Our hip joints are among the largest and strongest in the body, providing strength and flexibility for walking, running, and jumping. They also take a beating. One of the most common causes of outer hip pain is hip tendonitis — a problem we call greater trochanteric pain syndrome. You may also hear it called trochanteric tendonitis, gluteal tendinopathy, or trochanteric bursitis. It is common and treatable.

Dr Masci diagnoses and treats greater trochanteric pain syndrome at his London clinics, including ultrasound-guided trochanteric bursitis injections as one-stop visits. So how do we treat it — and when does an injection help?

What causes greater trochanteric pain syndrome? 

greater trochanteric pain syndrome

The condition mostly arises from overuse injury to the tendons on the outside of the hip. Adults who walk, run, or play sports are more prone to it. Women suffer twice as often as men — likely related to pelvic shape — with the highest rates in older women. Other causes include a tendon tear, a fall onto the outside of the hip, and inflammatory conditions such as rheumatoid arthritis. Weak hip muscles play a central role.

Interestingly, a recent study found that people with hip tendonitis are more likely to develop hip arthritis later. We suspect weak buttock muscles drive both the tendon swelling and the joint wear. 

Greater trochanteric pain syndrome symptoms

Pain starts on the outside of the hip. It worsens when lying on that side, climbing stairs, walking for long periods, or running. Crossing your legs can hurt, the outer hip feels tender to touch, and night pain can be significant.

On examination, we use specific tests: standing on the affected leg, step-ups, and hip-hitching manoeuvres. Lifting the leg sideways reproduces the pain, and most people show clear weakness in side-raising. A general hip and spine examination excludes the mimics — hip arthritis, referred pain from the sacroiliac joint, and the lumbar spine.

Trochanteric bursitis on ultrasound

We investigate when you fail to respond to therapy or when your symptoms look unusual. Ultrasound shows tendonitis and any trochanteric bursitis, and can reveal calcifications or tendon tears. One key point: trochanteric bursitis rarely exists alone — if you have bursitis, you almost always have gluteal tendonitis underneath it. That matters for treatment. An X-ray or MRI helps when we suspect another cause, such as hip arthritis.

Greater trochanteric pain syndrome treatments

Self-care for hip tendonitis

Most cases of hip tendonitis respond to simple treatments.

First, lower the pressure on the tendons. Avoid lying on the painful hip, sleep with a pillow between your knees, avoid crossing your legs, and limit stretches such as the piriformis stretch. Second, reduce the activities that irritate the tendons — cut your step count to around 50% of normal or ease running intensity, keeping pain below 3 out of 10. Your phone’s step counter makes this easy to monitor. Third, a short 1–2 week course of ibuprofen supports the other treatments.

Greater trochanteric pain syndrome exercises

See a therapy expert to guide your rehab — evidence shows that exercises outperform both no treatment and injections, with improvements starting at 8 weeks and lasting at least 12 months.

The exercises build the muscles around the hip: glutes, hip flexors, and adductors. We start simple — side-lying hip raises, seated banded hip abduction, banded hamstring bridges — then progress quickly to standing work such as step-ups on a box. Strengthening the quadriceps and calves matters too. Perform the hip exercises once daily, and finish rehab with high-load, high-speed work such as weighted step-ups.

Soft-tissue massage and acupuncture sometimes help. For runners, a treadmill assessment can detect pelvic drop or a cross-over gait; shortening the stride and increasing cadence reduces load on the outer hip.

When can I run again? 

Once strength builds and pain settles, add hopping and jumping before running, 1–2 sessions per week, progressing gradually.

What if rehab doesn’t work?

Two main options follow: shockwave therapy and a trochanteric bursitis injection.

Shockwave therapy directs sound waves at the painful tendons, helping heal the tendons and stun the small pain-generating nerves. Evidence shows a series of 3–5 shockwave sessions improves pain at six months.

Trochanteric bursitis injection: what are the options?

An injection suits patients whose pain disrupts sleep or blocks rehab. Dr Masci performs every trochanteric bursitis injection under ultrasound guidance as a one-stop visit: consultation, diagnostic ultrasound, and injection in a single appointment at his London clinics.

Cortisone injection — £400

Cortisone is a potent anti-inflammatory. Research shows cortisone injections for greater trochanteric pain syndrome work — though less well than exercise. In another study, pain improved six weeks after a single injection, and the benefit lasted up to a year. Cortisone helps bursitis more than tendonitis — another reason the ultrasound diagnosis matters — and we use it cautiously because of its side effects on tendons.

PRP injection — ACP Max £1,350

For complex or recurrent cases, PRP offers a regenerative option. We draw blood from your arm, spin it to concentrate the platelets, and inject the platelet-rich plasma into the swollen tendons.

The formula decides the result. A high-quality study found a single superconcentrated PRP injection improved pain and function for at least two years — outperforming cortisone. We prefer a high platelet concentration, delivered by a second-generation system, Arthrex ACP Max, which provides the full superconcentrated dose in a single injection.

Needle tenotomy

Needle tenotomy repeatedly needles the tendon under local anaesthetic, triggering acute inflammation and healing. One study found that needling improved trochanteric tendonitis pain in about 80% of people at 2–3 months.

Whichever option you choose, have it under ultrasound. Accuracy decides whether the injection reaches the bursa, the tendon sheath, or the wrong place entirely. Choose a doctor with genuine experience in ultrasound-guided injections — Dr Masci performs over a thousand each year and teaches these techniques across the UK and Europe.

Frequently asked questions about greater trochanteric pain syndrome

How long does greater trochanteric pain syndrome last?

Like all tendonitis, it can grumble for months. Most people improve steadily if they persist with their exercises — the rehab studies show benefits lasting at least 12 months.

What if a cortisone shot doesn’t work for hip tendonitis?

Not every cortisone shot succeeds — we estimate only 2 in 5 people get sustained relief from a single injection. When cortisone fails, avoid repeating it. Shockwave helps some people; for others, we recommend a one-shot superconcentrated PRP (ACP Max), which has the strongest long-term evidence in this condition.

Is trochanteric bursitis the same as hip tendonitis?

Essentially, yes — they are two faces of the same problem. Bursitis rarely occurs without underlying gluteal tendonitis, so treatment must address the tendons (exercise, then injection if needed) rather than the bursa alone.

Gluteal tendon tear: Is the treatment different?

Gluteal tendon tears are harder to treat, but the approach is similar: exercise first, then shockwave or injections. One-shot superconcentrated PRP works particularly well in partial tears. Surgical gluteal tendon repair — sometimes via a keyhole approach — remains an option when everything else fails.

How much does a trochanteric bursitis injection cost in London?

At Dr Masci’s Chelsea clinic, an ultrasound-guided cortisone injection costs £400, and ACP Max superconcentrated PRP costs £1,350, each as part of a one-stop visit that includes a consultation and a diagnostic ultrasound. Other clinic locations cost more. Full fees here.

Final word from Sport Doctor London about greater trochanteric pain syndrome

Greater trochanteric pain syndrome — hip tendonitis — is a common, treatable cause of outer hip pain. Start with rehab; the evidence puts exercise first. If you stall, shockwave or a trochanteric bursitis injection comes next: cortisone sparingly for severe pain, superconcentrated PRP for lasting results. And always choose a doctor experienced in ultrasound-guided injections.

To book a one-stop assessment and injection in London, contact Dr Masci’s team here or call +44 (0) 203 488 0350.

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