If you place your hand on your hip, the bone you feel is the greater trochanter. It serves as an important attachment point for the muscles that move the hip. Greater trochanteric pain syndrome (GTPS) is a general term to describe multiple disorders that cause pain at the side of your hip. Hip pain is most common by overuse and repetitive friction between the muscle tendons. Over time this leads to inflammation and is what causes tendonitis and bursitis. We see hip pain most commonly in women between 40 and 60 years of age but it can happen to anyone at any age. Two specific conditions that associate with GTPS are trochanteric bursitis and snapping hip syndrome.
Trochanteric Bursitis
Trochanteric bursitis involves any of the three bursae that surround the hip near the muscle-tendon attachments. Most patients who present with lateral hip pain have a diagnosis of trochanteric bursitis or inflammation of the iliotibial band (IT Band syndrome). However, studies have found that GTPS almost always (92% from one study of 877 patients) involves BOTH tendonitis and bursitis simultaneously.
External coxa saltans, better known as “snapping hip” is typically caused by muscle tendons snapping as they ride over the greater trochanter. Movements that often reproduce the snapping are running or kicking a ball. Interestingly, snapping hip can be painless. However if inflammation of the bursae occurs the hip can become quite painful.
Chiropractors will perform several tests when a patient presents with hip pain to reproduce pain over the greater trochanter. X-ray, ultrasound, and MRI may also be utilized to confirm diagnosis and to rule out other causes of hip pain.
Hip Pain Conclusion
Chiropractic care for GTPS has a high success rate. Treatments may include manual therapy; correcting leg-length asymmetries with heel lifts; PT modalities such as pulsed ultrasound, electric stim, laser, pulsed magnetic field, and shock-wave therapy; exercise training; and activity modification education. For stubborn cases, your chiropractor may refer you for an injection of either cortisone or plasma-rich protein (PRP). On rare occasions, surgery may be appropriate.
