Treating Greater Trochanter Pain Syndrome in London

Appendix: key terms and content for greater trochanter pain syndrome

Trochanteric pain syndrome, also known as greater trochanteric pain syndrome (GTPS), is a common orthopedic problem that causes lateral hip pain. This condition can be diagnosed and assessed by healthcare professionals. GTPS is characterized by pain over the outside of the thigh/buttock muscle, and it can be treated with physiotherapy or surgical management depending on the severity of the condition. Understanding the clinically relevant anatomy, epidemiology, and aetiology of GTPS is essential for effective diagnosis and management.

Hip joint: Greater trochanter pain syndrome is a condition that causes pain in the outer hip and buttocks. It is often mistaken for hip joint pain, but the two are different. The greater trochanter is situated on the proximal and lateral side of the femur, just distal to the hip joint and neck of the femur. Repetitive friction between the ITB and greater trochanter can cause irritation to the structures around it, leading to GTPS. Common symptoms include pain at the side of the hip, difficulty walking, joint stiffness, swelling and warmth of the hip joint, catching and clicking sensation, among others. A physical exam and history-taking are done by a healthcare provider to diagnose GTPS.

Osteoarthritis: Greater Trochanter Pain Syndrome (GTPS) is a condition that causes pain on the outer part of the hip. It can occur for no apparent reason or may be related to osteoarthritis of the hips and knees or low back pain. The diagnosis is based on medical history as well as signs and symptoms. Factors that contribute to GTPS include sudden increased load on the hip, change in activity levels, reduced strength and flexibility of muscles around the hip and buttock, sedentary lifestyle, being overweight, and hormonal changes. Management of GTPS includes reducing pressure on the hip area, physical therapy, medication, and in some cases surgery.

MRI: Greater trochanter pain syndrome can be diagnosed through a physical exam, where the provider may ask the patient to point to the location of the pain, feel and press on the hip area, and move the hip and leg. In some cases, imaging tests such as X-rays, ultrasound, or MRI may be done to confirm the diagnosis. Direct palpation of the greater trochanter can carry a positive predictive value for MRI findings. Rest and self-care are often recommended as treatment options for GTPS.

Corticosteroid injection: Greater trochanter pain syndrome can be managed with various conservative treatments such as physiotherapy, activity modification, and pain-relief medication. If these treatments fail to control the pain, corticosteroid injection can be considered. This injection helps in reducing inflammation and provides relief from the pain. Other therapies like shockwave therapy and ultrasound can also be used as adjunct therapies. Surgical intervention is only considered if conservative management fails. In the acute phase, rest, ice, soft tissue therapy, taping, and medications (NSAIDs and/or paracetamol) can help manage the pain.

Trochanteric bursa: Greater trochanter pain syndrome is a condition that involves inflammation of the trochanteric bursa, which is located on the outer part of the hip. This can cause pain and discomfort in the hip area, especially during movement. Diagnosis involves identifying positive findings such as fluid-filled and thickened trochanteric bursa with evidence of inflammation, tendinopathic echogenic findings, or tears within the gluteus medius or gluteus minimus tendons. Treatment options may include physical therapy, corticosteroid injections, and in severe cases, surgery. Stretching exercises for the iliotibial band (ITB) can also help relieve symptoms by reducing compression on the affected area.

Hip osteoarthritis: Greater trochanter pain syndrome is a common cause of hip pain, especially in women aged 40-60 who are peri-menopausal/menopausal/post-menopausal. It is often associated with hip osteoarthritis or lower back pain. Endurance sports such as running or cycling may decrease the risk of developing GTPS. Direct palpation and the single leg stance test are used to diagnose GTPS, which can be differentiated from hip osteoarthritis by assessing the patient’s ability to put on shoes and socks. High BMI and sudden increase in activity/load are known risk factors for GTPS.

Gluteal tendons: Greater trochanter pain syndrome is caused by impingement of the gluteal tendons and bursa onto the greater trochanter by the iliotibial band (ITB) as the hip moves into adduction. Compressive forces are increased where there is weakness of the hip abductor muscles due to lateral pelvic tilt. The gluteal tendons originate at the back of your pelvis and insert into the greater trochanter. A tight structure known as the iliotibial band (ITB) stretches from your pelvis, down the outside of your thigh to your knee and covers the gluteal tendons and trochanteric bursa. The ITB exerts higher compressive forces on the gluteal tendons with increased adduction, amplifying the compression.

Arthritis: Greater trochanter pain syndrome, also known as hip bursitis, can be caused by various factors such as overuse or stress on the hip, hip injury, bone spurs on the hip, and arthritis of the hip, knee, or foot. Arthritis is one of the possible causes of this condition. It is more common in older adults who may have weaker hip abductor muscles and experience pain in the outer hip region. A sudden increase in activity levels or prolonged standing can also contribute to excessive friction in the affected area. Proper diagnosis and treatment are essential for managing greater trochanter pain syndrome.

Treatment of gtps: Greater trochanter pain syndrome (GTPS) can be treated with various methods. Shock wave therapy has shown promising results in treating GTPS, but further research is needed to determine its role. Simple analgesia such as paracetamol and anti-inflammatory drugs like ibuprofen can also help relieve pain. It’s important to seek advice from a pharmacist or GP before taking any medication and not exceed the recommended dosage. A better understanding of the relationship between GTPS and hip OA is necessary for further research into treatment options and patient management. People suffering from GTPS may experience poor quality of life compared to asymptomatic individuals, similar to those with end-stage hip OA.

Abduction: Greater trochanter pain syndrome is a common hip condition that causes pain and discomfort in the outer part of the hip. Abduction exercises, such as the hip abduction exercise, can help to alleviate the symptoms of this condition by strengthening the gluteus medius muscle. This exercise involves standing straight while holding onto a support and lifting your leg sideways without bending your trunk. Repeat this exercise for 10 times to improve hip stability and reduce pain caused by greater trochanter pain syndrome.

Greater trochanter pain syndrome can be managed through various pain management techniques. Ice and heat therapy are often suggested for pain relief, but their effectiveness is not fully supported by evidence. Manual therapy can also be helpful in releasing myofascial restrictions in the hip and lumbar spine which can cause increased friction at the lateral hip. If exercises cause discomfort, seeking advice from a pharmacist or GP for pain management is recommended. If symptoms do not improve after 12 weeks of exercise, consulting a doctor or healthcare provider for further advice is necessary.

Greater trochanter pain syndrome is a condition that causes tenderness and pain on the outer part of the hip. The pain can be triggered by activities such as walking, running, or even lying on your side. It is often associated with limited range of motion, including internal rotation. Internal rotation of the hip can be limited due to tension in the iliotibial band (ITB), vastus lateralis, and tensor fasciae latae (TFL) muscles. Strengthening and stretching exercises that target these muscles can help alleviate symptoms of greater trochanter pain syndrome.

Greater trochanter pain syndrome, also known as trochanteric bursitis or hip bursitis, is a condition characterized by pain and inflammation in the outer part of the hip. It is often caused by repetitive stress or injury to the tissues surrounding the greater trochanter, such as the tendons and bursa.