Lateral Hip pain

What is Lateral Hip Pain?

Lateral hip pain refers to pain on the side of the hip around the region of the greater trochanter.   This condition has been commonly known as trochanteric bursitis, but in more recent times the involvement of muscles and tendons of the buttocks have been recognised as a source of pathology and the term “gluteus medius tendinopathy” has been used to describe lateral hip pain.

What causes lateral hip pain?

Lateral hip pain is primarily an overuse injury. The hip often becomes sore after activity has increased above an individual’s normal levels.  People commonly feel the onset of the pain after doing unaccustomed activities such as lots of stair climbing, hill walking or starting a new exercise regime.

Lateral hip pain is also an issue of compression. Weakness in the buttock muscles and sub-optimal biomechanics often contribute to this issue.  We rely on our buttock muscles to help us to stand up straight and support the hip joint.  If these muscles are weak, then the opposite side of the pelvis tends to drop down when we stand on one leg causing increased compression of the tendons over the bony prominence on the side of the hip.  This may contribute to aggravation of the tendons as well as the underlying bursa.

In some cases, lateral hip pain can be brought on by an acute episode such as falling on the side of the hip.

 

image taken from blogs.bmj.com 4.11.15lateral hip pain1

What are the common signs of Lateral Hip Pain?

Commonly, people describe pain with the following activities:

  • Lying on the side
  • Stair climbing
  • Sitting in low chairs
  • Crossing legs
  • Squatting

Who does it affect?

  • Runners
  • Women more commonly than men

 

lateral hip pain 2

How is it diagnosed?

Diagnosis is usually confirmed by a combination of clinical assessment and imaging. Imaging techniques may include ultrasound or MRI.  An x-ray is sometimes also used to rule out any underlying joint pathology or other diagnoses.

What treatment options are available?

In the early stages, treatment may include pain relief and rest from aggravating activities such as stair climbing, hill running or prolonged walking. Other day to day activities that cause increased compression should also be modified or avoided.  This may include avoiding sitting on low chairs and crossing your legs.  Individualised and specific strengthening exercises can be prescribed by your physiotherapist help to improve the stability of the pelvis.  Soft tissue treatment techniques such as massage and dry needling can also help to provide some relief.  Occasionally, corticosteroid injections are used if pain does not settle; however, it is still important to address strength and biomechanical deficits to avoid recurring symptoms.