Tips

Suffering from GTPS Pain? I Have Some Tips for You

2021-07-09 / No Comments

Updated on 2024-03-19

Disclaimer: The following is not medical advice and is provided for informational purposes only.

Contents

1 – Introduction

On May 13, 2020, I experienced a recurrence of thoracic spine pain. I believe the pain recurrence was the result of temporarily discontinuing use of arthritis-strength acetaminophen, which had been helpful in managing the pain since 2018. It was very painful to have pressure applied to the thoracic area of my spine, so I began sitting on the sleeper sofa in the family room, using sofa pillows from the living room sofa in an attempt to relieve the pain while allowing me to sit with back support.

The sofa pillows didn’t help much, so I began using my hands and elbows to help keep my full body weight from being applied to my spine area while my back was against the pillows. I believe the cushions on the sleeper sofa are also shot as I noticed that I sank quite a bit when I sat on the sofa.

One day the last week of May 2020, I began experiencing pain in my left hip while sleeping. I have experienced pain off and on in both hips since 2016 and I later learned through an Internet search in 2017 that the pain was due to a condition called greater trochanteric pain syndrome (GTPS). Usually, the pain just caused discomfort while sleeping, requiring me to get out of bed because I couldn’t sleep due to the discomfort. Two or three times in the past, I awoke with a really stiff and sore left hip, to the point that the stiffness and soreness caused me to limp when I walked. However, the stiffness and soreness would be gone by the end of the day.

This time was different. The pain progressively became worse. I was awakened throughout the night by the infamous jump effect, causing me to bump my head a number of times against the headboard of the bed. I’m a side sleeper, so sleeping on my left side aggravated my GTPS pain. Sometimes the jump effect would result in a sharp pain radiating from my left hip down the outside of my left leg to the knee. I ended up deciding to try to sleep exclusively on my right side, but I had reservations about doing that because I feared the same thing happening to my right hip.

Sure enough, within a few days of sleeping exclusively on my right side, I was awakened by the same jump effect that I had experienced with my left hip. I was miserable. I was trying to deal with thoracic and lumbar spine pain and now both of my hips were very painful as well. I was only able to sleep for about 3 hours a night for 2 to 3 nights because of the GTPS pain and then I would become so exhausted that I was finally able to sleep a few hours more for one night. I would then repeat the vicious sleep cycle.

Some might ask why I didn’t try sleeping on my back. Up until recently, sleeping on my back has always been uncomfortable. For as long as I can remember, I’ve always been a side sleeper. When I began experiencing thoracic spine pain in 2017, I was unable to sleep on my back at all.

I began going for walks again in 2019, after finally getting over exacerbating a herniated lumbar disc due to a fall in my home office and resolving a podiatry issue. I had worked up to walking almost 2 miles about every 2 – 3 days. Based on what I’ve read online, my continuing to walk when I began having GTPS pain may not have been a wise thing to do.

I ended up deciding to see an orthopaedic doctor and scheduled an appointment for the end of June 2020 with a highly rated doctor in my area. The doctor diagnosed me with bilateral GTPS, or GTPS in both hips. He recommended giving me a cortisone injection in both hips to alleviate the pain so that I could begin physical therapy. I didn’t disagree with the physical therapy recommendation because I had read online that physical therapy resolves GTPS most of the time.

I could go into more details about the doctor visit, but I will incorporate that into what didn’t help as far as GTPS pain management. I will also go over things that I learned from online research that proved to be helpful to me.

2 – What Hasn’t Helped

I initially tried capsaicin pain cream. I had tried using capsaicin pain cream in the past for other body pain relief, but I wasn’t impressed with the results. However, I thought I’d give capsaicin pain cream another try. While I did experience a burning sensation after applying the cream, something that hadn’t happened previously, I really didn’t like the effects. Capsaicin pain cream has a numbing effect, which I really didn’t like. Although capsaicin pain cream had a numbing effect on my hips, it didn’t seem to help much with my GTPS pain.

I’m a big fan of natural remedies, so I did quite a bit of research on natural remedies for GTPS pain, inflammation, and pain in general. I next tried using peppermint and rosemary essential oils diluted in a base of avocado oil, but the solution had no effect on my GTPS pain.

I then tried alternating hot and cold gel packs which seemed to help some, but the effect was limited and the therapy was of no value while sleeping.

Next, I tried sleeping on my stomach using sofa pillows for support, but that was extremely uncomfortable. I also worried about making my spine issues worse because sleeping on your stomach is supposed to be the worst sleep position for spine health. In August 2020, I tried sleeping on my stomach again for a few nights, but I used a shredded memory foam pillow and a buckwheat hull pillow to support my body. While the pillows offered much better support and comfort than the sofa pillows, sleeping on my stomach was still uncomfortable, but did give my hips a 2-3 hour respite from being slept on.

