Do you get pain when you lay on your side at night time? Finding that walking for long distances at pace is causing you pain in your hip and buttock?
You may have Greater Trochanteric Pain Syndrome (GTPS).
GTPS is a broad term that encompasses any pain relating to the lateral hip. It includes conditions such as
- Trochanteric bursitis (which affects the fluid filled sac behind the hip whose role is to reduce friction between the tendon and the greater trochanter of the femur)
- Gluteal tendinopathies (which is an injury relating to the tendons that insert into the greater trochanter of the femur)
What Causes Greater Trochanteric Pain Syndrome (GTPS)?
There are many causes of GTPS but the common causes include :
- Prolonged exposure to pressure on the hip (laying on your side)
- Repetitive movements (such as walking or running)
- Direct trauma (such as falling onto your side)
- Beginning vigorous exercise which your body is not used to
- Post-menopausal women are at greater risk of GTPS
What Are The Symptoms Of GTPS?
Greater Trochanteric Pain Syndrome can feel like a
- Dull aching pain in the lateral buttock (around the back of the hip joint)
- Pain directly on the side of the hip (for example when laying in bed at night time)
- Aching pain that radiates down the outside of your leg until your knee
In general, it will worsen over time and is particularly noticeable after performing weight bearing exercise.
How Is It Diagnosed?
Your physiotherapist will question you thoroughly first and then perform some tests to see if they can reproduce the pain.
Generally, it will be painful to touch just behind the greater trochanter (most bony part of your hip).
It can also be accompanied by gluteal muscle weakness, which is evident with a single leg squat.
If you have seen your General Practitioner, they may have sent you for an X-Ray and Ultrasound of your hip and may have recommended having a cortisone injection.
To Cortisone Or Not To Cortisone, That Is The Question!
On Ultrasound, the radiologist may have picked up that your Bursa is inflamed and may benefit from a cortisone.
Although the decision is yours, there are pros and cons.
The injection may help settle the pain down in the short term, but for long term relief you will need to engage in strengthening exercises to keep the muscles and tendons strong and address the cause of the problem not just the symptoms.
Physiotherapy For Greater Trochanteric Pain Syndrome
Initially your physiotherapist will work with you to help reduce the pain you have been experiencing. They may use techniques such as
Once the pain has settled, your local physiotherapist will move you into the next phase of your rehabilitation – improving range and strength. Treatment may now include less ‘hands-on’ techniques and involve more exercises that target the cause of the problem such as weak gluteal muscles.
In the longer term, exercise therapy (whether it be completed at home or as part of an exercise class) has been shown to improve outcomes significantly.
In some cases, pain may not settle with physiotherapy and may require further investigation.
5 Tips To Help Relieve Your Hip Pain
It is important to do whatever you can to reduce the aggravating factors that lead to pain in the hip.
Following these few tips and tricks can help settle the pain quicker and get you back to your normal hip-pain free self!
- Avoid crossing your legs and/or ankles when sitting
- Get in and out of the car like you are wearing a mini skirt! (keep your knees together)
- Make sure that your hips are slightly higher than your knees when you are sitting on a chair or the couch (you may find sitting on a dining chair more comfortable than a soft, low couch)
- Sleep on your unaffected side with a thick pillow between your knees at night time
- Use heat packs to help temporarily relieve the pain
Do You Have Lateral Hip Pain?
If you suspect that you may have Greater Trochanteric Pain Syndrome, consult your physiotherapist ASAP. The sooner that you address the problem, the sooner it will resolve with the right tools.
Want to read more about hip pain? Check out some of our other blogs