Trochanteric Bursitis

Trochanteric bursitis is an inflammation of the bursa, which is a thin, slippery  film that sits between bones and soft tissue as a protection for joints. The trochanteric bursa is around the hip and can become inflamed by repetitive movement or by physical force.

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Understanding Trochanteric Bursitis

A bursa is a thin, slippery, sac-like film. It contains a small amount of fluid. This structure is found between bones and soft tissues in and around joints. A bursa cushions and protects a joint. It keeps parts of a joint from rubbing against each other. If a bursa becomes inflamed and irritated, it's known as bursitis.

The trochanteric bursa is found on the hip joint. It lies on top of the bump at the top of the thigh bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis.

Causes and risk factors of trochanteric bursitis

Causes may include:

  • Overuse of the hip during running or other sports, dance, or work.

  • Falling on or irritation to the side of the hip.

This condition may occur along with other problems, such as osteoarthritis of the hip or knee, or low back problems. In rare cases, it may occur after hip surgery.

Risk factors that lead to trochanteric bursitis

Several risk factors can lead to the development of trochanteric bursitis. Some of these include:

  • Age: Trochanteric bursitis is more common in adults over the age of 40.
  • Gender: Women are more likely to develop trochanteric bursitis than men.
  • Obesity: Excess weight puts extra pressure on the hips and can lead to bursitis.
  • Repetitive movements: Repeating the same motions over and over again can put strain on the hip and lead to bursitis.
  • Previous injury: If you have injured your hip in the past, you are more likely to develop bursitis.
  • Arthritis: Osteoarthritis and rheumatoid arthritis are both risk factors for trochanteric bursitis.

If you have any of these risk factors, it is important to be aware of the signs and symptoms of trochanteric bursitis so that you can seek treatment if necessary.

Symptoms of trochanteric bursitis

The most common symptom of trochanteric bursitis is pain on the outside of the hip.

This pain may be dull and achy or sharp and stabbing. It may be worse when you move your hip, lie on that side, or put pressure on the area.

You may also notice swelling, tenderness  and warmth around the outside of the hip, near the bony bump at the top of the thigh.

The pain may travel down the leg.

How is bursitis diagnosed?

Your healthcare provider will ask about your health history and do a physical exam. You may also need tests such as:

  • X-ray. This test uses energy beams to make pictures of internal tissues, bones, and organs on film.

  • MRI. This test uses large magnets, radio waves, and a computer to make detailed pictures of organs and structures within the body.

  • Ultrasound. This test that uses high-frequency sound waves to look at the internal organs and tissues.

  • Aspiration. For this test, the healthcare provider uses a thin needle to remove fluid from the swollen bursa. The fluid is checked for infection or gout as causes of bursitis.

Blood tests. Lab tests may be done to confirm or rule out other conditions.

Treatment for trochanteric bursitis

These may include:

  • Resting the hip. This allows the bursa to heal.

  • Prescription or over-the-counter pain medicines. These help reduce inflammation, swelling, and pain. NSAIDs (nonsteroidal anti-inflammatory drugs) are the most common medicines used. Medicines may be prescribed or bought over the counter. They may be given as pills. Or they may be put on the skin as a gel, cream, or patch.

  • Cold packs and heat packs. These help reduce pain and swelling.

  • Stretching and strengthening exercises. These improve flexibility and strength around the hip.

  • Physical therapy. This includes exercises or other treatments.

  • Injections of medicine into the bursa. This may help reduce inflammation and relieve symptoms. The medicine is usually a corticosteroid. This is a strong anti-inflammatory medicine.

What can I do to prevent bursitis?

Try the following measures to prevent bursitis:

  • Warm up before exercising or before sports or other repetitive movements.

  • Start new exercises or sports slowly. Gradually increase the demands you put on your body.

  • Take breaks often when doing repetitive tasks.

  • Cushion “at risk” joints by using elbow or knee pads.

  • Stop activities that cause pain.

  • Practice good posture. Position your body correctly when doing daily activities.

If you don’t give your hip time to heal, the problem may not go away, may return, or may get worse. Rest and treat your hip as directed by your healthcare provider.

When should I call my healthcare provider?

Call your healthcare provider if you have any of the following:

  • Pain or trouble moving that affects your regular daily activities.

  • Pain doesn’t get better or gets worse with treatment.

  • A bulge or lump develops at the affected joint.

  • Redness or swelling develops at the affected joint.

  • You have fever, chills, or night sweats.

Exercises to Help with Trochanteric Bursitis

If you have been diagnosed with trochanteric bursitis, your doctor may have recommended a course of exercises to help improve your condition. These exercises can help to stretch and strengthen the muscles around the hip, which can in turn help to take some of the pressure off of the bursa.

Please note: It is important to discuss these exercises with your healthcare provider before trying anything on your own. You will not want to risk further injury.

Standing Hip Abduction

One simple exercise that can be done at home is a standing hip abduction. To do this exercise, stand with your feet shoulder-width apart and place your hand on a chair or countertop for balance. Slowly lift your leg out to the side, keeping your thigh muscle tight. Hold for a count of five, then lower back down. Repeat 10 times on each side.

Side-Lying Lateral Leg Lift

Another helpful exercise is the lying lateral leg lift. To do this exercise, lie on your side on a mat or other firm surface. Place your top leg on top of a small pillow or rolled-up towel for support. Slowly lift your bottom leg towards the ceiling, keeping your thigh muscle tight. Hold for a count of five, then lower back down. Repeat 10 times on each side.

Standing Hip Hike

If you are looking for more of a challenge, you can try the standing hip hike exercise. To do this exercise, stand with your feet shoulder-width apart and place your hand on a chair or countertop for balance. Shift your weight onto one leg and raise the other leg as high as you can without arching your back. Hold for a count of five, then lower back down. Repeat 10 times on each side.

Stretching for trochanteric bursitis

In addition to strengthening the muscles around the hip, it is also important to stretch these muscles. This can help to improve the range of motion and flexibility, which can in turn help to reduce the pressure on the bursa.

Pigeon Pose

One stretch that may be helpful is the pigeon pose. To do this stretch, start in a tabletop position on your hands and knees. Bring your right knee forward and place it behind your right wrist. Slide your left leg back, keeping your foot pointed straight ahead. You should feel a stretch in your right hip and buttocks. Hold for 30 seconds, then repeat on the other side.

Lying Quad Stretch

Another stretch that can be helpful is the lying quad stretch. To do this stretch, lie on your side on a mat or other firm surface. Place your hand on the floor in front of you for stability. Bend your top leg and reach back to grab your ankle. Gently pull your heel towards your buttocks, feeling a stretch in the front of your thigh. Hold for 30 seconds, then repeat on the other side.

If you are having difficulty with any of these exercises or stretches, please talk to your healthcare provider. They can help to modify the exercises or suggest alternate exercises that may be more appropriate for your situation.

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