The cortisone injections I received during my initial visit to an orthopaedic doctor the end of June 2020 only alleviated my GTPS pain for 3 or 4 days. I tried doing some physical therapy at home and that also seemed to aggravate my GTPS pain. I had scheduled a series of physical therapy appointments after my initial orthopaedic appointment, but I decided to cancel all of them after my home physical therapy experience. I also feared being told to self-quarantine at home if I was supposedly exposed to someone at the doctor’s office who supposedly tested positive for COVID-19. Finally, driving myself to the twice weekly appointments would have been too uncomfortable, so my wife would have had to take off time from work to drive me. I didn’t want to put that burden on my wife.

On my followup visit with the orthopaedic doctor in July 2020, I was given four options:

  1. MRI of my hips to find out what might be going on
  2. Another round of cortisone injections
  3. Physical therapy
  4. Surgery

Because of my thoracic spine pain, there was no way I could lay on an MRI table or even sit properly for a seated MRI. I wasn’t interested in another round of cortisone injections since the first round had no effect. I also learned through online research that cortisone injections can delay or prolong the GTPS healing process. I didn’t want to do physical therapy for reasons already mentioned. I thought the mention of surgery was very premature, so I left the doctor’s office with the intention of not returning.

I had been using a knee cushion for a few years, but the cushion I used wasn’t very supportive. The knee cushion just about completely compressed when placed between my legs. Therefore, I decided to purchase a different brand. The newer knee cushion was a lot more supportive, but using it aggravated my GTPS pain for some reason.

I thought using Ben Gay pain cream or similar (I used Walmart’s Equate brand) might help. Using pain cream seemed to help a little, but the pain relief wasn’t enough nor very long lasting.

In the summer of 2017, I began experiencing pain in both of my knees, which I thought might be arthritis related. I discovered through reading some online posts that emu oil could be beneficial for arthritis and inflammation, so I began using that on both knees and I thought it helped. In addition to using pain cream, I thought I’d give emu oil a try to see if it helped with my GTPS pain, but it didn’t seem to have any noticeable effect.

I tried sleeping on my sides with the upper leg crossed over my body. Through some experimentation, I noticed that not resting the upper leg on top of the lower leg, and straightening the lower leg, while sleeping on my side resulted in some relief of my GTPS pain. However, crossing the upper leg over my body and resting it on the mattress resulted in wicked, sharp pains in my pelvic area.

Toward the end of July 2020, I began using ibuprofen, although I really didn’t want to. I’ve read too many things about the nasty side effects of using ibuprofen long-term. However, I was somewhat desperate to get some pain-free sleep, so I decided to only use 400mg of ibuprofen right before I went to bed. The ibuprofen seemed to help some, but the pain relief wasn’t enough and the pain relief was only good for 5 – 6 hours. I also didn’t want to take ibuprofen on a long-term basis.

I thought long and hard of a way that I could sleep on my sides with my legs stacked, but with something supporting the upper leg so that it wasn’t resting on the lower leg. I thought a piece of large diameter PVC pipe might work, but the big box hardware stores only sell whole length PVC pipe and it isn’t cheap. I did a bit of research on the Internet and discovered FlexPVC in Nevada that sold PVC pipe by the foot and they would cut the pipe in half lengthwise for an additional fee if desired. I ordered an 11-inch length of 10-inch diameter pipe cut in half lengthwise.

I was elated when I tried the PVC pipe. I was able to sleep on my sides with my legs stacked without the upper leg resting on the lower leg. However, the PVC pipe proved to be too rigid and using it for two nights in a row ended up causing quite a bit of pain in my legs, even with cushioning.

I began using a shredded memory foam camping/travel pillow in 2018 to support my upper arm when sleeping on my sides. I decided to try using the camping/travel pillow to support the upper leg while sleeping on my sides, but the pillow was too small and the foam compressed over time during sleep. The lack of proper support aggravated my GTPS pain and also caused sharp pains in my pelvis.

3 – What Has Helped

Not long after I began experiencing GTPS pain in May 2020, I quickly discovered that wearing brief style underwear aggravated the condition due to the seam on the leg openings resting right on the greater trochanter area. The leg opening seam would get pressed into the greater trochanter area when I laid on my sides. I didn’t have any other style of underwear to wear, so I slept without underwear until the boxer style underwear I ordered arrived. I had been considering purchasing new underwear anyway because my existing underwear were becoming worn out.

