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Greater Trochanteric Pain Syndrome (GTPS)

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Greater Trochanteric Pain Syndrome (GTPS) Greater Trochanteric Pain Syndrome (GTPS) Information for you Follow us on Twitter @NHSaaa Find us on Facebook at www.facebook.com/nhsaaa Visit our website: www.nhsaaa.net All our publications are available in other formats Greater Trochanteric Pain Syndrome (GTPS) Information for you Greater trochanteric pain syndrome (GTPS), also known as lateral hip pain or trochanteric bursitis, is a common condition where you can experience pain and tenderness on the outside of the hip and buttock region, shown in the picture below. Sometimes it may travel down as far as the outside of the knee. Greater trochanteric pain syndrome (GTPS), also known as lateral hip pain or trochanteric bursitis, is a common condition where you can experience pain and tenderness on the outside of the hip and buttock region, shown in the picture below. Sometimes it may travel down as far as the outside of the knee. GTPS is more common in people over 40 years old, and affects more women than men. It can affect both hips and can be associated with low back pain. In most cases, the symptoms from GTPS will ease with time. For those people whose pain persists, treatment is usually GTPS is morepainkillers, common strengtheningin people over exercises 40 years for the old, weak and muscle affects more women than men. It can affect bothgroups hips andand occasionallycan be assoc corticosteroidiated with injection. low back pain. In most cases, the symptoms from GTPS will ease with time. For those people whose pain persists, treatment is usually painkillers, strengthening exercises for the weak muscle groups and occasionally corticosteroidCausesinjection. There are many factors that can contribute to GTPS: Causes: there are many factors that can contribute to GTPS • Inflammation of one of the bursae (a small cushioning • Inflammationfluid filledof one sac of that the lies bursae between (a the small tendons cushioning and fluid filled sac that lies between bones of the hip); the tendons and bones of the hip); 2 • Reduced strength and flexibility of the muscles around the hip and buttock. This in turn can cause a secondary inflammation of one of the bursae around the hip joint; • Secondary to low back pain; • Inactive lifestyle, causing weakness in the buttock muscles; • Being overweight; • Postural habits, for example, standing on one leg for long periods of time, crossing legs when sitting, or lying on affected side for long periods; • Secondary to osteoarthritis (OA) of the hip or knee. Symptoms These can vary from person to person depending on the initial factors that are causing the condition. People may experience: • Pain when walking; standing for long periods; sitting with legs crossed. • Pain at night when lying on the affected side. • Reduced strength and flexibility of the muscles around the hip and buttock. This in turn can cause a secondary inflammation of one of the bursae around the hip joint; • Secondary to low back pain; • Inactive lifestyle, causing weakness in the buttock muscles; • Being overweight; • Postural habits, for example, standing on one leg for long periods of time, crossing legs when sitting, or lying on affected side for long periods; • Secondary to osteoarthritis (OA) of the hip or knee. Symptoms These can vary from person to person depending on the initial factors that are causing the condition. People may experience: • Pain when walking; standing for long periods; sitting with legs crossed. • Pain at night when lying on the affected side. • Pain from the hip joint or the lower buttock region travelling down the outside of the thigh to the knee. 3 Management Helpful tips • Avoid sitting with your legs crossed as this will reduce the pressure on the painful area. • Avoid sitting with your knees wide apart or close together. • When standing, try not to push one hip out to the side or stand on one leg. • Avoid very low chairs. • Keep active but avoid overdoing it. • Use a handrail when climbing the stairs if needed, or take one step at a time with your good leg leading going up and the sore leg leading coming down. 4 • Pain• fromPain the from hip thejoint hip or jointthe loweror the buttock lower buttock region regiontravelling travelling down the down outsidethe outside of the of the thigh tothigh the knee.to the knee. ManagementManagement HelpfulHelpful tips tips • Avoid• sittingAvoid withsitting your with legs your crossed legs crossed as this aswill this reduce will reduce the pressure the pressure on the onpainful the painful • Pain from thearea. hip jointarea. or the lower buttock region travelling down the outside of the thigh to the• knee.Avoid• sittingAvoid withsitting your with knees your wideknees apart wide or apart close or together. close