Greater Trochanteric Pain Syndrome in general Practice

This thesis focuses on patients with greater trochanteric pain syndrome. These patients suffer from local pain at the lateral side of the hip. The syndrome is characterized by chronic intermittent or continuous pain at and around the greater trochanter, sometimes radiating to the lateral aspect of the hip or lateral thigh and increasing with physical activity. Lying on the affected side can interfere with restful sleep. In 1952 Spear and Lipscomb described a series of 40 patients with a dull aching pain in the trochanter region and distinguished this condition from referred pain or local infectious diseases. In the late 1970s, Little described this condition as bursitis trochanterica. Finally, in 1991, Collee et al. described this condition as greater trochanteric pain syndrome (GTPS). The syndrome occurs in all age groups, but the incidence is highest in patients aged 40-60 years and up to four times higher in women. In a retrospective study in general practice the incidence of trochanteric pain was calculated to be 1.8 per 1000 patients per year. So, in a standard general practice about four new patients with trochanteric pain present themselves per year. The prevalence of GTPS in adults with musculoskeletal low back pain is reported to be 20-35%.7 A cross-sectional study in a population at risk for osteoarthritis of the knee showed that 17.6% had GTPS.7 The symptoms of GTPS can be considered as a chronic disease. Lievense et al. found that 29% of the patients with GTPS still suffered from this pain after 5 years. Spear and Lipscomb showed that the complaints of GPTS in their cohort of 40 patients lasted from 2 weeks to 27 years. In the study of Anderson the symptoms of the 45 patients persisted from 4 weeks to 5 years.

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