I also noticed that the seam at the bottom of my t-shirts aggravated my GTPS pain because the seam laid right over the greater trochanter area. When I laid on my side, the seam would get pressed into the greater trochanter area. Therefore, I decided to shorten some of my t-shirts by cutting about 2-3 inches off of the bottom and I only used them for sleeping.

boxer style underwear and shortened t-shirt

One of the first posts I discovered during my initial GTPS research recommended using an egg crate or convoluted mattress topper. I researched the offerings on Amazon, decided on one, and purchased it. The egg crate mattress topper I purchased is made of memory foam with cooling gel, is 2-inches high, and is queen size. I received the mattress topper on 07/22/2020, I unpackaged it, and then I laid it out on the floor in my bedroom for 24 hours to allow it to fully expand.

I had doubts that the egg crate mattress topper would work. After laying it out on the bedroom floor to allow it to fully expand, I stepped on it and the mattress topper compressed completely to the floor. I slept on the mattress topper for the first time on the night of 07/23/2020. I slept like a baby, sleeping for 11.5 hours and I was able to sleep for 1.5 – 2 hours at a time on each side of my body.

I was diagnosed with cervical spondylolisthesis of my C-7 vertebra in 2018. I had been using a shredded memory foam pillow to lay my head on while sleeping, but I felt that it was aggravating my cervical spondylolisthesis due to the foam compacting over time during sleep. I did some Internet research and decided to purchase a buckwheat hull pillow. Now that I had another pillow to lay my head on while sleeping, I could try using my standard size shredded memory foam pillow to support the upper leg slightly crossed over my body while sleeping on my sides.

I had removed some of the shredded foam when I received the pillow after purchase because it was too high. The pillow wasn’t supportive enough for leg support, so I put the removed foam back into the pillow. The result was more favorable, but the foam would compress over time while sleeping resulting in intermittent aggravation of my GTPS pain as well as pain in my pelvis and/or buttocks.

One of the benefits of a buckwheat hull pillow is that it doesn’t compress during sleep. I thought using a buckwheat hull pillow for upper leg support while sleeping on my sides might work better than the shredded memory foam pillow. Therefore, I ordered another regular size buckwheat hull pillow.

After using the buckwheat hull pillow for about two weeks, I determined that it was too firm and high for leg support, so I removed a little over a pound of the buckwheat hulls and that turned out to work well. I was able to sleep more comfortably on my sides with the upper leg crossed slightly over my body supported by the buckwheat hull pillow.

By October 2020, I was starting to feel well enough that I began going out and helping my wife clean up leaves in the yard. I continued going out to clean up leaves on a weekly basis. However, the week prior to Thanksgiving, I had gone out twice within a one week period to clean up leaves. I’m not sure if it was cleaning up leaves in general or cleaning up leaves twice within a one week period, but I ended up aggravating my GTPS pain. On Thanksgiving morning, I got up from my desk in my home office to get ready for bed and the pain in my left hip was bad enough that it was painful to walk. I had planned to shop at Walmart over the weekend, but I thought doing so would be too much for my left hip. I asked my wife to go shopping for me.

A few weeks earlier, I was browsing the pain remedy aisle at one of the Walmart stores in my area and I noticed something called diclofenac sodium 1% gel. I had read about diclofenac sodium when I did some research about ibuprofen. This was in gel form for topical application so the side effects would not be as bad as taking a pain reliever orally. I asked my wife to get me a tube of the gel when she went shopping for me the weekend following Thanksgiving.

I applied the diclofenac sodium 1% gel to my left greater trochanter area and to my lower left buttock on Sunday night, 11/29/2020, and I immediately began noticing a difference; the pain was dramatically subsiding. The tube my wife purchased for me from Walmart was only 1.76 ounces, so I would need more to complete a 21-day course. I discovered that Costco carried a package of Voltaren brand diclofenac sodium 1% gel containing one 1.76-ounce tube and two 5.29-ounce tubes for $35.99. I purchased two packages in December 2020.

The first 21-day course of diclofenac sodium 1% gel worked wonderfully. The maximum dosage course is 21 days, so I took a 1-day break and the pain came back. I began a second 21-day course and while the second course wasn’t as effective as the first course, the pain relief was still good. After the second 21-day course, I was able to take a 2-day break before the pain came back. I decided to do a third 21-day course and the pain relief was less effective than the second 21-day course. I was also concerned about the side effects from long-term use. I also experienced frequent cold sore outbreaks on areas of my lips during the time period that I used diclofenac sodium 1% gel and I’m fairly certain that it was caused by the diclofenac sodium 1% gel. I didn’t experience any more cold sores after I stopped taking diclofenac sodium 1% gel.

The GTPS pain in my right hip had gone away by August 2020, but the pain started bothering me again in January 2021. I was already applying diclofenac sodium 1% gel to two areas of my body (left greater trochanter area and lower left buttock), so I could not use it on my right greater trochanter area. You are only supposed to use diclofenac sodium 1% gel on two areas of your body at a time.

