Persistent pain in the hip or on the side of the thigh can greatly impact your daily life, making activities like walking, climbing stairs, or even sitting uncomfortable. If you are experiencing such discomfort, you might be dealing with one of several conditions that affect the gluteal region: Gluteal Tendinopathy, Trochanteric Bursitis, or Enthesopathy of the Gluteal Muscles. These conditions affect the soft tissues around the hip joint in different ways but all result in pain and limited function. By understanding these conditions, you can better seek the right care and prevent further issues.
What is Gluteal Tendinopathy?
Gluteal tendinopathy is a condition affecting the tendons of the gluteal muscles, specifically the gluteus Medius and gluteus Minimus. These muscles are important for stabilising the hip and pelvis during movement. The tendons attach these muscles to the greater trochanter, a bony prominence on the outside of the hip. Repetitive strain or overuse can cause these tendons to develop small tears and become inflamed, leading to tendinopathy.
Symptoms of gluteal tendinopathy typically include a dull ache on the outer side of the hip that can worsen with activities such as walking, climbing stairs, or prolonged standing. The pain may also radiate down the side of the thigh, which can sometimes be mistaken for sciatica, although it is not nerve-related. The discomfort can be long-lasting and might interfere with sleep, especially if lying on the affected side.
Causes of Gluteal Tendinopathy
The main causes of gluteal tendinopathy are mechanical, often related to overuse or repetitive strain. Activities that place repeated stress on the hip tendons, such as running, long-distance walking, or sports that involve frequent side movements, can contribute to this condition. Additionally, factors such as weak gluteal muscles, improper gait, or poor posture can increase the load on the tendons, making them more prone to injury. Age-related changes in the tendons can also play a role, as tendons lose their elasticity and capacity to repair themselves effectively over time.
What is Trochanteric Bursitis?
Trochanteric bursitis involves inflammation of the bursa, a small fluid-filled sac located over the greater trochanter of the hip. The bursa acts as a cushion to reduce friction between the tendons and the bony prominence of the hip. When the bursa becomes irritated or inflamed, often due to repetitive friction or direct injury, it leads to trochanteric bursitis.
The primary symptom of trochanteric bursitis is pain on the outside of the hip, which can start as sharp and intense and gradually become a more widespread ache. This pain is often made worse by activities such as walking, climbing stairs, or standing for long periods. In more severe cases, pain may occur even when resting or lying on the affected side, which can disrupt sleep.
Causes of Trochanteric Bursitis
Trochanteric bursitis is commonly caused by repetitive hip movements that lead to friction between the tendons and the bursa. This can happen in activities like running, cycling, or hiking. A direct injury, such as a fall onto the hip, can also cause bursitis by directly inflaming the bursa. Additionally, systemic conditions like rheumatoid arthritis or gout can make individuals more likely to develop bursitis due to underlying inflammation in the body.
What is Enthesopathy of the Gluteal Muscles?
Enthesopathy refers to disorders of the entheses, which are the connective tissues where tendons or ligaments attach to the bone. In the case of the gluteal muscles, enthesopathy typically affects the site where these muscles attach to the pelvis. Enthesopathy is often characterised by pain at the attachment points, leading to discomfort and limitations in function.
Symptoms of enthesopathy of the gluteal muscles include a deep, aching pain in the buttock or hip region, which may worsen with movement or prolonged sitting. The pain can be long-lasting and is often associated with stiffness and a reduced range of motion in the hip. Unlike gluteal tendinopathy, which is primarily due to tendon overload, enthesopathy is more often related to inflammation or stress at the attachment site.
Causes of Enthesopathy of the Gluteal Muscles
Enthesopathy can result from repetitive strain or overuse, similar to tendinopathy, but it is also commonly linked to systemic inflammatory conditions such as ankylosing spondylitis or psoriatic arthritis. These conditions cause inflammation at the entheses, leading to pain and potential damage at the attachment sites. Mechanical factors such as excessive foot pronation, differences in leg length, or wearing improper footwear can also contribute to the development of enthesopathy by altering the distribution of stress on the hip attachments.
Personalised Treatment Approaches at Our Clinic
At our clinic, we recognise that each patient is unique, as are their symptoms and conditions. We take a personalised approach to treatment, focusing on non-invasive methods that do not use drugs, needles, or injections. Our primary aim is to reduce your pain and improve your function through tailored therapeutic strategies that may include specific exercises, manual therapy, and lifestyle changes, as well as special pieces of equipment – offering painless solutions.
Once your pain is managed, our secondary goal is to create a comprehensive plan to reduce the likelihood of the condition returning. This plan is customised to address the underlying causes of your condition, such as muscle imbalances, biomechanical issues, or activity-related factors. We believe in empowering our patients with the knowledge and tools they need to maintain their improvements and prevent future episodes of pain.
If you would like to discuss your painful hip, please contact the clinic. We can determine the best option for you.