Greater Trochanter Pain: Causes and Treatment Options - Orthopedics

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Greater trochanter pain syndrome (GTPS) is a common condition that affects the area around the greater trochanter, which is the bony prominence on the upper part of the femur (thigh bone). This condition can result in pain and tenderness in the hip region, particularly when pressure is applied or during certain movements, such as stretching the hip outward. Your description of experiencing localized tenderness, a "stringy" sensation, and pain during specific movements aligns with the typical symptoms of GTPS.


Causes of Greater Trochanter Pain
1. Trochanteric Bursitis: One of the most common causes of pain in this area is inflammation of the bursa, a small fluid-filled sac that reduces friction between tissues. Trochanteric bursitis can occur due to repetitive activities, direct trauma, or prolonged pressure on the hip.

2. Tendonitis: The gluteus medius and minimus tendons, which attach to the greater trochanter, can become inflamed or irritated, leading to pain. This is often seen in individuals who engage in activities that involve repetitive hip movements.

3. Muscle Strain: Strain or injury to the muscles around the hip can also lead to pain in this area. This can happen due to overuse, improper technique during physical activities, or sudden increases in activity levels.

4. Hip Osteoarthritis: Degenerative changes in the hip joint can lead to referred pain in the greater trochanter area, especially in older adults.

5. Other Conditions: Less commonly, conditions such as fractures, tumors, or infections can cause pain in the hip region.


Treatment Options
1. Rest and Activity Modification: Avoid activities that exacerbate the pain, such as running or prolonged standing. Allowing the affected area to rest can help reduce inflammation.

2. Ice Therapy: Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce swelling and numb the pain.

3. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help alleviate pain and reduce inflammation.

4. Physical Therapy: Engaging in physical therapy can be beneficial. A physical therapist can provide exercises to strengthen the hip muscles, improve flexibility, and enhance overall function. Stretching exercises for the hip and gluteal muscles may also be recommended.

5. Corticosteroid Injections: If conservative measures do not provide relief, a healthcare provider may recommend corticosteroid injections into the bursa to reduce inflammation.

6. Surgery: In rare cases, if conservative treatments fail and the pain persists, surgical options may be considered to remove the inflamed bursa or repair any tendon injuries.


Seeking Medical Attention
Since you are currently abroad, it is advisable to seek medical attention from a local healthcare provider if the pain persists or worsens. They can perform a physical examination and may recommend imaging studies, such as an ultrasound or MRI, to rule out other potential causes of your pain.

In summary, greater trochanter pain can arise from various causes, primarily related to inflammation of the bursa or tendons around the hip. Treatment typically involves conservative measures, including rest, ice, NSAIDs, and physical therapy. If symptoms persist, consulting a healthcare professional is essential for a proper diagnosis and treatment plan.