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Greater Trochanteric Pain Syndrome

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trochanteric pain

After osteoarthritis, greater trochanteric pain syndrome is the most frequently encountered hip ailment, estimated to affect approximately 10% to 20% of the population. The individual typically experiences pain with single-leg stance, and the discomfort is often aggravated by side-lying on the affected hip.

This problem affects females four times as often as males.  Most commonly seen in ages of 40 to 60 year-olds. This common condition can be surprisingly difficult to treat without proper Chiropractic care and rehabilitative exercises, and symptoms may last months to years. While it was originally believed the lateral hip pain resulted from chronic inflammation in one of the three greater trochanter bursae, recent research confirms bursal inflammation correlates poorly with the presence of lateral hip pain. As a result, the term greater trochanteric bursitis has been abandoned in favor of greater trochanteric pain syndromegreater-trochanteric-pain-syndrome

Based on research the following outcomes proved very interesting.  One particular study of 229 patients diagnosed with unilateral greater trochanteric pain syndrome divided into one of three treatment protocols: a single local corticosteroid injection (25 mg prednisolone); a repetitive low-energy shockwave treatment; or a home training program that included specific hip abductor / rotator stretches and exercises as follows, performed twice daily, seven days a week for 12 weeks.  Study findings were interesting in that corticosteroid injection produced significant short-term improvements, while shockwave treatment and home stretches / exercises produced better long-term results.  Even though the injections initially gave better pain relief after a few months the exercise group had a far better outcome with greater pain reduction.

Other case evaluations indicate that home therapy coupled with chiropractic care offers the best long term outcome.  This approach restores function and rebalances the muscles.

Here are some of the exercises which I recommend for this problem.  If this does not seem to resolve quickly the most likely reason is nerve irritation of the lumbar spine.  Chiropractic treatment will correct this and allow for better and faster results.

Yours for Better Health, Dr. Shapero


Hip, Knee, Ankle and Foot Problems

Pain in hip concept
Many people think of chiropractic care as back care. It is true that chiropractic has a focus on the spine, primarily the nervous system. What many are unaware of is that chiropractic is concerned with restoring function to the entire body. With that in mind in my office I help people with problems in the arms and hands, as well as the hip, knee, ankle and foot. In a study published in 2009 by Brantingham et al, 2009, the authors reviewed all the research to date that was relevant to chiropractic and treatment of the hips, knee, ankle and foot. The research is growing at an incredible rate and has shown to be extremely effective in these areas of the body as well.

The authors reported “The data demonstrate that most chiropractors, based upon their professional training, routinely diagnose and treat extremity conditions” (p54). They also state “Extremity treatment is the second most frequently applied procedure within the chiropractic profession, with 76.1% reportedly using spinal and extremity procedures as compared with 18.7% who limit their practice to the spine only”. (p54).

The following chart will help you to see what conditions fell under the review of this research paper and how many studies there were related to a specific condition.

Condition Responded to Chiropractic Care Study Name and Date
Hip Osteoarthritis
Hoeksma et al 2004
Brantingham et al 2003
MacDonald et al 2006
Knee Osteoarthritis
Deyle et al 2000
Deyle et al 2005
Tucker et al 2003
Moss et al 2007
Hillerman et al 2006
Cliborne et al 2004
Currier et al 2007
Ankle Sprain
Pellow and Brantingham 2001
Green et al 2001
Coetzer et al 2001
Eisenhart et al 2003
Collins et al 2004
Vicenzino et al 2006
Lopez-Rodriquez et al 2007
Kohne et al 2007
Plantar Facitis
Dimou et al 2004
Metatarsalgia (pain in the foot)
Peterson et al 2003
Govender et al 2007
Big Toe Pain Shamus et al 2004
Brantingham et al 2005

If you have been dealing with one of these conditions for longer than a week or so chances are there are some underlying problems that
have gone undetected. If the problem was simply muscle you would see some diminishing pain within a day or two.
If you have overworked a muscle taking a nice hot shower or bath and resting should relieve the pain within a day or so. If the area has been strained then ice should be applied for an hour or so in ten minute increments. If anti-inflammatory medications are used they will
begin to interfere with healing after about 72 hours of use. If you have one of the above situations occurring and it seems to come and go or not fully resolve after a week or so then it is time to look deeper.

The authors concluded Overall, when reviewing the increasing quantity and quality of included trials, Chiropractic care for lower extremity disorders appears to be of high value and safe.

When it comes to your health, nothing is more important than your nervous system. That is why doctors of chiropractic will always screen your spine for evidence of pinched nerves while they are attending to problems in other areas of your body. If you are suffering with problems in your hips, knees, ankles or feet, Dr. Shapero’s care has been show to have positive effects on symptoms and function. Serving the community for over 25 years.

  1. James W. Brantingham, DC, PhD, Gary Globe, DG, MBA, PhD, Henry Pollard, DG,Marian Hicks, MSLS, Gharmaine Korporaal, MTech:Chiropractic and Wayne Hoskins, BGhSc, MGhiro MANIPULATIVE THERAPY FOR LOWER EXTREMITY CONDITIONS: EXPANSION OF LITERATURE REVIEW. J Manipulative Physiol Ther 2009;32:53-71.

To Your Health, Dr. Shapero

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