“Hip pain” is one of the most common complaints seen by a joint replacement surgeon.


There are many causes of hip pain but three diagnoses represent the most common causes of non-traumatic presentations for evaluation of hip pain. These three most common causes of hip pain are greater trochanteric pain syndrome, hip joint arthritis, and lumbar radiculopathy.


In a series, this column will examine the three most common causes of non-traumatic “hip pain” and help create an understanding of when your hip pain is not coming from your hip or hip joint.


Greater trochanteric pain syndrome


Pain on the outside of the hip is most commonly from greater trochanteric pain syndrome. Greater trochanteric pain syndrome includes the generic hip bursitis but also includes tears in the abductor tendons. Pain can be present at rest, walking, or even getting up from sitting down. This can be debilitating.


Management measures are mainly non-surgical. People with painful greater trochanteric pain syndrome will usually undergo an evaluation by their physician and sometimes have an x-ray of the hip taken to rule out hip arthritis.


Physical therapy can be prescribed. Home exercises can also be very useful. Anti-inflammatory medications can also provide relief. Other non-surgical options can include a cortisone injection to the trochanteric region.


If no significant relief with all non-surgical measures, or no lasting relief, an MRI can be considered. An MRI of the hip can sometimes show tears in the abductor tendons or evidence of inflammation of the trochanteric bursa. In these cases, if with significant debilitative symptoms and after exhaustive non-surgical care, surgical intervention can be considered.


Surgical intervention can be open or arthroscopic. Abductor tendon tears are best surgically treated with repair of the tendon tears.


Dr. Oluwaseun Akinbo M.D. is an orthopedic surgeon at HaysMed. For more information, https://www.haysmed.com/oluwaseun-akinbo/.