Trochanteric Bursitis (Hip Bursitis)

Trochanteric Bursitis (Hip Bursitis)

John Miller Physiotherapist

Article by John Miller

Trochanteric Bursitis

Managing Hip Bursitis

Trochanteric bursitis stands out as the most prevalent type of hip bursitis, significantly contributing to Greater Trochanteric Pain Syndrome (GTPS). It develops from the inflammation of the bursa, a tiny sac that provides cushioning at points where tendons cross joints.

Specifically, this condition affects the superficial trochanteric bursa, located by the prominent bone on the hip’s side (femur). In more severe cases, a deeper bursa may also become inflamed.

Causes of Hip Bursitis

Typically, repeated compression of the bursa leads to inflammation and pain.

Weakness in the gluteal muscles, notably the gluteus medius, often accompanies this condition, resulting in a Trendelenburg gait pattern, indicative of hip muscle weakness.

GTPS, and subsequently hip bursitis, is more common in females, patients who are overweight or obese, and patients aged 40 to 60 years. It has been suggested that the larger width of the typical female pelvis may cause increased tension on the iliotibial band over the greater trochanter.

Research suggests that inadequately rehabilitated low back pain or hip pathologies can lead to such muscle weaknesses. However, properly tailored exercise protocols focusing on muscle strengthening can effectively reverse this condition. Such exercises should concentrate on individually weak muscles to enhance the strength of gluteal and hip rotator muscles.

Young, active individuals and older adults with gluteal muscle weakness are susceptible to trochanteric bursitis. Activities often linked to this condition include running with poor muscle control, bushwalking to the point of fatigue, and cycling with a high seat causing muscle strain.

Acute cases may arise from falls or sports-related impacts on the hip.

For advice on hip muscle weakness, consulting a physiotherapist experienced in gluteal and hip pathologies is crucial.

Diagnosing Hip Bursitis

Diagnosis typically occurs during a clinical consultation, involving a review of medical history and a physical examination of the hip, pelvis, and back.

Additional diagnostic tools like ultrasound scans or MRI may be employed for confirmation. A key diagnostic indicator is tenderness over the greater trochanter (hip bone) when pressure is applied.

Symptoms

Common symptoms of hip bursitis include:

  • Pain and swelling over the side of the hip bone.
  • Referred pain travelling down the outer thigh, possibly reaching the knee.
  • Discomfort when sleeping on the affected hip or after prolonged sitting.
  • Pain during activities such as stair climbing, running, walking, or standing for extended periods.

Seeking advice from a trusted hip physiotherapist or doctor is advisable if these symptoms are present.

trochanteric bursitis
Trochanteric Bursitis (Hip Bursitis)

Effective Treatments for Trochanteric Bursitis

Treatment strategies include:

  • Early pain relief and anti-inflammatory measures.
  • Kinesiology tape to de-load the bursa.
  • Corrective exercises targeting specific muscle weaknesses.
  • Preventative exercises to reduce future bursa irritation.
  • Weight reduction is beneficial.

Anti-inflammatory Agents

When considering anti-inflammatory options, it’s crucial to have a discussion with your doctor. This conversation should cover both NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) and natural anti-inflammatories like arnica. Your doctor’s guidance is essential to prevent potential side effects.

Applying ice packs several times daily can be beneficial. Ice is a natural anti-inflammatory agent that helps reduce pain and swelling.

Corticosteroid Injections for Hip Bursitis

Another effective treatment is a combined injection of a corticosteroid and a local anaesthetic directly into the bursa. This procedure is performed under ultrasound guidance and can significantly decrease inflammation. The local anaesthetic offers immediate pain relief, while the cortisone gradually works over the subsequent days.

Although these injections can alleviate pain, they don’t necessarily address underlying issues like muscle weakness that might have contributed to the bursitis. Therefore, it’s important to also consider corrective and preventative exercises. These exercises are key strategies for preventing recurrence of the condition.

Steroid injections can relieve pain for 3 to 6 months, but individual responses may vary. Steroid injections may be repeated but are limited to 3 or 4 injections per year due to the increased risk of side effects from cumulative steroid administration. (Raythatha M et al 2019)

Phased Treatment Approach

Phase I:

Focuses on alleviating pain and protecting the hip, employing strategies like active rest, ice therapy, and cortisone injections. Treatment techniques may include ice, electrotherapy, acupuncture, de-loading taping techniques, and the temporary use of mobility aids.

Phase II:

Aims to restore normal hip function, including joint range of motion, muscle length, strength, and walking patterns. PhysioWorks’ “Hip Core Stabilisation Program” assists in regaining standard hip muscle control.

Phase III:

The final stage targets returning to desired activities, with rehabilitation tailored to individual functional goals.

Surgery, specifically a bursectomy, remains a rare treatment option for persistent cases.

Expected Results and Prevention

Physiotherapy often yields positive outcomes within weeks, though chronic cases may take longer. Maintaining rehabilitation exercises even after pain subsides is crucial for preventing recurrence. The best prevention strategy includes excellent hip muscle control, guided by your physiotherapist or doctor.

