Greater trochanteric pain syndrome (GTPS) is a common cause of pain on the outer side of the hip, centered around the bony prominence known as the greater trochanter. The duration of this pain varies significantly, but understanding the underlying causes and steps toward recovery provides insight into the expected timeline. The vast majority of cases resolve completely with conservative management.
Understanding Greater Trochanteric Pain Syndrome
Greater trochanteric pain syndrome is an umbrella term for pain felt around the greater trochanter, the large bony knob on the side of the thigh bone. This condition was historically and often incorrectly referred to as trochanteric bursitis, which describes inflammation of the fluid-filled sac in the area. Current understanding, supported by diagnostic imaging, shows that the pain most frequently originates from gluteal tendinopathy, involving the tendons of the gluteus medius and gluteus minimus muscles.
People with GTPS typically experience a deep, aching, or burning pain on the outside of the hip that can sometimes radiate down the thigh. This pain is characteristically aggravated by specific activities, such as walking for long periods, climbing stairs, or standing on one leg. Pain while lying on the affected side is a frequent and disruptive symptom that often disturbs sleep. Activities that place direct pressure on the area, such as sitting with crossed legs, also tend to worsen symptoms.
Typical Recovery Timelines
The expected recovery time for Greater Trochanteric Pain Syndrome varies considerably, but the outlook is positive, with over 90% of individuals achieving full recovery through non-surgical means. For many, symptoms begin to improve significantly within a few weeks of starting a structured treatment plan and diligent activity modification. A standard, well-managed case of acute GTPS—a new onset of pain—often requires approximately six to twelve weeks of consistent care and rehabilitation to achieve substantial relief.
Complete resolution of symptoms can take two to three months or longer due to the nature of tendon healing. Cases that have been ignored or poorly managed for six months or more are considered chronic and may require a longer rehabilitation window, sometimes extending to six to twelve months of dedicated physical therapy. While the prognosis is favorable, recurrence remains a possibility, particularly if underlying factors of muscle weakness or poor movement patterns are not corrected.
Factors Influencing Healing Speed
The speed of recovery from GTPS is determined by several patient-specific and condition-related variables. The primary factor is the severity of the underlying tendon damage, ranging from simple irritation to more advanced degeneration or even a partial tendon tear. Tendons that have progressed to a degenerative state require a longer, more intensive period of therapeutic loading to regain strength and structure.
Co-morbidities also play a significant role in prolonging the recovery timeline. Conditions such as low back pain, osteoarthritis of the hip or knee, and an increased body mass index (BMI) place additional mechanical stress on the gluteal tendons, making it harder for them to heal. Advancing age is another variable, as tendon tissue turnover and repair mechanisms naturally slow down in older adults, requiring a slower progression through rehabilitation.
The patient’s active participation in their recovery is a major determinant of healing speed. Failing to adhere to prescribed activity modifications, such as avoiding sleeping on the painful side or sitting with crossed legs, will continually compress the healing tendon. Non-compliance with the progressive loading exercises recommended by a physical therapist can significantly extend the duration of the syndrome by preventing the tendon from strengthening.
Treatment Strategies to Shorten Duration
The fastest path to recovery from GTPS involves a multi-faceted approach focused on reducing irritation and progressively strengthening the affected tendons. The cornerstone of treatment is physical therapy, which is designed to improve the load capacity of the gluteal tendons through targeted exercises. Initially, therapy often involves isometric exercises—sustained muscle contractions in comfortable positions—to reduce pain before progressing to heavier, slow resistance training over several months.
Activity modification is a simple yet powerful strategy, requiring patients to identify and avoid postures that compress the gluteal tendons, such as “hip-hanging” while standing or sleeping directly on the painful side. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can offer short-term pain relief, but they are not a long-term solution and are best used to manage discomfort enough to engage in therapy. Corticosteroid injections can also provide a temporary reduction in pain, often lasting up to three months, which is beneficial for creating a pain-free window that allows the patient to participate fully in physical strengthening exercises.
For chronic cases resistant to initial conservative care, more advanced options may be considered to stimulate healing and shorten the overall duration. Extracorporeal shockwave therapy (ESWT) delivers mechanical pulses to the affected area to initiate a healing response in the degenerative tendon tissue. While surgery is rarely necessary, it is reserved for individuals whose pain persists for six to twelve months despite exhausting all non-surgical interventions, typically involving the repair of significant tendon tears or removal of severely inflamed tissue.