Trochanteric bursitis is inflammation of the bursa (a small, cushioning sac located where tendons pass over areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur).
The superficial trochanteric bursa is located over the greater trochanter. This is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases.
What Does Trochanteric Bursitis Feel Like?
People who are suffering from Trochanteric Bursitis tend to suffer from One or more of the following symptoms:
- Pain and swelling occurring over the side of the hip
- Referred pain that travels down the outside thigh and may continue down to the knee
- Pain when sleeping on your side; especially the affected hip
- Pain upon getting up from a deep chair or after prolonged sitting (eg. in a car)
- Pain when climbing stairs
- Pain in sitting with the legs crossed
- Increased pain when walking, cycling or standing for long periods of time
What Causes Trochanteric Bursitis?
The trochanteric bursa may become inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone. In a sporting context this can occur traumatically from a fall or an impact contusion.
The most common reason though is that the pain comes on gradually via a repetitive irritation to the bursa from such walking or running with poor hip control (hyperlink to specific page), walking into fatigue, or cycling, especially when the bicycle seat is too high.
It is can also occur as a result of:
- Scoliosis – curvature of the spine
- Unequal leg length
- Weak hip muscles (poor hip control) – hyperlinked
- Hip Arthritis (hyperlink)
- Back Pain (hyperlink)
- Calcium deposition in the gluteal tendons that run over the bursa
- Rheumatoid arthritis.
How Do You Treat Trochanteric Bursitis?
Bursitis means that your bursa is inflamed. Regular application of ice packs for 15 minutes is highly recommended to help reduce your pain and swelling.
NSAIDs or anti-inflammatory drugs (i.e. neurofen or voltaren). Use of these medications should be discussed with your doctor, although the topical application of an anti-inflammatory gel (available from your pharmacist or Leading Edge Physical Therapy).
A single injection of a corticosteroid (cortisone) with a local anaesthetic into the bursa may be required to stimulate your healing response. It is preferable to have this injection using ultrasound guidance. If this is required, we can arrange for you to see one of our network of GPs or Orthopaedic Surgeons.
The most important thing in treating Trochanteric Bursitis is to firstly try and reduce the pain.
Pain is the main reason that you seek treatment for trochanteric bursitis. In truth, it was actually the final symptom that you developed and should be the first symptom to improve.
Bursa inflammation it best eased via ice therapy and techniques or exercises that deload the inflamed structures.
Your Leading Edge Physiotherapist will use an array of treatment tools to reduce your pain and inflammation. These include: ice, electrotherapy, acupuncture, deloading taping techniques and soft tissue massage.
If the inflammation is controlled and the bursa “settles down” you are not out of the woods – we need to address the root cause of the problem. This is most likely poor hip control (hyperlink).
Your Leading Edge Physio will prescribe a series of progressive and tailored rehabilitation exercises to address the hip control issues identified in your assessment to reduce the amount of pressure on the bursa.
The final stage of your rehabilitation is aimed at returning you to your desired activities. Everyone has different demands for their hips that will determine what specific treatment goals you need to achieve. For some it be simply to walk around the block. Others may wish to run a marathon.
Your Leading Edge Physio will tailor your hip rehabilitation to help you achieve your own functional goals.
Will My Bursitis Come Back?
Trochanteric bursitis does have a tendency to return. The main reason it is thought to recur is due to insufficient rehabilitation.
In addition to your muscle control, your physiotherapist will assess you hip biomechanics and start correcting any defects. It may be as simple as providing your will core abdominal exercises or consulting with our podiatrist about your foot control to address any biomechanical faults in the legs or feet. Your physiotherapist will guide you.
Fine tuning your hip stability and function by addressing any deficits in core strength and balance, learning self-management techniques and achieving the ultimate goal of safely returning to your previous sporting or leisure activities!
Can You Prevent Trochanteric Bursitis?
Muscle weakness or fatigue is a major cause of trochanteric bursitis. So addressing your strength and endurance is necessary to avoid a recurrence.
Wearing adequate footwear which supports any biomechanical imbalances in your feet is a key preventative measure. Speak to our podiatrist about having a footwear assessment or gait analysis.
Successful weight management minimises excess stress on the hip joints, which can alleviate pressure on the bursa. If you need advice regarding your weight-loss please discuss with your doctor or dietitian.
I Think I Have Trochanteric Bursitis – What Should I Do Right Now?
To help your injury resolve as fast as possible:
- avoid or modify activities and positions, which cause your pain. Recovery is easier if you stop irritating the hip.
- avoid sitting with knees higher than your hips.
- avoid lying on your side
- avoid sitting with legs crossed or sitting on you legs so that the hip is rotated.
- avoid sitting on the edge of the seat and contracting the muscles that flex your hips.
If you are not sure if you need an assessment, you can ENTER YOUR DETAILS HERE and one of our physios will give you a call back to discuss your problem and work out the next step in your recovery.