This condition is very common. It can usually be managed with physiotherapy, simple analgesics (such as Panadol Osteo), NSAIDs (anti inflammatories such as Voltaren, Indocid or Naprosyn) or COX2 Inhibitors (such as Celebrex or Mobic).
If this does not help, then the next step is to consider cortisone injections (under ultrasound guidance). Often, up to 6 injections might be tried (2 months apart, if necessary).
Platelet Rich Plasma (PRP) injections may also be tried. These are also injected under ultrasound guidance. A full course of 3 injections might be needed, but this depends on the response.
Ultimately, if the above does not alleviate the symptoms, and the symptoms are severe, then surgery may be undertaken.
The surgery involves excising the trochanteric bursa and, where necessary, debriding (removing degenerate/diseased tendon) and repairing the gluteal tendons. Sometimes, if the tendon tear is severe and extensive, a reconstruction using a LARS band (artificial tendon) might be required.
Rehabilitation after the surgery is prolonged: crutches are often required for 6-12 weeks and then a walking stick for a further 6 weeks. The surgery may not fix the limp. It often takes up to a year for the limp to improve, but it doesn't always do so despite the surgery. In many cases, however, the pain is improved after the first 3 months.
