What is Trochanteric Bursitis?
More than 50% of patients who present for physiotherapy with hip pain are suffering from trochanteric bursitis.
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 are Trochanteric Bursitis Symptoms?
One or more of the following symptoms may be experienced:
- 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 be inflamed by a group of muscles or tendons rubbing over the bursa and causing friction against the thigh bone. This injury can occur traumatically from a fall or a sport-related impact contusion.
It can also be a case of gradual onset via a repetitive trauma to the bursa from such activities as running (with poor muscles control or technique), walking into fatigue, or cycling, especially when the bicycle seat is too high.
It is also a secondary injury associated with chronic conditions such as:
- Scoliosis – curvature of the spine
- Unequal leg length
- Weak hip muscles
- Osteoarthritis (degenerative joint disease) of the hips or lower back
- Calcium deposition in the gluteal tendons that run over the bursa
- Rheumatoid arthritis.
How is Trochanteric Bursitis Diagnosed?
We will provide you with an assessment of your medical history and a physical examination of your hip, pelvis and back. A hallmark sign is if you feel tenderness over the bursa or greater trochanter (hip bone) when pressure is applied.
Diagnosis can also be confirmed by medical imaging techniques that include ultrasound scan & MRI.
How is Trochanteric Bursitis Treated?
Our physiotherapy rehabilitation program is aimed at improving the muscle control around the hip, pelvis and lumbar spine. The key to successful Trochanteric Bursitis treatment is a carefully prescribed, progressed and supervised exercise program that restores the correct balance between all the muscle groups around the lumbar spine, pelvis and hips. Cortisone injections may be required to reduce the inflammation of the bursa and assist in the completion of the treatment program.
What Results Can You Expect for Trochanteric Bursitis?
While some people can respond quickly to physiotherapy treatment within a few weeks, more chronic cases where a tendinopathy exists in the gluteal muscle group under the bursa can require a few months to achieve recovery.
Trochanteric bursitis is successfully managed in the vast majority over a period of approximately six weeks. It is important to not stop your rehabilitation exercises as soon as you pain abates.
Excellent hip muscle control is your best rehabilitation and prevention strategy. Please follow the advice of your physiotherapist or doctor.
We can get you started on the right track to recovery! If you have any specific questions, please ask them.