Treatment

Explain the patient that the condition is usually self limiting and tends to respond to conservative therapy such as:

• rest
• nonsteroidal anti inflammatory drugs
• application of ice and heat to the affected area
• stretching and strengthening
• weight loss if appropriate
• physical therapy
• behavior modification - aimed at improving flexibility, muscle strength and joint mechanics while decreasing pain
• low energy shock wave therapy (SWT)

Patients who continue to have pain despite the initial conservative methods should be treated with local anaesthetic and corticosteroid injections to provide intermediate-term relief (1)

• the response rate ranges from 60-100%
• inject the point of maximal tenderness (1)

Surgical interventions are reserved for patients with refractory disease, non-respondent to conservative treatments. Surgery usually incorporates a combination of interventions which include:

• bursectomy
• iliotibial band (ITB) release
• trochanteric reduction osteotomy
• gluteal tendon repair (2)

Reference:

• (1) Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesth Analg. 2009;108(5):1662-70
• (2) Reid D. The management of greater trochanteric pain syndrome: A systematic literature review. Journal of Orthopaedics. 2016;13(1):15-28.