Greater trochanteric pain syndrome


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Greater trochanteric pain syndrome is a condition which causes pain on the outer side of the hip that may also travel down the outer side of the leg. In many people the pain is caused by a problem with the tendons of some of the muscles that work around the hip (tendinopathy); and in some people a fluid filled pouch called a bursa, which lies in this area, can get inflamed.

What are the symptoms of greater trochanteric pain syndrome?
Symptoms include:
  • Pain – this is often felt in a specific area on the outside of upper thigh, and can become very painful and tender to touch
  • Swelling – can occur around the same area
  • Pain when walking and going up or down stairs
  • Difficulty crossing the legs
  • Pain when lying on the painful side in bed
  • Warmth around the outside of hip
The level of pain can vary from person to person, most people report a dull ache which often can interrupt sleep at night.

What causes greater trochanteric pain syndrome?
This problem can develop after a direct trauma to the side of hip, such as a fall. More commonly it can develop due to the surrounding muscles becoming weak, poor posture, or sometimes it can develop with seemingly no cause.

How is it diagnosed?
Usually a doctor or Physiotherapist will be able to make a confident diagnosis from your symptoms following a physical assessment. However sometimes an ultrasound scan may help aid diagnosis.
 
How can I manage my greater trochanteric pain?
  • Paying close attention to posture and position can help with this problem
  • Avoid crossing the legs while sitting and try to avoid letting your knees come together as you get up from a chair
  • Avoid sleeping on the painful side and try placing a pillow between the knees
There is self-management advice provided below to help minimise symptoms and facilitiate the healing process:

Pain relief
Painkillers such as paracetamol and ibuprofen or anti-inflammatory gels may be helpful to control the pain and allow you to continue exercising. Discuss this with your GP or Pharmacist.

Some people find ice effective in reducing their pain. Apply an icepack for 15 mins, two to three times a day. Avoid applying the ice directly to your skin,instead use a towel or have a fabric layer inbetween.

If pain is a significant problem and you are unable to exercise, in some cases a steroid injection may be useful in the short term to enable you to exercise the leg.

Weight loss
If you are overweight, reducing your weight can also improve symptoms through reducing the stress on your joints and muscles. 

Exercise
It may take up to 12 weeks of exercise rehabilitation to make a significant improvement in the symptoms but you should see some gradual improvements along the way.
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Further management options
If there is no response to the self-management information above within four to six weeks, seek further advice from your Physiotherapist or GP.  


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