Pain on the side of your hip? Conservative and surgical options for treatment

pain on the side of your hip

Greater Trochanteric Pain Syndrome (GTPS) refers to a collection of musculoskeletal conditions that present as lateral sided hip pain or pain on the outside of the hip.

Over the last 10 years our understanding of the causes of lateral hip pain has improved significantly. We have moved from the diagnosis of trochanteric bursitis, to gluteal tendinopathy and now to greater trochanteric pain syndrome. These differences in nomenclature reflect our greater understanding of the complexity of the causes of lateral hip pain.

Conditions affecting the side of the hip

Conditions include

  • Gluteus Medius and Minimus (Gut med/min) tendinopathy,
  • Glut med/min tears (either partial or full thickness),
  • Snapping/tight Iliotibial band,
  • Osteoarthritis of the hip joint, and/or
  • Referred pain from the spine

Conservative Treatment

The initial treatment for greater trochanteric pain syndrome includes

  • rest,
  • activity modification and
  • possibly use of anti-inflammatory pain relief medication.

Physiotherapy plays an important role in the treatment of GTPS.

Physiotherapists will often prescribe an exercise program. This may include ITB stretching, eccentric gluteal strengthening exercises, along with core and deep hip external rotator exercises, as well as perform manual therapy/dry needling.

Some patients who are in too much pain to perform a structured exercise program, may get benefit from a guided corticosteroid injection. The evidence indicates that a steroid injection to the hip is effective in reducing pain and improving function in the short term (up to 12 weeks) in patients with Greater Trochanter pain syndrome, but not effective beyond that. Once the pain has been reduced with an injection, they can then start on their exercise program.

Surgical Treatment

Some patients with tears of their gluteus medius/minimus (partial thickness and especially large, full thickness tears), unfortunately, do not respond to conservative treatment. Referral to an orthopaedic surgeon should be considered, as patients suffering from chronic GTPS appear to suffer levels of disability and quality of life similar to levels associated with end stage hip osteoarthritis.

Surgery for tears of gluteus medius/minimus may be open or “keyhole” (endoscopic), and for small or partial thickness tears, can involve suturing the tendon directly back on to the bone. Large tears (those with tendon retraction/poor quality of tendon or fatty atrophy visible on MRI) are the most difficult to repair, and in the past have been associated with relatively high failure rates (reported up to 30% in some literature). More recent surgical options for these patients include tendon allografts (eg using a donated achilles tendon), gluteus maximus muscle transfer, and synthetic ligament repairs (using LARS ligament).

At Burleigh Heads Physiotherapy Centre, we have had experience in recently treating patients who have undergone LARS ligament reconstruction, and have had excellent results. These patients presented with intractable lateral hip pain and difficulty walking anything more than 5 minutes, and have now progressed to being essentially pain free, and can walk freely.

The rehabilitation following this procedure is quite lengthy but is essential to safely get the maximum recovery possible. Our patients have done well and I am delighted to report that they are very happy with their outcomes.

Can our Physios help you with hip pain? Call for an appointment!

Gold Coast Physiotherapy – Burleigh Heads and Broadbeach Physiotherapy Centres 07 5535 5218

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Our Response to Covid-19

This page is up to date to our best knowledge, however, this is a rapidly evolving situation so we apologise for any potential delay in updating this information.

We want to reassure all our patients that we are following stringent infection control procedures in our clinic, and screen all people coming into the clinic, to exclude any patients that have any signs or symptoms consistent with Covid-19, as well as screening any patients that should be in isolation ie recently returned from overseas, or have been advised to isolate due to recent exposure with a known Covid-19 patient.

All our staff have now completed the Department of Health Covid-19 Infection Control Training.

What are we doing to minimise risk?

  • Screening patients for risk factors over the phone or through text messages before they attend appointments. Those with risk factors or symptoms are advised not to attend & to seek medical advice.
  • Hand sanitiser station at the front of the building must be used before you enter.
  • Following stringent infection control measures within the clinic. This includes
    • Disinfecting all beds, door handles, EFTPOS machine before and after each patient use.
    • Linen changed between each patient and commonly touched surfaces through the practice are cleaned regularly throughout the day.
    • Minimising the distances between clients in the waiting room- some chairs are outside undercover.
  • We have advised our team members not to come to work if they have cold or flu-like symptoms.
  • We are following all Department of Health recommendations for our type of business.

On the 30th March 2020 – the Australian government issued a statement that “People aged over 70, aged over 60 with pre-existing conditions, or Indigenous people aged over 50 should stay home wherever possible for their own protection.”

The decision to come in for physiotherapy treatment really is an individual one – if you feel that your treatment is medically necessary, and are comfortable with the risks of leaving your home and coming to physiotherapy, then rest assured that when you attend our physiotherapy clinic, we are following our strict infection control processes and doing everything we can to minimise your risk whilst in our care. However, we completely understand if you are not comfortable with coming in for treatment.

TELEHealth Consultations

We are offering telehealth consults and home visits (where suitable) for patients who cannot attend our clinic.

Read more about TELEhealth Consultations here.

Staying Healthy

  • Wash your hands often (and for 20 seconds) with soap and water
  • Cough into your elbow or use a tissue to cover your mouth when you cough or sneeze
  • Social distancing practices – Avoiding close contact with others, such as touching, including shaking hands
  • Limit contact with people who are sick, and stay home if you are sick and encourage employees to stay home when sick
  • Get 7-8 hours’ sleep a night to help your immune system stay strong
Please stay safe and take care of each other!

We are monitoring the situation very closely and will make adjustments to our business as we are further informed. Our priority is the health & well being of our patients and our staff. Thanks for your understanding.

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