Greater trochanteric pain syndrome: epidemiology and associated factors

Arch Phys Med Rehabil. 2007 Aug;88(8):988-92. doi: 10.1016/j.apmr.2007.04.014.

Abstract

Objectives: To describe the prevalence of greater trochanteric pain syndrome (GTPS); to determine whether GTPS is associated with iliotibial band (ITB) tenderness, knee osteoarthritis (OA), body mass index (BMI), or low back pain (LBP); and to assess whether GTPS is associated with reduced hip internal rotation, physical activity, and mobility.

Design: Cross-sectional, population-based study.

Setting: Multicenter observational study.

Participants: Community-dwelling adults (N=3026) ages 50 to 79 years.

Interventions: Not applicable.

Main outcome measures: Greater trochanteric tenderness to palpation in subjects with complaints of hip pain and no signs of hip OA or generalized myofascial tenderness.

Results: The prevalence of unilateral and bilateral GTPS was 15.0% and 8.5% in women and 6.6% and 1.9% men. Odds ratio (OR) for women was 3.37 (95% confidence interval [CI], 2.67-4.25), but age and race were not significantly associated with GTPS. In a multivariate model, adjusting for age, sex, ITB tenderness, ipsilateral and contralateral knee OA, BMI, and LBP, ITB tenderness (OR=1.72; 95% CI, 1.34-2.19), knee OA ipsilaterally (OR=3.47; 95% CI, 2.72-4.42) and contralaterally (OR=1.74; 95% CI, 1.32-2.28), and LBP (OR=2.79; 95% CI, 2.22-3.50) were positively related to GTPS. In this complete model, BMI was not associated with GTPS (OR=1.10; 95% CI, 0.80-1.52 when comparing >or=30 with <25kg/m(2)). Hip internal rotation range of motion did not differ based on GTPS status. After multivariate adjustment, GTPS did not alter physical activity score, but bilateal GTPS was significantly associated with a higher 20-meter walk time and chair stand time.

Conclusions: The higher prevalence of GTPS in women and in adults with ITB pain or knee OA indicates that altered lower-limb biomechanics may be related to GTPS. Slower functional performance in those with GTPS suggests that the study of targeted rehabilitation may be useful. A longitudinal study will be necessary to identify causal factors and outcomes of interventions.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Distribution
  • Aged
  • Arthralgia / epidemiology*
  • Arthralgia / etiology*
  • Bursitis / complications*
  • Bursitis / epidemiology
  • Cross-Sectional Studies
  • Female
  • Femur*
  • Hip Joint / physiopathology
  • Humans
  • Low Back Pain / epidemiology*
  • Low Back Pain / etiology*
  • Male
  • Middle Aged
  • Osteoarthritis, Hip / complications
  • Osteoarthritis, Hip / epidemiology
  • Osteoarthritis, Knee / complications
  • Osteoarthritis, Knee / epidemiology
  • Pain Measurement
  • Prevalence
  • Range of Motion, Articular
  • Severity of Illness Index
  • Sex Distribution
  • Syndrome
  • United States / epidemiology