March 21, 2018
What is Greater Trochanteric Pain Syndrome ?
Greater Trochanteric Pain Syndrome (GTPS) is a chronic condition potentially affecting a number of structures around the hip. It is characterised by pain and tenderness over the outside of the buttock and thigh. The pain usually arises from a tendinopathy (tendon injury) in the gluteal muscles. Previously it was thought that the pain was caused by inflammation of a bursa; known as trochanteric bursitis (a bursa is a fluid filled sac which reduces friction between bone and soft tissue). However, recent studies have shown that injury to the gluteal tendons is often the cause of pain.1,2
Who does Great Trochanteric Pain Syndrom Effect?
GTPS has been reported to affect between 10 and 25% of the population with a greater prevalence amongst women.
What causes GTPS?
There are a number of possible causes for GTPS, these include:
- Trauma e.g. a fall onto the hip or contact sports
- Overuse of the muscles e.g. repetitive movements such as running/walking
- Standing with weight on one leg for long periods
- Ongoing lower back pain
How does it manifest itself?
GTPS tends to come on quite gradually and usually manifests itself as pain over the lateral part of the hip. Over time the symptoms can build up to the point where it becomes painful to walk, run or climb stairs. It can also interfere with sleep as it may become uncomfortable to lie on the affected side.
How is GTPS diagnosed?
GTPS is normally diagnosed by your osteopath or physiotherapist in the clinic but, on rare occasions, MRI or ultrasound scans may be required.
What are the treatment options?
Treatment of GTPS is aimed at reducing/eliminating the pain and restoring full function. Treatment options include ice, rest, anti-inflammatory medications, stretching, strengthening and flexibility exercises. Your therapist can advise on the appropriate course of action. If symptoms persist despite conservative treatment it is possible to alleviate the pain by using steroid injections, surgery or Shockwave Therapy.
Shockwave Therapy has been shown to be more effective in the long-term than steroid injections with a 74% success rate for Shockwave Therapy fifteen months after treatment as opposed to 48% for steroid injections.3 Shockwave Therapy involves delivering acoustic shockwaves to the injured tissues to provide rapid pain relief and stimulate a healing reaction. Most patients require between 3 and 6 treatments over a 12 week period alongside a bespoke exercise programme to experience a significant improvement in their symptoms although pain relief can occur almost immediately after the first session.
1 Klauser AS, Martinoli C, Tagliafico A, et al (2013). Greater trochanteric pain syndrome. Seminars in Musculoskeletal Radiology, 17(1).
2 Reid, Diane. The Management of Greater Trochanteric Pain Syndrome: A Systematic Literature Review. Journal of Orthopaedics 13.1 (2016): 15–28. PMC. Web. 20 Mar. 2018.
3 Rompe JD, Segal NA, Cacchio A, Furia JP, Morral A, Maffulli N. Home training, local corticosteroid injection, or radial shock wave therapy or greater trochanter pain syndrome. Am J Sports Med. 2009 Oct;37(10):1981-90. doi: 10.1177/0363546509334374. Epub 2009 May 13.