Trochanteric Bursitis
What is Trochanteric Bursitis?
Trochanteric bursitis, often referred to as hip bursitis, greater trochanteric bursitis or greater trochanteric pain syndrome, is a condition characterized by inflammation of the bursa located between the greater trochanter of the femur (the bony prominence on the outide of the hip) and the overlying tendons and muscles.
The bursa is a small, fluid-filled sac that acts as a cushion, reducing friction between tendons, muscles, and bones around joints during hip movement.
Trochanteric bursitis can occur independently or in conjunction with other hip issues, making it a common source of hip pain and discomfort.
Common symptoms of greater trochanteric bursitis include pain and tenderness on the outside of the hip, especially when lying on the affected side, walking, or climbing stairs. The pain may also radiate down the thigh.
Trochanteric Bursitis Presentation
Individuals with trochanteric bursitis typically experience pain and tenderness in the outer hip region, specifically over the greater trochanter.
The pain often radiates down the side of the thigh and may be exacerbated by activities that involve hip motion, such as walking, climbing stairs, or sitting for extended periods.
Trochanteric Bursitis Symptoms
Pain in the Outer Hip Area: The primary symptom is persistent pain located on the side of the hip near the greater trochanter.
Tenderness and Swelling: There may be tenderness and occasional swelling over the affected bursa.
Pain Aggravated by Prolonged Sitting: Sitting for extended periods or engaging in activities that put pressure on the hip, like crossing legs, can worsen the pain.
Thigh Pain: Some individuals may experience pain that radiates down the side of the thigh, often leading to misdiagnosis or confusion with other conditions.
Pain with Stretching: Stretching the hip or performing activities that involve hip movement can elicit discomfort.
Difficulty Sleeping on the Affected Hip: Many patients find it uncomfortable to sleep on the side with trochanteric bursitis due to the pressure on the inflamed bursa.
Reduced Hip Mobility: Pain and inflammation can limit hip joint mobility, affecting daily activities and exercise routines.
Trochanteric Bursitis Management & Treatment
Trochanteric bursitis can be effectively managed with a combination of conservative measures, therapies and lifestyle adjustments aimed at reducing inflammation and relieving pain. Here's a breakdown of the key components of trochanteric bursitis management:
Ice Therapy or Cold/Heat Therapy: To alleviate pain and inflammation in the affected area, consider cold therapy (icing for around 20 minutes on/off) during acute episodes and heat treatment to promote blood flow to the affected hip.
Manual Therapy: Reduce muscle tension, improve blood circulation, and alleviate pain through manual therapy techniques:
Massage: Targeted massage of the hamstring muscle group can relieve muscle tightness.
Trigger Point Therapy: Address trigger points in the hip and gluteal muscles, possibly using dry needling.
Physiotherapy: Specific exercises can help strengthen the muscles around the hip joint, enhance flexibility, reduce muscle imbalances, promote healing and correct any biomechanical issues contributing to bursitis.
Trochanteric Bursitis Exercises:
Strengthening: Focus on strengthening hamstrings and hip muscles to provide stability to the hip joint.
Stretching: Incorporate stretching exercises to improve flexibility:
Use a foam roller on hamstring and calf muscles.
Perform static stretches for the glute, piriformis, and calf muscles.
Postural Education: Maintain proper posture in both sitting and standing positions. Consider ergonomic modifications to reduce stress on the affected bursa.
Activity Modification: Identify activities that worsen symptoms, such as lying on the sore side, prolonged sitting or standing, walking, or running or high-impact exercises, and modify or avoid them.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Anti-inflammatory medications can help alleviate pain and reduce inflammation, under the guidance of your doctor.
The gluteus medius muscle often plays a role in development of and treatment of greater trochanteric bursitis, as the gluteus medius is one of the muscles that attach near the greater trochanter. It plays a crucial role in stabilising the pelvis during walking, running, and other lower body movements. Weakness or dysfunction of the gluteus medius can lead to increased stress on the greater trochanteric bursa, potentially contributing to the development of bursitis.
Physiotherapy exercises targeting the gluteus medius are often prescribed as part of the treatment plan for trochanteric bursitis. Strengthening exercises for the gluteus medius can help improve hip stability and strength, reducing strain on the bursa in previously aggravating activities such as standing, walking and running, and promote healing.
Consult with a healthcare provider or physiotherapist to develop a personalized trochanteric bursitis management plan tailored to your specific needs and goals.