Not long after my GTPS pain flareup in May 2020, I read a post by Dr. David Williams, DC (doctor of chiropractic) who recommended using DMSO (dimethyl sulfoxide). I bought a bottle of DMSO and tried it, but I believe using a pre-mixed quantity of solution and application inexperience resulted in the DMSO not working initially. I re-read the post and I decided to give DMSO another try. This time, DMSO worked wonderfully, providing even better pain relief than diclofenac sodium 1% gel. I stopped using diclofenac sodium 1% gel in February 2021. I currently apply DMSO to the left and right greater trochanter areas, as well as the upper and lower areas of my left buttock.

The GTPS pain in my left hip became worse in January 2021 when I slept on my left side. I brought my thoracic spine pain under control in August 2020, so I thought I’d try sleeping on my back in January 2021 to give my hips a break from being slept on once-in-awhile. To my surprise, I was able to sleep on my back. I’m thinking my ability to sleep on my back is due to the use of the egg crate memory foam mattress topper.

It was a blessing to be able to sleep on my back because by February 2021, I was no longer able to sleep on my left side. Whenever I attempted to sleep on my left side, within 10-15 minutes my left hip would become too painful to lay on and I would sometimes experience the infamous jump effect.

I’ve discovered that sitting on hard surfaces aggravates my GTPS pain, so I use cushioning when sitting on a hard surface. I’ve also discovered that sitting in camp chairs aggravates my GTPS pain due to the fabric gripping my hip areas, so I either avoid or try not to spend too much time sitting in such chairs.

Other things that I try to avoid that tend to aggravate my GTPS pain: staying up for 20 or more hours; going up and down stairs too often; standing for long periods of time; sitting for long periods of time; spending too much time sitting in bucket style vehicle seats; provocative physical activity, especially if it involves walking on unlevel surfaces; e.g. hilly areas.

4 – Conclusion

I still suffer from some occasional GTPS pain, but I’m much better than I was earlier in the year. I need to start doing some exercises to stengthen my glutes as well as some stretching to relieve tightness.

I’ve experienced some of the most wicked pain of my life due to my recent GTPS flareup. I’ve had pain in both hips, both buttocks, and in my pelvis. I have a hard time deciding which pain has been worse; my spine pain or the GTPS pain. I hope the tips I’ve provided in this post prove to be as helpful to you as they have been to me if you are currently experiencing, or if you are ever unfortunate enough to experience, GTPS pain.

5 – Additional Information About DMSO

Note: In the last two books listed above, a recommendation is made to apply DMSO with your bare hands. Based on my personal experience, I would not recommend using your bare hands to apply DMSO. Use heavy duty nitrile gloves. I’ll provide more details in a future blog post.

6 – 2022-09-20 Update

Life continues to toss lemons my way and I continue to come up with ways to make lemonade. I’m not sure how much longer I can continue doing so, though. I’m kind of getting burned out by all of it.

In early July, 2022 I began experiencing lumbar spine pain episodes after getting out of bed. I don’t know if my lumbar spine pain was due to sleeping on my back, from trimming the low hanging branches of the cherry tree in the front yard (maybe too much reaching) in late June, 2022, or a combination of both. However, everytime I slept on my back, I would experience a lumbar spine pain episode either a few hours after getting out of bed or right after getting out of bed. I finally decided that I had to stop sleeping on my back because I’ve read that doing so can be problematic for those with degenerative disc disease, which I’ve been told I have.

I was very concerned about the prospect of not being able to sleep on my back because I tried to sleep on my left side a few weeks prior to my lumbar spine pain episodes. I was still unable to sleep on my left side without aggravating my GTPS pain. I tried sleeping exclusively on my right side, but doing so resulted in my right greater trochanter area becoming more painful again.

I then thought maybe breaking up my sleep sessions in 3-4 hour segments might help. Doing so helped some, but the shorter sleep sessions weren’t ideal because I wasn’t getting enough restful sleep. I then tried sleeping on my stomach again, but I was never able to sleep on my stomach because it was just too uncomfortable.

One time I awoke in frustration at not being able to get enough restful sleep and I tried positioning my legs differently while on my right side. Instead of resting my left leg (upper leg while lying on my right side) in front of my body on a pillow, I rested my right leg in front of my body while laying my left leg on a pillow. The new leg positioning resulted in less pressure being placed on my right greater trochanter area.

I tried a similar position on my left side, but again my left greater trochanter area couldn’t take the pressure of my body weight. I then tried what I call a modified starfish position while lying on my left side and to my surprise, my left greater trochanter area was able to tolerate that position.

Finally, I was able to get a good night’s sleep once again. However, I would like to eventually be able to lie on my left side again because using the modified starfish position means that I’m still lying on my back somewhat, which I’m fairly confident aggravates my thoracic spine pain.

If you have a question or comment, leave it in the Comment box at the bottom of the page.

Post header image courtesy of Camila Quintero Franco at Unsplash.

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