What is it?

Greater trochanteric pain syndrome refers to pain originating from various structures in the lateral hip, including tendons and bursa. The greater trochanter is a bony landmark on the outside of the hip, just below the neck of the femur. This is the location where several tendons attach, including those from the gluteus maximus, medius, minimus and the tesnor facia latae. Due to the contraction of all these muscles around the bones of the hip, there are structures called bursae. Bursae are fluid-filled sacs that function to lubricate joints in areas where there is large amount of friction due to constant sliding of tendons over bones.

Why did I get it?

Pain at the greater trochanter can be caused by trauma, but more often it is associated with repetitive micro-trauma caused by active use of the muscles inserting at this location. The micro-trauma results in degenerative changes of tendons, muscles, or fibrous tissues. Altered lower limb biomechanics has been associated as a predisposing factor to greater trochanteric pain syndrome.

How is it diagnosed?

A thorough clinical examination by a physiotherapist will most commonly diagnose the condition due to the clinical findings. Occasionally diagnostic imaging may be used to determine the site and extent of the pathology.

Treatment options

  • Non-steroidal anti-inflammatory drugs
  • Behaviour modification
  • Addressing joint biomechanics
  • Manual therapy
  • Improving flexibility
  • Steroid injections (in severe cases or if pain persists)

Prognosis

Favourable outcomes are expected of those whom have been diagnosed with greater trochanteric pain syndrome as the condition normally responds well to conservative physiotherapy management.

Recommendations

Early stages

  • Activity modification – avoid aggravating activities
  • Ice
  • Anti-inflammatories
  • Self trigger point massage
  • Exercises to correct biomechanical faults

Exercises

  • Heel tap/step down
  • Glute med strengthening – standing theraband
  • Core strength – bridges
  • Foam rolling of ITB
  • Pretzel stretch