Trochanteric Bursitis

What is trochanteric bursitis?

Trochanteric bursitis is a common condition that causes pain on the outer side of the hip. It occurs when the bursa, a small fluid-filled sac that acts as a cushion between the bones and soft tissues, becomes inflamed. This bursa is located near the greater trochanter, which is the bony prominence at the top of the thighbone (femur).

At Blacktown Health, our team of Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktown often see patients with trochanteric bursitis. We know how painful this condition can be when you sleep, walk, and climb stairs, so we've put together this guide to help people better understand the condition and make sense of the many treatments out there you can use to recover from this condition.

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Are there different types of trochanteric bursitis?

While trochanteric bursitis specifically refers to inflammation of the trochanteric bursa, it's often part of a broader condition called greater trochanteric pain syndrome (GTPS). This syndrome can involve:

• Trochanteric bursitis: Inflammation of the bursa itself
• Tendinopathy: Degeneration of the gluteal tendons that attach to the greater trochanter
• Muscle tears: Small tears in the gluteal muscles

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What are the symptoms of trochanteric bursitis?

The symptoms of trochanteric bursitis can vary, but common signs include:

• Pain on the outer side of the hip
• Pain that worsens with activities like walking, climbing stairs, or lying on the affected side
• Tenderness when pressing on the outer hip area
• Pain that radiates down the outer thigh
• Stiffness in the hip, especially after sitting or lying down for long periods
• Increased pain at night, particularly when lying on the affected side

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What causes trochanteric bursitis?

Trochanteric bursitis can be caused by several factors:

• Repetitive stress: Activities that involve repeated hip movements
• Trauma: A fall or direct impact to the hip
• Overuse: Excessive exercise or physical activity
• Poor posture: Especially while standing or walking
• Leg length discrepancy: When one leg is longer than the other
• Spine problems: Conditions like scoliosis can affect hip alignment
• Previous surgery: Hip or knee replacements can sometimes lead to bursitis

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What are the risk factors for developing trochanteric bursitis?

Certain factors can increase your risk of developing trochanteric bursitis:

• Age: It's more common in middle-aged and older adults
• Gender: Women are more likely to develop it than men
• Obesity: Excess weight puts more stress on the hip joints
• Certain sports: Activities like running or cycling can increase risk
• Occupations: Jobs that require prolonged standing or climbing stairs
• Medical conditions: Rheumatoid arthritis, gout, or diabetes can increase risk
• Leg length discrepancy: Having one leg longer than the other

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How is trochanteric bursitis diagnosed?

When you visit one of the Tangram Health clinics with symptoms of trochanteric bursitis, our healthcare professionals will use several methods to diagnose your condition:

• Medical history: They'll ask about your symptoms, when they started, and how they affect your daily life.
• Physical examination: Your Physiotherapist or Chiropractor will check your hip for tenderness, swelling, and range of motion. They may also assess your gait (how you walk).
• Specific tests: There are several tests that can help diagnose trochanteric bursitis including:
  • The FABER test (Flexion, Abduction, External Rotation)
  • The Trendelenburg test
  • Resisted external de-rotation test.
• Imaging tests: In some cases, X-rays, MRI, or ultrasound scans may be recommended to rule out other conditions or assess the extent of inflammation.

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Do I need any scans to diagnose trochanteric bursitis?

While trochanteric bursitis is often diagnosed through physical examination, imaging tests can be helpful in some cases:

• X-rays: These can't show the bursa itself but can rule out other conditions like fractures or arthritis.
• MRI (Magnetic Resonance Imaging): This gives a detailed view of the soft tissues and can show inflammation in the bursa or any associated tendon problems.
• Ultrasound: This can show fluid in the bursa and is often used to guide injections if needed.
  

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How is trochanteric bursitis treated?

Treatment for trochanteric bursitis aims to reduce pain and inflammation, improve function, and prevent recurrence. At Blacktown Health, we offer a range of treatments, including:

• Rest and activity modification: Avoiding activities that aggravate your symptoms
• Ice or heat therapy: To reduce pain and inflammation
• Exercise therapy: Our Physios, Chiros, and Exercise Physiologists can design an exercise program to strengthen your hip muscles and improve flexibility
• Pain relief: Over-the-counter pain medications or prescription drugs may be recommended
• Assistive devices: Canes or crutches can help reduce pressure on the affected hip
• Corticosteroid injections: These can provide significant pain relief in some cases
• Surgery: In rare cases where conservative treatments haven't helped

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How can I avoid positions that compress the tendon?

Avoiding positions that compress the tendon is an important part of managing trochanteric bursitis. Here are some tips:

• Avoid sleeping on the affected side. Use a pillow between your knees when sleeping on your other side.
• Don't cross your legs when sitting.
• Avoid sitting for long periods. Get up and move around regularly.
• When standing, try not to lean on one hip.
• Use a cushion to sit on hard surfaces.
• Avoid activities that involve repetitive hip movements until your symptoms improve.

