What are the treatment options for greater trochanteric pain syndrome?
Greater trochanteric pain syndrome will usually resolve without any specific treatment. However, it often takes several weeks or more and for some unlucky people, may last months or even longer.
Reducing or avoiding activity (such as running or excessive walking) for a while, may help to speed recovery. In addition, the following may be useful:
- Early on, applying an ice pack (wrapped in a towel) for 10-20 minutes several times a day may improve your symptoms.
- Taking paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may help to reduce the pain.
- Losing weight. If you are overweight or obese then losing some weight is likely to improve your symptoms.
- Physiotherapy is often used and is often very effective.
- Injection of steroid and local anaesthetic. If the above measures do not help then an injection into the painful area may be beneficial.
- If the condition is severe or persistent then you may be referred to a specialist for advice regarding further treatment.
Joint (intra-articular) steroid injection
There is strong evidence of a short-term benefit from peri-trochanteric corticosteroid injections for up to three months with the greatest effect at six weeks; however, pain coming back in the long term is common. Peri-trochanteric corticosteroid injections may be most useful if used for pain relief in the short term to enable physiotherapy which will improve the long-term outlook (prognosis).
What is the outlook for greater trochanteric pain syndrome?
Greater trochanteric pain syndrome is usually a self-limiting condition and resolves in over 90% of people with conservative treatment such as rest, analgesia, physiotherapy, and corticosteroid injection.
Risk factors for a poorer outcome include a worse symptom profile, ie greater pain intensity, longer duration of pain, greater limitation of movement, and greater loss of function, and older age.
Further reading and references
Greater trochanteric pain syndrome (trochanteric bursitis); NICE CKS, August 2016 (UK access only)
Williams BS, Cohen SP; Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 2009 May108(5):1662-70.
Strauss EJ, Nho SJ, Kelly BT; Greater trochanteric pain syndrome. Sports Med Arthrosc. 2010 Jun18(2):113-9.
McMahon SE, Smith TO, Hing CB; A systematic review of imaging modalities in the diagnosis of greater trochanteric pain syndrome. Musculoskeletal Care. 2012 Dec10(4):232-9. doi: 10.1002/msc.1024. Epub 2012 Jul 4.
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