Conclusion

Trochanteric bursitis can restrict your daily activities due to discomfort, but proper treatment and rehabilitation can lead to significant improvements. Always work closely with your physiotherapist or doctor, adhere to their advice, and continue your exercises to avoid recurrence. If experiencing symptoms of trochanteric bursitis, seek professional help

Introduction to Hip & Groin Pain

Hip and groin pain affects a wide array of individuals, from athletes to the elderly. Understanding the common causes and treatments of this pain is vital for maintaining overall well-being and mobility.

Common Causes of Hip Pain

hip & groin pain
Hip &Amp; Groin Pain Causes &Amp; Treatment

Lateral Hip Pain and Its Causes

Groin Pain: Different Types and Causes

Other Muscle-Related Pain

Systemic Diseases Affecting the Hip

Referred Pain Sources

  • Sciatica: Pain radiating along the sciatic nerve, which runs from the lower back through the hips and down the legs.
  • Lower Back Pain: Can refer pain to the hip area.
  • Pinched Nerve: Nerve compression in the spine or hip area.

Hip Surgery: A Solution for Severe Cases

What's New in Hip & Groin Pain Research?

Recent studies suggest the importance of tailored exercise programs in managing hip and groin pain. Physiotherapy techniques focusing on strengthening and stabilising the deep hip rotators and core muscles have shown significant improvements in pain management and mobility.

What to Do? Seeking Professional Advice

If you're experiencing hip or groin pain, it's crucial to consult with a physiotherapist or doctor.

They can assess your condition, provide a personalised treatment plan, and guide you through exercises tailored to your specific needs.

Conclusion

Hip and groin pain can significantly impact your quality of life. However, with the right knowledge and professional guidance, managing and overcoming this pain is achievable.

Hip, Groin, Buttock Pain FAQs

Welcome to our comprehensive FAQ section, designed to address your concerns about hip, groin, and buttock pain. Here, we aim to provide clear, accessible information to help you understand the potential causes of your discomfort and the various treatment options available. Our physiotherapy experts have compiled a series of questions and answers to guide you through common issues, from hip impingement to sciatica, and everything in between. For more in-depth exploration, we've linked to related articles on our website, allowing you to delve deeper into each topic.

Hip, Groin, Buttock Pain
Hip, Groin, Buttock Pain Faqs

Hip Pain FAQs

Dealing with hip pain can be challenging, impacting your mobility and quality of life. Explore our detailed articles for insights on diagnosis, treatment options, and the importance of hip core muscles in maintaining joint health.

Lateral Hip Pain FAQs

Lateral hip pain, including conditions like gluteal tendinopathy and hip bursitis, requires targeted treatment strategies. Discover effective physiotherapy approaches to manage and alleviate your pain.

Groin Pain FAQs

Groin pain can significantly affect your ability to perform daily activities. Learn how to recognise serious symptoms and find effective relief methods through our expert advice.

Buttock Pain FAQs

Buttock pain, including conditions like SIJ pain and sciatica, can be debilitating. Our articles offer insights into symptoms, causes, and comprehensive treatment options to help you recover.

Conclusion

Our FAQ section is designed to be your go-to resource for hip, groin, and buttock pain. Whether you're dealing with a temporary discomfort or a chronic condition, understanding your symptoms and knowing the best treatment options is crucial. Remember, while our website provides valuable information, consulting a physiotherapist for a tailored diagnosis and treatment plan is always recommended. Explore our related articles for more in-depth knowledge and take the first step towards a pain-free life today.

Related Articles

  1. Greater Trochanteric Pain Syndrome (GTPS) - Readers can learn about the causes and management of pain near the greater trochanter, which is closely related to lateral hip pain.
  2. Trochanteric Bursitis - Hip Bursitis: Causes & Treatments - This article explains the causes of hip bursitis and offers treatment solutions, relevant to those experiencing lateral hip pain.
  3. Gluteal Tendinopathy: Causes, Symptoms, And Treatment - Offers insights into the causes and treatment of hip tendinitis, a condition linked to lateral hip pain.
  4. Hip Adductor Tendinopathy - Effective Physio Solutions - Focuses on groin pain caused by inflammation or degeneration of tendons in the hip region, directly relevant to the groin pain FAQ.
  5. Hip Flexor: Iliopsoas Groin Pain: Causes And Treatment - Provides detailed information on hip flexor issues, which can cause groin pain, making it highly relevant to readers of the original article.
  6. Hip & Groin Pain Guide: Causes, Treatment, Physio Advice - A comprehensive guide on hip and groin pain, covering common causes and treatments that align with the article's topics.
  7. Piriformis Syndrome - Understanding & Physio Treatment Tips - Discusses piriformis syndrome, a condition causing buttock pain, which is directly related to one of the SEO keywords.
  8. What Is Hip Impingement? - Explains hip impingement, a condition causing hip and sometimes groin pain, providing valuable insights into potential causes of the reader's discomfort.
  9. Sacroiliac Joint Dysfunction (SIJ) Causes, Relief, Treatment - Relevant for readers experiencing buttock pain, as it covers SIJ pain, a topic mentioned in the original article.
  10. Hip Arthritis - While not directly mentioned in the FAQ sections, hip arthritis can be a source of hip pain, making this article useful for readers wanting to understand more about hip conditions and pain management.
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