Mostly women over 50 and overweight suffer from it. Weight loss and targeted physiotherapy are very effective. Surgery on tendons, only in the most difficult cases
Painful syndrome of the greater trochanter (a bony protrusion of the femur) one of the main reasons for lateral hip pain. Unlike other painful conditions of the musculoskeletal system, it is not the prerogative of sportsmen. Rather has a fondness for overweight womenaffecting up to one in four past the age of 50, while much less common in men (one in ten, always after middle age). In the presence of suspicious symptoms, it is advisable to immediately run for cover, worth the risk of the pain becoming chronic.
What causes painful greater trochanter syndrome?
In the past pain localized to the trochanteric region was most often attributed to ainflammation of the bagssmall sacs filled with liquid, present at the level of the insertion of the tendons on the bone and which serve to reduce friction and cushion shocks – he said Marco Minetto, associate professor in physical and rehabilitative medicine at the University of Turin at the Molinette hospital -. Then, however, it was seen that an inflammatory process of the bags was not always present, so we started talking about gluteal tendinopathy, referring to a degenerative pathology of the gluteus medius tendon, the most important tendon that inserts on the greater trochanter. Not all patients can detect important signs of tendon degeneration and inflammation. For all these reasons today we prefer to use the term trochanteric pain syndromein which all these different factors probably play a role (as well as others not yet known) and where the real problem is lateral hip pain.
How is it recognized?
A fairly well localized pain in the trochanteric region that can be evoked by palpation of this area is typical. Generally the pain is not particularly intense, but still annoyingespecially if you take certain positions. This happens, for example, when lying on the side: many patients say they can no longer sleep on the side as they did until recently.. In the presence of these symptoms, which in themselves are very suggestive, a careful examination is useful during which the specialist can perform a series of maneuvers to check if the pain increases when the abductor muscles of the thigh are involved that open the limb. lower outwards. Furthermore it may be helpful to do an ultrasound and, in selected cases, an MRI, to evaluate any changes in the tendons of the gluteus medius or gluteal muscles or signs of bursitis or to rule out other causes of hip pain. Also fundamental a careful collection of the patient’s history: in fact, it is not infrequently discovered that in the past he had had the same ailments.
How can it be cured?
You can act on several fronts, starting from weight loss up to, in rare cases, surgery. Physiotherapy with therapeutic exercises plays a central role. Furthermore, the targeted stimulation of the tendons and muscles of the buttocks can enhance the analgesic effect of the painkilling drugs taken to counteract the pain. Among the exercises indicated there are those of both static (the so-called “isometric contractions”) and dynamic muscle contractions, as well as stretching. Postural hygiene measures and physical therapy with focal shock waves are also helpful. If these first-line treatments do not give the desired results, cortisone infiltrations or promising infiltrations with growth factors can be used that would help revitalize the area. Tendon surgery with bursa removal is reserved for the most stubborn cases.
May 22, 2022 (change May 22, 2022 | 18:26)
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