Greater Trochanter Pain Syndrome
What is Greater Trochanter Pain Syndrome?
Greater trochanter pain syndrome (GTPS), is a condition described with pain on the side of the hip. This pain is caused by excessive friction, irritation, and eventually chronic inflammation of the soft tissues located on the side of the hip. Annually this condition affects 1.8 per 1000 patients. This condition is more common in women than men.
Cause of GTPS
GTPS can be caused by a variety of factors that could lead to muscular and structural dysfunction of the lateral hip. GTPS is oftentimes a soft tissue driven condition, where the hip joint itself could be healthy. GTPS may also be associated with other painful conditions:
- Disc degenerative disease in the lumbar spine
- Ischiofemoral impingement
- Pelvic or femoral fractures
- Iliotibial band syndrome
- Hip injury or arthritis
Symptoms of GTPS
Symptoms of GTPS vary, and can include:
- Unilateral pain on the back of the hip and upper thigh
- Tenderness when palpating the side of the hip
- Increased pain when sleeping on the affected side
- Weakness and decreased range of motion in the hip
Diagnosis of GTPS
As lateral hip, thigh, and back pain can have several causes, diagnosing GTPS requires a variety of tests to be diagnosed confidently. Your doctor will carefully review your symptoms and medical history and perform a physical examination. Diagnostic tests for GTPS include:
Physical Examination: A variety of tests can be used to palpate and assess the soft tissues associated with GTPS. A series of provocative tests can be used to rule out other back and hip issues.
MRI Scan: This study uses a large magnetic field and radio waves to produce images of soft tissue and bone that help exclude other possible diagnoses.
X-rays: This study uses electromagnetic beams to exclude other possible diagnoses, such as the presence of stress fractures or bony deformities.
Ultrasound: This study uses high-frequency sound waves to produce images of the tissues.
Treatment for GTPS
Treatment for GTPS varies based on age, health, type of damage, and severity. Your doctor may initially recommend conservative treatment to help relieve the symptoms. Conservative measures usually are enough to treat cases of GTPS.
Anti-inflammatory medication: Your doctor may recommend non-steroidal
anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation in the soft tissues of the lateral hip.
Rest and Activity Modification: Reducing or modifying physical activity can provide time for soft tissues of the lateral hip to heal.
Ice or Heat: Applying ice or heat can help promote healing and eliminate pain to soft tissues of the hip.
Extra-articular Injections: Your doctor may recommend steroid injections or platelet-rich plasma (PRP) injections to soft tissues to promote recovery.
Physical therapy: After a rest period, exercises are recommended to address muscle imbalances and allow the soft tissues of the lateral hip to return to normal function.
If conservative treatment methods are ineffective, and if the patient and physician feel necessary, surgical methods can be recommended. Below are possible surgical interventions for GTPS:
- Trochanteric bursectomy
- Trochanteric micropuncture
- Gluteus medius or minimus repair
- Iliotibial band release
Depending on operative findings and procedures performed, rehabilitation from surgery can take several weeks to several months.