Greater Trochanteric Pain Syndrome explained by Jason Kirkbride DO, Princeton Spine & Joint Center
“Greater Trochanteric Pain Syndrome is an umbrella term for pain located on the lateral side of your hip or the outer portion of your hip. It used to be called trochanteric bursitis and Bursa is simply a fluid filled sac used to reduce friction between tissue layers, between two tendons or between bone and tendon. As the tendons rub together, inflammation can set it, and we call this a bursitis. There are many bursa located over the lateral side of the hip and any one of them could be the cause of the pain.
We now know that there are many other culprits that could be causing the pain on the lateral side of the hip. The Gluteus minimus tendon and Gluteus medius tendon, both extend from the buttock region and insert on a greater trochanter located in the lateral side of the hip. Partial tears or inflammation in these tendon sheaths can cause pain in the area without an underlying bursitis. Additionally, a snapping sensation can be felt over that side of your hip and it’s more apparent when you’re climbing stairs or any motion with hip flection. This is caused by the Gluteus maximus tendon or the proximal iliotibial band as it travels back and forth over the greater trochanter increasing the friction.
Symptoms of Greater Trochanteric Pain Syndrome include pain on the outside of your hip. It’s often worse with pressing in the area, climbing stairs or lying on the affected side. Treatment of greater trochanteric Pain Syndrome includes treating the inflammation with either oral or topical nonsteroidal anti-inflammatory medications. Corticosteroid injections guided towards the pathology identified on ultrasound. Imaging can also address the inflammation. It is important to follow this up with a course of physical therapy to address any bio mechanical or muscle imbalances to prevent recurrence of the symptoms. If physical therapy and anti-inflammatory medications failed to improve the symptoms, regenerative medicine techniques can be used for refractory cases. These include tenotomy, prolotherapy or platelet rich plasma injections. It is also important to recognize that Greater Trochanteric Pain Syndrome can develop while trying to compensate for another injury such as osteoarthritis of the hip, sacroiliac joint dysfunction or low back pain. Sometimes by treating this underlying disorder, Greater Trochanteric Pain Syndrome can improve with little direct treatment.”
~Jason Kirkbride DO