Best Practice Case Studies-Case 135 Asset 5 Trochanteric Pain Syndrome

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Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain and tenderness, especially in women. It is now understood to involve irritation or inflammation of structures around the greater trochanter, often the gluteal tendons and other soft tissues, rather than just the trochanteric bursa, which is why the older term “trochanteric bursitis” is less accurate.<br /><br />Symptoms include pain on the outside of the hip, swelling, stiffness, and tenderness over the greater trochanter. Pain often worsens with walking, pressure on the area, or lying on the affected side at night. GTPS can affect one or both hips. Common risk factors include female sex, obesity, knee pain, iliotibial band tenderness, and low back pain. Redness, marked swelling, fever, or malaise are not typical and may suggest another problem, such as infection.<br /><br />Diagnosis usually relies on a detailed history and physical examination. Imaging is often unnecessary, though x-rays, ultrasound, CT, or MRI may be used if another condition is suspected.<br /><br />Most cases improve on their own within weeks to months, though some last longer. Treatment may include activity modification, ice or heat, NSAIDs or other pain relievers, home exercises, and physical therapy. Steroid injections may be used if conservative care fails or pain is too severe for rehabilitation. Surgery is rarely needed.<br /><br />Prevention focuses on stretching and strengthening the hips, legs, and low back, maintaining a healthy weight, eating well, avoiding tobacco and excessive caffeine, getting enough sleep, and moving regularly during the day. Physical activity usually does not need to stop completely, but may need to be modified.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 135

Topic Hip

Keywords

greater trochanteric pain syndrome

GTPS

lateral hip pain

gluteal tendons

trochanteric bursitis

hip tenderness

physical therapy

steroid injections

risk factors

hip exercises

4th Edition

4th Edition, Case 135

Hip