Your hip typically has about six small fluid-filled sacs called “bursa” that act as cushions between tendons and bone. One of the most common causes of hip pain is a condition called, “hip bursitis” which means that one or more of your bursas have become painfully inflamed. The broader (more accurate) diagnosis of “Greater trochanteric pain syndrome” (GTPS) describes an uncomfortable collection of problems affecting the outermost portion of your hip. GTPS can include swelling of one or more of the fibrous tendons that attach your muscles onto your hip – a condition called, “tendinitis.” In addition to bursitis & tendonitis, GTPS may originate from tightness in the muscle that travels over your hip en route to your knee- resulting in compression and irritation to your hip.
Greater trochanteric pain syndrome is most common in middle age to elderly adults and is 2-4 times more common in females. Sometimes the problem affects both hips at the same time. Approximately 1/3 of patients with GTPS have lower back pain. Patients who have arthritis in their hips and knees are more likely to suffer from ongoing complaints.
Your symptoms probably include a persistent pain on the outside of your hip, buttock, and upper thigh. Your discomfort may be aggravated by sitting with your leg crossed, arising from a seated position, prolonged standing, climbing stairs, and high-impact activities, like running. Sometimes patients find it difficult to sleep, since lying on the painful hip usually increases symptoms.
For adults, x-rays may or may not be needed to confirm the diagnosis, but children and adolescents usually require films to rule out more serious childhood diseases. Be sure to tell your doctor if you notice that you have a fever, leg numbness, pain radiating significantly beyond your knee, or pain in the front of your groin crease (the area where you leg meets your pelvis.)
Conservative treatment, like the type provided in this office, is successful in about 90% of cases. If you have acute pain, you may need to temporarily limit or discontinue activities that increase your discomfort. Using ice or ice massage at home may help. Some patients find temporarily relief by applying sports creams. Very commonly, patients with pain on the outside of their hip suffer from weakness in one of their buttock muscles, called the “gluteus medius.” When this muscle lacks strength, it is unable to protect your hip during normal activities, like walking. Research has shown that strengthening your hip has a dramatic effect on your progress.
Athletes should avoid running on a banked surface, like the crown of a road or indoor track. Be sure to reverse directions each mile if you run on a circular track. Avoid running on wet or icy surfaces, as this can cause increased tension in your hip. Runners with a “lazy” narrow-based running gait will benefit by increasing their step width to minimize stress on their hip. Cyclists need to make sure that their seat is not positioned too high. Overweight patients should consider weight reduction programs.