Greater trochanteric pain syndrome

Greater Trochanteric Pain Syndrome

What is Greater Trochanteric Pain Syndrome?

Greater Trochanteric Pain Syndrome (GTPS) is a medical condition that causes pain in the outer part of the hip, specifically the greater trochanter area of the femur (thigh bone). The term 'Trochanteric Bursitis' was previously used to describe this condition, but it is now understood to involve more than just bursitis, including tendinopathy and muscle tears. GTPS predominantly affects middle-aged women and can significantly impact mobility and quality of life.

Causes of GTPS

Several factors can contribute to the development of GTPS, including:

• Overuse Injuries: Repetitive motion or prolonged pressure on the hip area can lead to tendon and bursa inflammation.
• Muscle Imbalances: Weakness or tightness in the hip muscles can alter normal gait and add stress to the tendon attachments.
• Trauma: A direct blow to the hip or falling on the hip can result in inflammation.
• Biomechanical Issues: Abnormalities in the way you walk or run can predispose you to GTPS.

Symptoms of GTPS

People with GTPS typically experience the following symptoms:

• Pain: Persistent pain on the outside of the hip, which may radiate down the outside of the thigh.
• Tenderness: Tenderness around the greater trochanter when pressing on the hip.
• Swelling: Possible swelling or warmth over the lateral hip region.
• Pain at Night: Pain may worsen at night or when lying on the affected side.
• Limited Range of Motion: Difficulty or discomfort with movements such as walking, climbing stairs, or sitting cross-legged.

Diagnosis

Diagnosing GTPS typically involves a thorough clinical evaluation by a healthcare provider. They may review your medical history, perform a physical examination focusing on the hip area, and assess your gait. Additionally, imaging studies such as X-rays, ultrasound, or MRI may be requested to rule out other conditions and confirm the diagnosis.

Treatment Options

GTPS is usually manageable with a combination of the following treatments:

• Rest and Activity Modification: Avoiding activities that exacerbate symptoms and allowing time for healing.
• Physical Therapy: A focused exercise programme to strengthen hip muscles, improve flexibility, and correct biomechanical issues.
• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce pain and inflammation.
• Injections: Corticosteroid injections can provide temporary relief from pain and inflammation.
• Extracorporeal Shock Wave Therapy (ESWT): A non-invasive treatment using shock waves to promote healing.
• Surgery: Rarely needed, but may be considered in severe or refractory cases.

Prevention

To prevent GTPS, consider adopting the following lifestyle modifications:

• Maintain a Healthy Weight: Reducing excess weight can lessen the stress on your hips.
• Exercise Regularly: Engage in a balanced exercise routine that includes strength training, stretching, and aerobic activities.
• Proper Footwear: Wear supportive shoes that align well with your gait and activity levels.
• Avoid Overuse: Gradually increase activity intensity and duration to avoid overstressing your hip muscles.
• Good Posture: Maintain proper posture during activities to ensure even distribution of body weight.