Table 1: Lateral hip and thigh pain:
Theoretical and pragmatic underpinnings
of algorithm recommendations

Algorithm component	Comments	References
Greater Trochanteric Pain Syndrome (GTPS)
GTPS diagnostic criterion	Pain over the greater trochanter is best classified as a syndrome because multiple etiologies can lead to pain at the lateral hip	[8]
GTPS commonly coexists with chronic low back pain	Greater trochanteric tenderness was present in 44.9% of people with chronic low back pain, versus in 6.0% of controls	[12]
Trendelenburg sign — description	Trendelenburg’s sign is positive if, during single-leg stance on the affected leg, the contralateral pelvis drops and/or the trunk shifts toward the stance leg	[30]
Trendelenburg sign is common in people with chronic low back pain	Trendelenburg sign was positive in 54% of people with chronic low back pain versus 9.7% of controls	[12]
Corticosteroid injection is not first-line treatment	An ultrasound study of 877 patients and an MRI study of 174 patients demonstrated that only approximately 20% of GTPS cases had true bursitis (i.e., inflammation). Additionally, corticosteroid injections are toxic to local tendon tenocytes and potentially contribute to further weakening of tendons	[9,10], [17–20]
Hip abduction strengthening is first-line treatment	In 229 patients, at 15 months gluteal strengthening (80% success rate) was superior to corticosteroid injection (48% success rate)	[16]
Iliotibial Band Syndrome (ITBS)
ITBS commonly co-exists with GTPS	Odds ratio of 2.54	[8]
Ober’s test—reliability	Inter-rater reliability was 97.6%, and intra-rater reliability was 90%	[24,25]
Hip abduction strengthening is first-line treatment for ITBS	In a prospective trial, 22/24 runners treated with hip abductor strengthening were pain-free at 3 months	[27]
Hip Osteoarthritis (OA)
Pain from hip OA can refer to the lateral hip	Symptomatic hip OA presented as lateral hip pain in 27% of patients	[7]
Lumbar radicular pain
Lumbar radicular pain can refer to the lateral hip and thigh	In 48 subjects with lumbar disc herniation, 33% experienced pain in the lateral thigh and 46% had a herniation at the L1-2, L2-3, or L3-4 level	[29]
Seated slump test — sensitivity and specificity	For lumbar disc herniations, the seated slump test had a sensitivity of 0.84 and specificity of 0.83, which was overall superior to the straight leg raise test, which had a sensitivity of 0.52 and specificity of 0.89	[31]
McKenzie therapy for radiculitis	A positive pain response to repeated end-range lumbar motion (i.e., McKenzie therapy/mechanical diagnosis and treatment) predicted a positive response to non-operative care	[39]
Oral corticosteroids for radicular pain	In a randomized, double-blind, placebo-controlled trial of 269 patients with a lumbar disc herniation, a short course of oral corticosteroids resulted in modestly improved function but no improvement in pain	[40]
Lumbar Spinal Stenosis (LSS)
Pain from lumbar spinal stenosis can refer to the lateral hip and thigh	In 50 subjects with lumbar spinal stenosis, 42% experienced pain in the lateral thigh	[29]
GTPS = greater trochanteric pain syndrome ITBS = iliotibial band syndrome OA = osteoarthritis.