Outer-hip pain that appears only when lying on that side and eases when you roll over is very likely GTPS — and two weeks of sleep changes, pillow support, and gentle glute strengthening resolves a large share of cases. If the pain persists beyond that, is now present during the day, or has any red-flag features, get it assessed. GTPS is highly treatable, and the alternatives (OA, referred back pain, or rarely a fracture) need their own management.
🚨 Make an Appointment If:
Pain persists for more than two weeks despite sleep and activity changes
The pain is deep in the joint or groin, not the outer hip
It spreads down the leg or below the knee
It follows a fall, especially if you are over 65
You have trouble bearing weight, or the leg feels weak
There is fever, redness, or swelling over the hip
Night pain wakes you every night and is not relieved by changing position
Why Assessment Matters
GTPS affects 10–25% of adults and responds well to physiotherapy — but only if the diagnosis is right. Hip OA (about 10% of people over 55), referred back pain, and the rare fracture or infection all need different treatment, and the examination plus simple imaging sorts them in one visit. The longer GTPS goes unmanaged, the more the gluteal tendons weaken and the harder recovery becomes.
What to Expect
Examination: pressing the greater trochanter, hip rotation and strength tests, and a check of the lower back.
Ultrasound: shows bursal fluid and tendon thickening — the usual confirmation for GTPS.
X-ray or MRI: used when OA, fracture, or other structural causes are suspected.
Physiotherapy: the standard treatment — gluteal strengthening and loading management, with good evidence for resolving GTPS.
Which Professional to See
A physiotherapist is the best first stop for suspected GTPS — the treatment is exercise, and they can confirm the diagnosis by examination. A GP is the right start for red flags, imaging, or uncertainty about the cause. An orthopaedic surgeon or rheumatologist is involved for OA, persistent cases, or rare causes.
Urgency Guide
Same day / urgent: fever with hip pain, inability to bear weight, or pain after a significant fall.
Within a week or two: persistent pain beyond two weeks, deep groin pain, or pain spreading down the leg.
Routine: classic outer-hip night pain you want confirmed and treated.
While you wait, the relief page has sleep positioning and strengthening strategies.
Questions the Doctor May Ask
Is the pain on the outer hip or deep in the groin?
Does it happen only when lying on that side, or also during the day?
What makes it better — rolling over, standing, or movement?
Have you had a fall, a long hike, or a recent change in exercise?
Is there fever, redness, swelling, or trouble bearing weight?
What Happens If You Wait — and What You Can Do Now
Waiting two weeks with sleep-position changes and gentle strengthening is the correct first step for classic outer-hip pain. Waiting months is how gluteal tendons weaken and recovery lengthens. While you wait: sleep with a pillow between the knees, avoid lying flat on the tender side, and start the gentle gluteal exercises on the relief page. If the pain moves into the groin, follows a fall, or comes with fever or weight-bearing trouble, move the appointment up — those change the diagnosis entirely.
How to Prepare for the Appointment
Describe exactly where the pain sits — on the bony outer hip, deep in the groin, or in the buttock — because that single detail separates soft tissue, joint, and spine. Note when it happens (night, stairs, sitting, walking), what relieves it, and whether it follows a fall, a hike, or a jump in exercise. Mention any morning stiffness and how long it lasts. If you are over 65 or had a fall, say so prominently — that changes the urgency. This information lets the clinician examine the right structures and order the right imaging on the first visit.
What the Tests Will Show
The examination is the main diagnostic tool: pressing directly over the greater trochanter reproduces GTPS pain, while hip rotation tests and weight-bearing manoeuvres distinguish joint pain. Strength testing — side-lying leg raises — reveals the gluteal weakness that drives most GTPS. Ultrasound shows bursal fluid and tendon thickening, confirming the soft-tissue diagnosis in seconds. X-ray is added when OA or a fracture is suspected, and MRI for deeper problems or persistent cases. The reassuring part: classic outer-hip night pain is usually confirmed and treated without any imaging at all, because the examination is that characteristic.
Treatment Options at a Glance
Physiotherapy: the standard treatment — gluteal strengthening and load management, effective for the majority of GTPS.
Sleep positioning: pillow support and back-sleeping, as on the relief page.
Pain relief: short anti-inflammatory courses for flares, with advice.
Injections: for persistent bursitis after a course of physiotherapy.
Surgery: rarely needed, reserved for cases that fail all conservative treatment.
⚠️ Medical Disclaimer: This site is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional for medical concerns.