together. • When• standing,When standing, try not tryto pushnot to one push hip one out hipto theout sideto the or sidestand or on stand one on leg. one leg. Management • Avoid• veryAvoidlowvery chairs.low chairs. • Keep• activeKeep, activebut avoid, but overexertion avoid overexertion or activities or activities that you that are you not are used not to. used to. Helpful tips • Use• a handrailUse a handrail when climbing when climbing the stairs theif stairs needed,if needed, or take or one take step one at stepa time at witha time with • Avoid sitting yourwith yourgoodyour legs leg good leadingcrossed leg leading going as this up going will and reduce up the and sore the the legpressure sore leading leg onleading coming the painful coming down. down. area. • AvoidSleep sittingingSleep with positions youring positionsknees wide apart or close together. • When standing, try not to push one hip out to the side or stand on one leg. • AvoidAvoidSleepingvery lowlyingAvoid chairs. on positionslying the onpainful the painfulside or sidewith orthe with painful the painfulleg crossedleg crossed over the over other the as other in the as picture in the picture • Keep below.active,below.but avoid overexertion or activities that you are not used to. • Use a handrail when climbing the stairs if needed, or take one step at a time with your good• Avoid leg leading lying going on the up andpainful the sore side leg or leading with thecoming painful down. leg crossed over the other as in the picture below. Sleeping positions Avoid lying on the painful side or with the painful leg crossed over the other as in the picture below. Try• TrylyingTry lying on lying your on on back your your with backback a pillowwith with a underpillow a pillow yourunder kneesunder your, kneesor your lie on, orknees, your lie on good your side good with side pillows with pillows between your legs to keep them parallel as shown below. betweenor lie your on yourlegs to good keep themside parallelwith pillowsas shown betweenbelow. your legs to keep them parallel as shown below. Try lying on your back with a pillow under your knees, or lie on your good side with pillows between your legs to keep them parallel as shown below. ExercisesExercises Exercises 5 Exercises Below Beloware some are exercisessome exercises which will which help will strengthen help strengthen the affected the muscles and over time help reduceaffected the musclespain. If you and are over seeing time a help physiotherapist reduce the they pain. will advise you further on these. If you are seeing a physiotherapist they will advise you further on these. • Isometric abduction - Lie on your back with the affected leg closest to a wall. Press • theIsometric foot of the abduction affected leg - Lie against on your the backwall and with hold the for ten seconds. Repeat the sameaffected exercise, leg closest but standing to a wall. up. Press the foot of the affected leg against the wall and hold for ten seconds. Repeat the same exercise, but standing up. Below are some exercises which will help strengthen the affected muscles and over time help reduce the pain. If you are seeing a physiotherapist they will advise you further on these. • Isometric abduction - Lie on your back with the affected leg closest to a wall. Press the foot of the affected leg against the wall and hold for ten seconds. Repeat the same exercise, but standing up. • Single leg stand – practice standing on one leg. Try to build up the length of time you can do this for. • Single leg stand – practice standing on one leg.6 Try to build up the length of time you can do this for. • Side lying hip abduction - lie on your good side, painful leg on top and supported on a pillow. Lift the painful leg a couple of centimetres off the pillow and hold for ten seconds. • Side lying hip abduction - lie on your good side, painful leg on top and supported on a pillow. Lift the painful leg a couple of centimetres off the pillow and hold for ten seconds. Below are some exercises which will help strengthen the affected muscles and over time help reduce the pain. If you are seeing a physiotherapist they will advise you further on these. • Isometric abduction - Lie on your back with the affected leg closest to a wall. Press the foot of the affected leg against the wall and hold for ten seconds. Repeat the same exercise, but standing up. • Single leg stand – practice standing on one leg. Try to build up the length of time you can do this for. • Single leg stand - practice standing on one leg. Try to build up the length of time you can do this for. • Side lying hip abduction - lie on your good side, painful leg on top and supported on a • Side lying hip abduction - lie on yourpillow. good Lift side,the painful painful leg a couple of centimetres off the pillow and hold for ten leg on top and supported on a pillow.seconds.
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