses on managing acute pain and reducing mechanical compression on the irritated tendons. This often involves avoiding activities like sleeping on the affected side or standing with one hip “hanging.”
The healing process involves a gradual reduction of symptoms as the underlying tendon tissue repairs and adapts to load. Full resolution of pain and restoration of function usually takes three to six months, especially if the condition was chronic before diagnosis. Conservative treatment, which includes physiotherapy, is successful in resolving symptoms for over 90% of people with GTPS.
Factors That Extend the Duration of Pain
Several intrinsic patient and condition characteristics can significantly extend recovery past the typical three-month mark.
Severity and Age
The severity of the underlying gluteal tendinopathy, such as a partial tendon tear compared to simple inflammation, requires a longer period for biological tissue healing. Older age is also a factor, as the natural turnover rate of collagen decreases with advancing years, slowing the repair process.
Biomechanical Factors
Co-morbidities play a substantial role in extending GTPS symptoms. Obesity or being overweight increases the compressive load on the hip tendons, impeding healing. Existing issues in the lumbar spine or a noticeable difference in leg length can alter gait mechanics, placing undue stress on the hip abductor muscles and preventing full recovery. Furthermore, a long duration of symptoms prior to diagnosis often means the tendon has progressed to a chronic state of disrepair, which is slower to resolve than a recent injury.
Non-Adherence to Treatment
Non-adherence to prescribed activity modifications and exercises commonly delays healing. Tendons require a careful balance of rest and gradually increasing load. Continuing activities that provoke pain, such as sustained standing or running, will re-aggravate the injury. Failure to address underlying muscle weakness or imbalances through consistent, targeted physical therapy results in persistent mechanical strain on the healing tendons.
How Targeted Treatments Reduce Recovery Time
Physical therapy is a primary method for accelerating healing by addressing the root cause of tendon overload, often weakness in the gluteal muscles. A structured strengthening program, focusing initially on isometric contractions and then progressing to heavier, eccentric exercises, helps the tendon tissue adapt to load more quickly. Improvement in pain and function is typically seen within 6 to 8 weeks of consistent, personalized physical therapy, moving patients toward recovery faster than simple rest alone.
Corticosteroid injections provide rapid, short-term relief of pain and inflammation, which is beneficial for allowing patients to participate effectively in physical therapy. The greatest effect is often felt around six weeks, providing a crucial window to maximize the benefits of exercise. While not a cure, injections can break the cycle of pain and allow the necessary strengthening to occur, accelerating the overall return to function.
Advanced Interventions
In rare instances where conservative management fails after several months, specialized interventions may be considered. Extracorporeal shockwave therapy (ESWT) is a non-invasive procedure that applies targeted acoustic waves to stimulate healing in chronic tendon tissue. For the small percentage of individuals who do not respond to all other treatments, surgical intervention to repair torn tendons or remove inflamed bursae can be considered. Surgery initiates a new, structured recovery phase typically managed over several months.
Defining Chronic Greater Trochanteric Pain Syndrome
GTPS is considered chronic when significant pain persists beyond six months despite consistent, targeted non-operative treatment. This indicates that the underlying gluteal tendinopathy has failed to respond to initial conservative measures, often progressing to a degenerative state. The persistence of pain suggests a more complex issue, potentially involving greater tendon damage or a failure to correct all contributing biomechanical factors.
A chronic diagnosis requires reassessment to confirm the original diagnosis and consider specialized, second-line treatments. These advanced therapies may include platelet-rich plasma (PRP) injections, which utilize the patient’s own growth factors to stimulate healing. Specialized management with shockwave therapy or a focus on central pain sensitization through cognitive-behavioral approaches may also be warranted. Chronic cases require a more intensive, multidisciplinary approach to achieve symptom resolution.