Most patients with hip joint problems feel their pain in the groin. Many patients feel pain on the side of the hip around the bony prominence called the trochanter and this most commonly is not from the hip joint itself.
This pain is called Greater Trochanter Pain Syndrome and is particularly common in post-menopausal women.
What causes GTPS?
We don’t know what the cause is. Some patients have a spontaneous onset of pain while others can recall a minor injury or fall which starts the symptoms.
Pain can come from a number of sources. Most commonly there is some inflammation of the gluteal tendons or tendinopathy.
Sometimes there can be a tear of one or more of the gluteal tendons. There can be inflammation of the bursa (sack of lubricating fluid) over the trochanter (trochanteric bursitis) or the band of tissue that rubs over the hip (the iliotibial band or ITB) can be thickened and inflamed.
How do I treat GTPS?
GTPS can be a difficult problem to treat. Initially anti-inflammatory medication such as Indocid, Nurofen, Voltaren and Celebrex are used along with pain killers. Physiotherapy is the mainstay of treatment and you need a physiotherapist with experience treating this condition to look after you. It will take a number of months for physiotherapy to work. Occasionally we use injections such as cortisone or Platelet Rich plasma (PRP) to help with your treatment
Do I need investigations?
In the first instance a diagnosis can often be made from the history and examination. Often an x-ray is taken to exclude arthritis and an ultrasound may be used to show the condition of the tendon. An MRI is sometimes used to look for other causes of hip pain.
Do I need surgery?
Surgery is only considered when all else fails. Should there be a large tear in the tendon, surgery may be considered, but often the tendon is of poor quality and repairs may not be very strong. Surgery is associated with a long period of rehabilitation.