Greater trochanteric pain syndrome

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In a commentary on a study in the Journal of Orthopaedic & Sports Physical Therapy exploring dry needling techniques versus cortisone, Greater trochanteric pain syndrome (GTPS) is described as a chronic, intermittent pain and tenderness on the outside of the hip.

Treatment was also described as a medical community thinking that a swollen hip bursa was the source of such pain, which led to the use of corticosteroid injections to the bursa to help decrease swelling and pain.

Researchers now believe that injuries to the muscles and tendons around the hip are the actual cause of Greater trochanteric pain syndrome, not bursitis, in fact inflammation is often not one of the patient’s symptoms


Treating hip pain means treating the hip as a whole. Not on a specific, isolated diagnosis. This may answer why some hip procedures did not work as well as they should have.


The hip is a big joint, we believe to help patients achieve their treatment goals, they need to have their entire hip treated with our comprehensive Prolotherapy program for hip pain. This is explained below.

An example of concentrating on specific hip problems instead of treating the whole hip joint can be found in medical research studies trying to find out why some hip procedures did not work as well as they should have.

An example is a paper from doctors representing Italy’s leading research hospitals.(1) The team looked to see what caused greater trochanter pain syndrome in patients with suspected femoroacetabular impingement syndrome. After magnetic resonance arthrography of the hip and an evaluation of 189 patients, in the end it was hard to say what was the true pain cause because there were so many problems with the patient’s hips that they far outnumbered femoroacetabular impingement syndrome problems.

The biggest problem the patients had was 38% had tendinopathy of the hip, 16% had bursitis. Problems considered “normal hip pathology,” so there were many problems causing the patients discomfort.

Greater trochanteric pain syndrome – treatment debates – bringing in the needles


In a study published in The Journal of orthopaedic and sports physical therapy, doctors explored dry needling (injections where nothing is injected) as an alternative to cortisone injections to reduce pain and improve function in patients.

More on Dry Needling vs Cortisone

In the studyin  the Journal of Orthopaedic & Sports Physical Therapy, doctors documented their research.

In other words, dry needling worked just as well.

Greater trochanteric pain syndrome diagnosis and evaluation can be tricky


Researchers writing in the medical journal Current sports medicine reports gave a good summary of the challenges of identifying and treating Greater trochanteric pain syndrome. Here is what they wrote:

Why do clinicians keep looking for bursitis when bursitis is not the problem?


Supportive of this statement is multiple studies showing that degeneration of the gluteal tendons, which attach near the bursa often fool providers into thinking the patients have bursitis.

The first study come from the European journal of radiology:

Researchers from Argentina came to the same conclusion:

Researchers from Australia came to the same conclusion:

Researchers from United States came to the same conclusion:

Continuing your research on treatments on our site:
The following pages offer treatment options as offered her at Caring Medical.


1. Pozzi G, Lanza E, Parra CG, Merli I, Sconfienza LM, Zerbi A. Incidence of greater trochanteric pain syndrome in patients suspected for femoroacetabular impingement evaluated using magnetic resonance arthrography of the hip. La radiologia medica. 2017 Mar 1;122(3):208-14. [Google Scholar]

2 Hip Pain: Dry Needling Versus Cortisone Injections. J Orthop Sports Phys Ther 2017;47(4):240. [Google Scholar]

3 Brennan KL, Allen BC, Maldonado YM. Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial. J Orthop Sports Phys Ther. 2017 Apr;47(4):232-239. [Google Scholar]

4. Ho GW1, Howard TM. Greater trochanteric pain syndrome: more than bursitis and iliotibial tract friction. Curr Sports Med Rep. 2012 Sep-Oct;11(5):232-8. [Google Scholar]

5.Kong A, Van der Vliet A, Zadow S. MRI and US of gluteal tendinopathy in greater trochanteric pain syndrome. European Radiology. 2007;17(7): 1772-1783. [Google Scholar]

6.  Quiroz C, Ruta S, Rosa J, Navarta DA, Garcia-Monaco R, Soriano ER. Ultrasound evaluation of the Greater Trochanter Pain Syndrome: Bursitis or tendinopathy? [Google Scholar]

7. Connell DA, Bass C, Sykes CJ, Young D, Edwards E. Sonographic evaluation of gluteus medius and minimus tendinopathy. European Radiology. 2003; 13(6): 1339-1347. [Google Scholar]

8. Long SS, Surrey DE, Nazarian LV. Sonography of Greater Trochanteric Pain Syndrome and the rarity of primary bursitis. American Journal of Roentgenology. 2013; 201(5): 1083-1086. [Pubmed] [Google Scholar]


 

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