Trochanteric Bursitis: What is it and how to treat it
In the world of musculoskeletal ailments, few conditions carry the frustrating sting of trochanteric bursitis. Imagine a sharp, persistent ache radiating from the outer part of your hip or upper thigh, every step a reminder of discomfort. It can be both debilitating and disheartening.
Trochanteric bursitis is characterised by discomfort and swelling in the tissues surrounding the outer hip or upper thigh. The condition stems from inflammation in the bursae, small sacs filled with fluid that cushion and help reduce friction between the bone (greater trochanter), tendons (gluteal tendon) and muscles near the hip joint.
The trochanter is the hip bone formed at the end of the femoral neck (the femur bone) and the greater trochanter is the large bony part of your hip on the side of your body, where your thigh curves outwards. It serves as a useful attachment point for muscles that help stabilise your pelvis.
When inflammation or swelling occurs in the bursa - issues arise, causing pain when the bursa moves over a bone.
Trochanteric bursitis may also be linked to pain originating from the tendons that insert into the greater trochanter as sometimes the pain can refer down the thigh or into the buttock, known as Greater Trochanteric Pain Syndrome. It is possible that the pain is radiating from the lower back and so a thorough assessment is necessary to accurately diagnose the condition.
Signs and Symptoms
The main symptom of trochanteric bursitis is pain that is located around the outside of the upper thigh/hip and may radiate further down the outer thigh.
The pain can be deep, may ache or burn and may become worse over time. It can be exacerbated by lying on your side, as commonly there will be tenderness over the outer hip. The pain will worsen with tasks that involve standing on one leg such as walking, running, dressing and climbing the stairs, and doing any exercise in general. You may notice the pain more when first moving after sitting, especially when crossed legged or in a low chair because these positions increase the compression of the tendon and bursa.
Causes
Common causes of trochanteric bursitis include:
Inflammation or tears in the gluteus medius tendon
Hip injury such as a fall on to the side of your hip area
Overuse and repetitive movements involving your hip area, such as excessive running or walking
Excessive pressure on your hip joint due to a misshapen or poorly positioned joint
Some infections like tuberculosis, and some diseases like arthritis can be associated with an inflamed fluid-filled bursa
The presence of surgical wire, implants or scar tissue in the hip area
Having a difference in your leg length
Risk
Trochanteric bursitis often starts after a sudden increase in activity, especially involving stairs, hills or running, and usually strikes people when they are middle-aged or elderly. The condition is most common in peri- and post-menopausal women because it is thought that the hormonal change during this time cause the collagen in the tendon to change and weight gain around the hips and tummy increases the load on the area.
As above, being overweight increases the load on the area and therefore the risk of the condition, as does poor strength in the abductor (outer) muscles of the hip, and poor postural habits such as standing shifted onto one leg and sitting crossed legged, as the bursa and tendons are placed under increased stress and can start to become painful.
Treatment
Treatment of trochanteric bursitis aims to reduce compression, modify the load on the irritated bursa and gradually strengthen around the hip.
There are several things you can do at home to treat the condition.
The first would be to try and avoid activities that worsen your symptoms like running and jumping and try low-impact exercises such as swimming. For temporary pain relief, you can apply ice packs to your hip for 10-20 minutes several times a day and over-the-counter non-steroidal anti-inflammatory drugs (aspirin, ibuprofen and paracetamol) and topical anti-inflammatory gels and creams are also effective for reducing pain and inflammation.
To reduce strain on your hip, you can try using a walking cane or crutch for a few days. However, this is not a long-term solution as it is important that you continue to move around as much as possible to keep your hip muscles strong. If you are overweight, losing excess weight will also reduce the strain on your hip and ease your hip bursitis symptoms.
In addition, Physiotherapy is often used and is often very effective. However, trochanteric bursitis can be a stubborn condition that does not always respond to conservative treatment and physiotherapy.
A steroid injection, also known as corticosteroid, is a potent anti-inflammatory and is very effective at reducing the pain and swelling associated with the condition. The steroid is combined with a local anaesthetic to ensure the procedure is relatively pain-free, and is carried out using ultrasound guidance to ensure the needle is placed in the correct place to get maximal pain relief. This then provides a pain-free window to progress your rehabilitation and return to sport/activity.
Prolozone injections are also an option. A mixture of ozone gas and nutrients are injected into the affected area and together these therapies promote healing and tissue regeneration in the bursa and surrounding structures, providing relief from pain and improving mobility.
At Leigh Injection Clinic we offer both steroid injections and prolozone injections to treat many different MSK related pains – including Trochanteric Bursitis. For more information please take a look at our website.
The Leigh Injection Clinic are based on the coast in Leigh on Sea, Essex – perfect for patients in Essex, Kent, London, and surrounding areas.
https://www.leighinjectionclinic.co.uk
https://purephysiotherapy.co.uk/conditions/trochanteric-bursitis/
https://www.spirehealthcare.com/health-hub/specialties/bones-and-joints/hip-bursitis/
https://www.kneeandhip.co.uk/hip-pain/trochanteric-bursitis/
https://www.leighinjectionclinic.co.uk/cortisone-injections-essex
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4910216/