The Greater Trochanteric Pain Syndrome: Clinical Presentation, Diagnosis, and Management

Abstract

Purpose of ReviewThis review describes the greater trochanteric pain syndrome in terms of its clinical presentation, diagnosis, and management.Recent FindingsWe emphasized recent studies including emerging therapies such as radiofrequency ablation of the trochanteric branches of the femoral nerve and new surgical therapies such as minimal invasive surgery and gluteal reconstruction.SummaryWe describe conservative therapies, such as lifestyle modifications and physical therapy and pharmacological approaches including local injections, as well as surgical procedures. Until recently, local injections involved the use of only local anesthetic and/or corticosteroid; however, recent studies have suggested a potential role for platelet-rich plasma or hyaluronic acid. In the absence of a gluteal tear or rupture, management is initially focused on the use of analgesics to control pain, lifestyle measures, and prolonged physical therapy to improve local muscle strength, followed by the addition of local extracorporeal shock wave therapy. If symptoms persist, a new approach involves an injection of local anesthetic, potentially followed by a corticosteroid or platelet-rich plasma injection, based on the response to the initial anesthetic injection. In the case of refractory pain or tendon rupture, surgical treatment may be indicated, depending on the age of the patient and the degree of local muscle atrophy and fatty infiltration.