Hi, I'm Ali! I'm one of the physios from sports-injury-physio.com.
This is the final instalment in our series on greater trochanteric pain syndrome,
which is the outside hip pain. We've talked quite a few things in this series: about
what structures might cause this problem, about where you might find symptoms, and a couple of
suggestions about how you can find positions that are more comfortable, and what exercises to avoid,
and ones to seek help to get prescribed for you. In this final episode, we're going to be talking
about what other things could be causing pain over this outside area that would need
to be either ruled out or treated alongside some of the symptoms we've already discussed
or treated in a different manner. So, thinking about other things that can refer to this outside
hip pain area, it can be particularly coming from your lower back. Now your lower back can refer
into different patterns down your legs, depending on which area might be sore or irritated.
It can also affect what the nerves are doing as they come out of your back
and they slide and glide as they move up and down the structures of your legs. This sliding
and gliding is totally normal and something that we would expect to see in everybody as we move.
But if something is irritating that nerve and not allowing that sliding and gliding to be as good
as possible, then the nerve that runs around those glute muscles and also around that outside of your
hip can get a bit irritated and replicate similar sorts of pain. Now, the thing is, when we look
back on what we expect to find when we're looking at symptoms and what I'd expect of you to tell
me in your history when I'm hearing how your pain started, what aggravates it, what makes it easier,
and what you can do and what you can't do, these are sometimes quite different when we're talking
about back pain that can radiate down this side. Or indeed, you might not have back pain,
but you might have the leg pain, and this may be related to these nerves. So, I would expect
to see something different or hear something different when you're telling me your history,
and I would also have a set of different tests that I would do to rule this in or rule this out.
And these symptoms can then be treated by treating that nerve or treating that lower back, and they
would be better for you than just assuming you have greater trochanteric hip pain and pain
syndrome, or this outside hip pain. Other things we want to look for is whether there's been any
trauma. So, by trauma – an accident, an incident, a fall, or any problems like that on that side
that doesn't necessarily typically relate to greater trochanteric pain syndrome. We'd want
to find out whether there's been a history of anything like stress fractures that we could look
at if you were particularly using your limbs on a repetitive loading basis with activities and that
load has suddenly suddenly changed, and again, those symptoms would be a lot more localized;
they wouldn't be as diffuse and spread out. So, your history would give us clues with this.
And the final things that we really want to rule out here is, yes, your hip joint itself. Now, it's
unlikely to cause just outside hip pain if it's your hip joint – it's more likely to cause groin
pain, and it's more likely to happen on slightly different aggravating factors. So, again, that
history and some of the tests we can do can help rule that in and rule that out. The other things
we want to think about are more serious things that have nothing to do with your bones or your
joints or your ligaments or your nerves and are something that can be more internal, or an illness
that can replicate pain on this outside area. And again, I'd expect to pick that up through
questioning you, and that's when we'd then send you on to a GP or a physician to have a look and
do some tests to find out what else might be going on if it's not in my physio remit to look at.
Now, please bear in mind that sometimes it's not as simple as this,
and you can have multiple components. You might have the greater trochanteric
pain syndrome ... greater trochanteric pain syndrome symptoms that we spoke about - that's a
tongue twister! - at the beginning, but you might also have a component of that nerve being a bit
irritated. So, there may be times where things overlap. Or you might have a stiff hip joint
and some of these could be compensatory, some of these could be part of the problem. And it's about
us unravelling all of that and treating all of those different components together.
So, thank you for listening to this whole entire series. There will be one standalone video that
links in with this, and that will be in regards to pain and how to look at your pain levels and work
out how much exercise is okay to do, or activity to do, and how you can guide even your rehab,
or your day-to-day life based on your pain levels. Thank you for listening. Take care! Bye!