Greater Trochanteric Bursitis
What is it?
Greater Trochanteric Pain Syndrome (GTPS) is a painful condition, affecting the outer thigh and hip area.
It happens when the tissues that lie over the bone at the top of the thigh (greater trochanter) become irritated. These tissues can include tendons, muscles or fluid-filled sacs (bursae) that help smooth movement between muscles, tendons and the hip bone.
This irritation might happen for a number of reasons, but it is most often due to overload. The structures cannot cope with the strain being put on them.
You will usually not need scans to diagnose GTPS. It is diagnosed through taking a medical history, and doing specific tests of the hip during a physical examination.
Symptoms
Pain in your outer thigh and hip area. This might feel like an aching or burning pain. The pain might be worse when you are lying on your side, especially at night.
The pain might be worse with exercise.
You might walk with a limp.
Mechanism of Injury
GTPS is most common in adult women. The exact cause is not fully understood. There are many factors that can contribute to it.
A direct fall on the outside edge of your hip.
Excessive load, for example prolonged walking or running. Poor running style can also lead to increased load on this area of the hip.
Prolonged or excessive pressure to your hip area can make GTPS worse. For example, sleeping on your affected side.
Weakness of the muscles surrounding the hip.
Common Management Techniques
Specific loading exercises prescribed by your Physiotherapist – research has shown that loading the muscles/tendons at the correct dosage results in better and faster outcomes.
Education/Advice – specific solutions to avoid aggravating movements.
Massage – reduce tension and spasm in associated muscles to promote better movement.
Dry Needling/Acupuncture – is a safe way to release tight muscles and decrease pain levels.
Heat/Ice – can be effective treatment modality that can be used to ease discomfort at home or at work.
Prognosis
Everybody will improve differently. For most people it will take 6 to 9 months of rehabilitation to make a return to full activities without pain.
It is normal to have some periods of increased pain, or flare-ups, during your recovery. If this happens, you might need to reduce your exercises until the pain returns to previous levels.
If your symptoms do not improve in 6 to 9 months, even when you have been completing an appropriate exercise programme, other treatment options can be considered. This includes injections, which you can talk to your physiotherapist about.