The use of “Trochanteric Bursitis” as a diagnosis for lateral hip pain is extremely common in orthopaedics and manual therapy. In fact, a simple google image search of the terms “hip” and “greater trochanter” led mostly to diagrams pertaining to such condition. However, given the numerous anatomical structures in the region of the lateral hip, recent literature has moved towards labeling a collection of signs and symptoms in this region as greater trochanter pain syndrome (likely to the chagrin of my colleague Dr. Andreo Spina, developer of Functional Anatomic Palpation Systems)
Greater Trochanter Pain Syndrome (GTPS) is described to include the following:
• Chronic continuous or intermittent pain local to the greater trochanter region
• Radiation to the lateral hip or thigh
• Pain increase with activity
• Pain aggravated by lying on the affected side
• Pain reproduced upon local palpation of the greater trochanter
• Supine resisted hip external rotation and single-legged stance may be positive for tendinous or bursal involvement
• Higher prevalence in women and those 40-60 years of age
• Patients may also present with tenderness of the iliotibial band and osteoarthritis of the knee (usually due to altered biomechanics of the lower extremities).
Treatment for GTPS commonly consists of an initial course of non-steroidal anti-inflammatory medication, electrotherapeutic modalities, and rehabilitative therapy. Local injection of corticosteroids has been regarded as the standard of care, however, its beneficial effect has yet to be validated by controlled research methods.
In practice, I generally utilize the approach taken by Dr. Spina (above) and aim for specificity in my diagnosis. Understandably, advanced imaging may be necessary to be 100% precise, however, as my colleagues at F.A.P. preach:
Specificity of Diagnosis = Specificity of Treatment = Specificity of Results!!!
*note: My review on the recently published study entitled “Home Training, Local Corticosteroid Injection, or Radial Shockwave Therapy for Greater Trochanter Pain Syndrome” from the American Journal of Sports Medicine will be posted shortly on Research Review Service