2024-10-03 07:31:43
Trochanteric pain syndrome or greater trochanter pain syndrome, better known as trochanteritis, includes a series of bone, muscle and inflammatory problems that basically cause severe hip pain. Overload due to movement or repetitive exercise, but also a sedentary lifestyle are the basis of these complex injuries which mostly affect women.
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Image from the “Bodyworlds 4” exhibition at the Museum of Science and Industry in Manchester, UK. EFE/RICCO EATON
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Image from the “Bodyworlds 4” exhibition at the Museum of Science and Industry in Manchester, UK. EFE/RICCO EATON
“Trochanteritis is a very common condition; it is probably, together with osteoarthritis, the first or second cause of consultation for hip pain. It appears after the third decade of life,” explains EFEsalud. surgeon and traumatologist Miguel Almaraz, specialist in the Hip Unit of the Cemtro Clinic in Madrid.
The traumatologist respects him 9 out of 10 patients are women and the main cause, among others, is the very constitution of the female hip structure, wider than the male one, whereby the fascia lata (connective tissue in the upper and lateral part of the leg) produces more pressure in the hip and inflammation .
The trochanter and other structures that can cause pain
The trochanter is a part of the top of the femur, an area of the bone into which muscles attach, the most important of which is the gluteus medius. And it is in that area that a series of structures are concentrated that can generate pain and constitute the painful syndrome of the greater trochanter or trochanteritis.
One of them is the bag or sac of synovial fluid which acts as a shock absorber against the impact of movement and “reduces slippage between muscle planes”, specifies the doctor.
When the bursa becomes inflamed that’s what it’s called trochanteric bursitis and it is also a painful and frequent injury.
It is called another pathology “spring hip” or coxa saltans which, when faced with certain hip movements, causes a sort of click and can generate inflammation.
But there are also other muscles, i external rotators of the hip and between these, very close to the trochanter, the sciatic nerve passes and its involvement is rarer.
One of those external rotators of the hip is the pyramidal that produces the call pyramidal syndrome: when the muscle is contracted or fibrotic bands are present, compression of the sciatic nerve can occur and what is called “false sciatica”which does not come from the lumbar spine, but its origin is in the hip area. The pain also spreads to the leg. This condition is not considered trochanteritis as such, but is included in greater trochanter pain syndrome.
“There are many causes that can cause trochanteric pain, pain that we generically call trochanteritis, although the correct term is painful syndrome of the greater trochanter because the causes are different,” explains the doctor.
Consider that although the buttock is part of the problem in many cases of trochanteritis, not all of them originate in this muscle, the pain can also come from the fascia lata or the quadriceps (muscle of the front of the thigh);
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Hip infographic provided by the Cemtro Clinic in Madrid.
” data-medium-file=” data-large-file=” tabindex=”0″ role=”button” alt=”trocanteteritis” class=”wp-image-357366 lazyload” style=”width:374px;height:auto ” src=” srcset=” 250w, 150w, 200w” data-sizes=”auto” data-eio-rwidth=”250″ data-eio-rheight=”251″/>Chair information provided by Clínica Cemtro de Madrid.
It looks like trochanteritis but it isn’t.
There are also other pathologies that can be confused with trochanteritis but are not. This is the case of a lumbar injury that radiates pain to the hip without there being any problems in that area of the body.
Also the arthrosis or joint problemswhich very often causes pain in the groin area, can reflect pain in the trochanter and create a false idea of trochanteritis when the origin is in a joint.
Repetitive movements or a sedentary lifestyle, two faces of trochanteritis
Trochanteritis occurs in two very different groups of people, the vast majority being women.
On the one hand, exactly those active in practiceespecially in running where the impact can cause this type of pain, but cycling, with the repetitive flexion-extension movement while pedaling, or squat exercises also generate pain.
“These are patients with excessive activity that causes overload of the gluteal muscles and is related to tendinitis,” explains traumatologist Miguel Almaraz.
On the other side there is the person sedentary“with few muscles”. In these cases it is possible that a rupture of the gluteus medius tendon occurs at the trochanter level and this can be confused with trochanteritis.
What to do and what not to do
Trochanteritis is usually resolved with physiotherapy exercises and rehabilitation exercises, such as stretching, especially at the level of the fascia lata; with infiltrations; with colds and with anti-inflammatories and analgesics.
But also change some habits since the hip area is overloaded by climbing stairs, going up and down slopes (like hiking) and doing squat-type exercises.
Surgery for difficult cases
The surgeon of Clinic Centerspecialized in traumatology, explains that surgery is recommended for those patients suffering from trochanteritis who have not responded to the most conservative measures, i.e. physiotherapy and infiltrations.
The surgery can be either open or arthroscopic, with minimal incisions, and aims to lengthen the contracture of the fascia lata, eliminate inflamed tissue such as the bursa, or remove inflammation of the gluteus medius, among other actions.
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