Greater Trochanteric Pain Syndrome
What is Greater Trochanteric Pain Syndrome?
Greater Trochanteric Pain Syndrome (GTPS) encompasses trochanteric bursitis, an inflammation of the trochanteric bursa, abductor tendinopathy, tears or inflammation of the gluteus medius and/or minimus muscles, and external coxa saltans or snapping hip. Bursae are sacs filled with fluid located throughout the body that help to reduce friction between muscles, tendons and bones, and allow for tendons and muscles to slide smoothly so you can move easily. Pain occurs when the muscles and tendons are inflamed or torn.
Greater Trochanteric Pain Syndrome can be caused by an injury to the hip, rheumatoid arthritis, bone spurs, wear and tear, or from abnormal hip motion for example from osteoarthritis or a labral tear. Additionally, it can be caused by overuse from activities such as running, stair climbing, bicycling, or standing for long periods of time.
Diagnosis and Examination
To receive a diagnosis, a qualified healthcare professional that specializes in musculoskeletal disorders will perform a detailed examination of the hip. Diagnostic imaging may be needed including X-rays, MRI, or ultrasound. An image-guided or office based injection may be recommended as well for diagnostic and therapeutic purposes.
Many people with Greater Trochanteric Pain Syndrome can experience relief by avoiding the activities that worsen symptoms. Additionally, physical therapy and/or injections may aid in relieving pain. Most treatment typically is non-operative.
If the bursa remains inflamed and painful after all non-surgical treatments have been tried, your doctor may recommend surgical removal of the bursa. Removal of the bursa should not compromise the hip joint itself, and the hip can function normally without it. In endoscopic removal, the bursa is removed through a small (1/4-inch) incision over the hip. A small camera, or arthroscope, is placed in a second incision so the doctor can guide miniature surgical instruments and cut out the bursa. Should the underlying problem be a tear in the abductors, the gluteus medius and minimus, this can be repaired openly or endoscopically similar to repairing the rotator cuff in the shoulder. Should the pain come from a snapping ilitiobial (IT) band, this can be released openly or endoscopically as well.