Best Treatment for Gluteal Tendinopathy +/- Trochanteric Bursitis?
This blog will be discussing treatment for gluteal tendinopathy, trochanteric bursitis or Greater Trochanteric Pain Syndrome (GTPS).
If you are not sure what these conditions are and what the difference is between these diagnoses, click here to read our blog on this topic. You might also like to click here to read our blog that discusses the usual symptoms and how they are diagnosed.
Best Treatment for Gluteal Tendinopathy: Your Options
The most common treatments for this condition are cortisone injection and physiotherapy (physical therapy). Simple advice around controlling tendon irritation associated with activity can help. Avoiding complete rest but controlling how much and how often vigorous activity (hill and stair walking or running) is done may help to settle the condition. Research has shown that about 50% of people will slowly recover over time, with just some simple advice.
Others will need more assistance to recover, for example, more specific advice about changing postures and movement habits such as walking and stairclimbing patterns. An exercise program that aims to improve condition of the gluteal (buttock) muscles and their tendons is also important. Getting stronger and learning how to move well will usually help reduce pain and improve ability to participate in everyday and recreational activities. A specific education and exercise approach provided by physiotherapists has recently been tested in a high-quality university research trial, called the LEAP Trial. It showed a success rate of approximately 80% in both the short term (8 weeks) and longer term (12 months).
Physiotherapy (Physical Therapy) versus Coritsone
People with this problem will usually be offered a cortisone injection by their doctor. Studies have shown that a cortisone injection, while providing short term relief for about 60% of people, is no more successful in managing this problem in the longer term, than a wait-and-see approach. There are also concerns that cortisone injections may have negative effects on tendon tissue, particularly multiple injections, so if you have not tried any treatments yet, try an Education & Exercise Approach with a Hip Pain Professional first.
Key features of this successful education and exercise programme for best treatment of gluteal tendinopathy
While you may have tried physiotherapy (physical therapy) before, research has shown that different treatment programs are not equally helpful.
Passive treatments such as massage and electrotherapy (machines) may provide some short-term relief.
However, only exercise can improve the health of muscles and tendons.
For gluteal tendinopathy, the particular program used in the LEAP Trial has shown the most successful results.
Visit a Hip Pain Professional to start your program based on the latest research today.
FREE DOWNLOADABLE RESOURCE
- Mellor R, Bennell K, Grimaldi A, Nicolson P, Kasza J, Hodges P, Wajswelner H, Vicenzino B., 2018. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy: prospective, single blinded, randomised clinical trial. BMJ. May 2;361:k1662. doi: 10.1136/bmj.k1662.
- Brinks A, van Rijn RM, Willemsen SP, et al. Corticosteroid injections for greater trochanteric pain syndrome: a randomized controlled trial in primary care. Ann Fam Med. 2011;9(3):226–34.
- Dean BJS, Lostis E, Oakley T et al. The risks and benefits of glucocorticoid treatment for tendinopathy: A systematic review of the effects of local glucocorticoid on tendon. Seminars in Arthritis and Rheumatism 2014; 43:570–576.
This blog was written by Dr Alison Grimaldi and Kirsty McNab, physiotherapists who have over 50 years of combined professional clinical experience, dealing with patients suffering from a wide range of hip and pelvic conditions.
Dr. Alison Grimaldi BPhty, MPhty(Sports), PhD is Practice Principal of Physiotec Physiotherapy, an Australian Sports Physiotherapist and Adjunct Senior Research Fellow at the University of Queensland, author and global educator.
Kirsty McNab BSc Hons, MPhty(Sports), is Practice Principal of Physiologix and a highly experienced Sports and Exercise Physiotherapist having worked extensively with elite athletes, the Olympic Winter Institute of Australia, and Tennis Australia.