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When are injections used for trochanteric bursitis?

Corticosteroid injections are sometimes used to treat trochanteric bursitis when other conservative treatments haven't provided enough relief. These injections can:

• Reduce inflammation in the bursa
• Provide significant pain relief
• Allow you to participate more comfortably in physical therapy

However, injections are typically not a long-term solution and are usually limited to a few times a year.

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When is surgery required for trochanteric bursitis?

Surgery for trochanteric bursitis is rarely needed. It's usually only considered when:

• Conservative treatments haven't improved your symptoms after 6-12 months
• Your pain is severe and significantly affects your quality of life
• There's evidence of tendon damage associated with the bursitis

Surgical options may include:

• Bursectomy: Removal of the inflamed bursa
• Iliotibial band release: Lengthening the iliotibial band to reduce pressure on the bursa
• Tendon repair: If there's associated tendon damage

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What role does exercise play in treating trochanteric bursitis?

Exercise is a crucial part of treating trochanteric bursitis. It helps to:

• Strengthen the muscles around your hip, particularly the gluteal muscles
• Improve flexibility and range of motion
• Correct imbalances that may be contributing to the bursitis
• Improve overall function and potentially prevent future episodes

Our Physiotherapists, Chiropractors, and Exercise Physiologists at Blacktown Health can design you an exercise program tailored to your specific needs. This might include:

• Stretching exercises for the iliotibial band and hip muscles
• Strengthening exercises for the gluteal muscles
• Core strengthening exercises
• Balance and stability exercises

Remember, it's important to start gently and gradually increase the intensity of your exercises.

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How can I prevent trochanteric bursitis or stop it from getting worse?

While you can't prevent all cases of trochanteric bursitis, there are steps you can take to reduce your risk or prevent it from worsening:

• Maintain a healthy weight: Excess weight puts more stress on your hip joints
• Practice good posture: Poor posture can contribute to hip misalignment
• Warm up before exercise: This can help prepare your muscles and reduce injury risk
• Gradually increase activity levels: Sudden increases in exercise intensity can lead to overuse injuries
• Wear proper footwear: Supportive shoes can help maintain proper alignment
• Address any leg length discrepancies: Your doctor, Physiotherapist, or Chiropractor can advise on this
• Strengthen your hip and core muscles: This can improve stability and reduce stress on the bursa

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What lifestyle changes can help manage trochanteric bursitis?

Making certain lifestyle changes can significantly improve your hip health and help manage trochanteric bursitis:

• Modify your sleeping position: Avoid sleeping on the affected side
• Adjust your work environment: Ensure your desk and chair are at the right height
• Take regular breaks from sitting: Get up and move around every hour
• Use assistive devices: A cane or walking stick can help reduce pressure on your hip
• Choose low-impact activities: Swimming or cycling may be easier on your hips than running
• Maintain good posture: Be mindful of your posture throughout the day
• Manage stress: Stress can increase muscle tension, which can worsen symptoms

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When should I see a healthcare professional about hip pain?

You should consider seeing a healthcare professional if:

• You have persistent pain on the outer side of your hip
• Your hip pain is affecting your sleep or daily activities
• You're having difficulty walking or moving your hip
• You've tried home remedies without success
• You're concerned about your symptoms

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Can trochanteric bursitis go away on its own?

In some cases, mild trochanteric bursitis may improve on its own with rest and home care. However, without proper treatment, it can become chronic and lead to long-term pain and reduced function. That's why it's important to seek professional help if you're experiencing persistent symptoms.

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How long does it take to recover from trochanteric bursitis?

Recovery time can vary greatly depending on the severity of your condition and the treatment approach:

• For mild cases treated early: You might see improvement in a few weeks to a couple of months
• For more severe or chronic cases: Recovery can take several months

Remember, everyone's recovery is different. Factors like your age, overall health, and how well you follow your treatment plan can all affect your recovery time.

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Take home message

Trochanteric bursitis is a common condition that can significantly impact your daily life and activities. However, with proper diagnosis and treatment, most people with trochanteric bursitis can find relief and improve their hip function.

At Blacktown Health, our team of experienced Physiotherapists, Chiropractors, and Exercise Physiologists in Blacktown can help you manage your trochanteric bursitis effectively. We offer a range of treatments and can provide personalised advice on exercises, lifestyle modifications, and pain management strategies. Remember, early intervention is key in managing trochanteric bursitis.

If you're experiencing persistent hip pain or have concerns about trochanteric bursitis, don't hesitate to contact us at Blacktown Health. We have clinics conveniently located in Mt Kuring-Gai, Asquith, Willoughby, Milsons Point, Dural, and Blacktown so you can get the right advice and treatment for your trochanteric bursitis.

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