Trochanteric Bursitis: Symptoms, Causes, Treatment

What are the symptoms of trochanteric bursitis?

Trochanteric bursitis, also known as greater trochanteric pain syndrome, is an inflammation of the bursa located on the outer side of the hip, near the greater trochanter of the femur. The symptoms typically include:

1. Hip Pain

Location: Pain is usually felt on the outer side of the hip, near the bony prominence called the greater trochanter.
Character: The pain may be sharp, aching, or throbbing and can worsen with certain activities.

2. Pain with Movement

Activities: Pain often intensifies with activities that involve hip movement, such as walking, climbing stairs, or getting up from a seated position.
Rest: The pain might improve with rest but can return with activity.

3. Tenderness

Physical Examination: The area over the greater trochanter may be tender to touch. Pressing on this area often elicits pain.

4. Limited Range of Motion

Hip Movements: There may be discomfort or a reduced range of motion in the hip joint, particularly with movements that involve rotation or extension.

5. Pain at Night

Sleeping Issues: The pain may worsen at night, especially if lying on the affected side, leading to disrupted sleep.

6. Swelling (Less Common)

Local Swelling: In some cases, there may be mild swelling or warmth over the affected area, though this is less common.

7. Weakness or Stiffness

Muscle Issues: The surrounding muscles may feel weak or stiff due to pain and limited movement.

Trochanteric bursitis is often associated with activities that put repetitive stress on the hip, such as running or prolonged standing, and can also result from injury or biomechanical issues. If you experience these symptoms, consulting with a healthcare professional for an accurate diagnosis and appropriate treatment is recommended.

What are the causes of trochanteric bursitis?

Trochanteric bursitis is primarily caused by inflammation of the bursa located near the greater trochanter of the femur. Several factors can contribute to the development of this condition:

1. Repetitive Stress

Activity: Activities that involve repetitive hip movements, such as running, cycling, or prolonged standing, can place excessive stress on the hip joint and bursa.
Occupation: Jobs or activities requiring frequent or prolonged standing and walking can also contribute.

2. Overuse Injuries

Exercise: Overuse of the hip from increased physical activity or sudden changes in activity levels can lead to inflammation of the bursa.

3. Biomechanical Issues

Gait Abnormalities: Poor alignment or abnormal gait patterns can increase stress on the hip and bursa, leading to inflammation.
Leg Length Discrepancy: Differences in leg length can affect hip mechanics and contribute to bursitis.

4. Muscle Imbalance or Weakness

Weak Muscles: Weakness or imbalance in the hip muscles, such as the gluteal muscles, can affect hip mechanics and contribute to bursitis.

5. Injury or Trauma

Direct Impact: Falls or direct trauma to the hip area can cause irritation and inflammation of the bursa.
Hip Surgery: Previous hip surgeries or procedures can increase the risk of developing bursitis.

6. Arthritis

Osteoarthritis: Degenerative changes in the hip joint can affect the bursa and contribute to inflammation.
Rheumatoid Arthritis: Inflammatory arthritis can also affect the bursa.

7. Tendonitis

Inflammation: Inflammation of the tendons around the hip, such as the iliotibial band or gluteal tendons, can cause secondary irritation of the bursa.

8. Postural Issues

Improper Posture: Prolonged poor posture or improper sitting positions can put additional stress on the hip and bursa.

9. Weight

Obesity: Excess body weight can increase stress on the hip joints and bursa, contributing to inflammation.

10. Other Medical Conditions

Systemic Conditions: Conditions such as diabetes or metabolic disorders can affect joint and bursa health, increasing the risk of bursitis.

11. Gender and Age

Gender: Women are more commonly affected by trochanteric bursitis, possibly due to differences in hip anatomy and biomechanics.
Age: It is more common in middle-aged and older adults, possibly due to age-related changes in the hip joint and surrounding structures.

Identifying and addressing these contributing factors can help in managing and preventing trochanteric bursitis. If you suspect you have this condition, consulting with a healthcare professional for a proper diagnosis and treatment plan is recommended.

What is the treatment for trochanteric bursitis?

The treatment for trochanteric bursitis focuses on relieving pain, reducing inflammation, and improving hip function. The approach often involves a combination of self-care measures, medical interventions, and physical therapy. Here’s a detailed overview of the treatment options:

1. Rest and Activity Modification

Rest: Avoid activities that exacerbate the pain, such as running or prolonged standing.
Modify Activities: Adjust activities or avoid repetitive movements that stress the hip.

2. Ice and Heat Therapy

Ice: Apply ice packs to the affected area for 15-20 minutes several times a day to reduce inflammation and pain.
Heat: Use a heating pad or warm compress after the acute inflammation has subsided to help relax the muscles.

3. Medications

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help reduce pain and inflammation.
Acetaminophen: May be used for pain relief if NSAIDs are not suitable.
Prescription Medications: In some cases, a healthcare provider may prescribe stronger pain relievers or anti-inflammatory medications.

4. Physical Therapy

Stretching and Strengthening Exercises: A physical therapist can design a program to stretch tight muscles and strengthen weak hip muscles to improve mechanics and reduce stress on the bursa.
Manual Therapy: Techniques such as massage or joint mobilization may be used to improve hip function and reduce pain.

5. Corticosteroid Injections

Steroid Injections: An injection of corticosteroids into the bursa can provide significant relief from inflammation and pain, especially if other treatments are not effective.

6. Orthotics and Supportive Devices

Shoe Inserts: Custom or over-the-counter orthotic devices may help correct gait abnormalities and reduce stress on the hip.
Hip Braces: In some cases, a brace or support may be recommended to help stabilize the hip.

7. Lifestyle and Postural Adjustments

Ergonomics: Improve posture and ergonomics, especially if sitting or standing for long periods, to reduce stress on the hip.
Weight Management: Achieving and maintaining a healthy weight can help reduce stress on the hip joint and bursa.

8. Surgical Intervention

Surgery: If conservative treatments do not provide relief and symptoms persist, surgical options may be considered. This can involve removing the inflamed bursa (bursectomy) or addressing underlying structural issues contributing to the bursitis.

9. Alternative Therapies

Acupuncture: Some individuals find relief from pain and inflammation through acupuncture.
Massage Therapy: Therapeutic massage may help alleviate muscle tension and improve circulation around the hip.

10. Ongoing Monitoring

Regular Follow-Up: Continued monitoring by a healthcare professional to assess progress and adjust treatment as necessary.

Implementing a comprehensive treatment plan that addresses pain relief, inflammation reduction, and underlying factors is crucial for effective management of trochanteric bursitis. Consulting with a healthcare provider or specialist is recommended to tailor the treatment approach to individual needs.