An inflammatory condition of a fluid-filled sac that is next to the hip joint. It occupies a superficial position and when when it’s irritated or inflamed it can result in hip pain.
Tochanteric bursitis can be attributed to numerous factors as given below:
Can develop over a period due to repeated friction from various muscles or ligaments on the bursa. Repetitive trauma can occur secondary to cycling with a high positioned bicycle seat, walking or running with poor technique.
Overuse of your hip joints by climbing, racing upstairs or prolonged standing, especially if you haven’t warmed up or stretched the joints before starting an intense or new activity.
Sports trauma, a fall on your hip or after a lateral sided hip surgical procedure.
Incorrect posture due to medical conditions like arthritis of the lumbar spine (lower back region), scoliosis, kyphosis and other spinal condition.
Certain medical conditions including psoriasis, degenerative diseases,rheumatoid arthritis,thyroid disorders, gout or some drug reactions can lead to bursitis.
Unequal leg length will place more pressure on one leg.
Lying on one side of your body for a prolonged period on a hard surface.
Formation of bone spurs on the hip bone or calcium deposits within tendons connected to the greater trochanter/top of the hip bone.
Trochanteric bursitis can encompass a range of symptoms which may include:
Generalized hip pain located on the outer aspect of the thigh or occasionally in the buttock.
Hip pain when lying on the painful hip.
Sharp pain when pressing on the outer region of the hip.
Difficulty going up stairs.
Increased hip pain when standing up from a low chair or when exiting the car.
Physical examination of the affected region by your Doctor, Physiotherapist or Chiropractor will help diagnose your condition. There is tenderness when applying pressure on the lateral aspect of the hip bone. A definite diagnosis of this condition can be made by imaging investigations including ultrasound, CT scan, MRI and even X-ray to rule out any concerns of hip fractures being the source of pain.
Your Physiotherapist or Chiropractor may use ice therapy to reduce the inflammation in the acute phase or when it is very irritable. Other forms of pain relief treatments include remedial massage for the surrounding muscle groups, acupuncture, electrotherapy, prescribing foot orthotics and advice on how to sleep comfortably. Sleeping posture advices include avoiding sleeping on the affected side if you can, or if you must then use a donut-shaped pillow which will take the pressure off the bursa. Sleeping with a pillow between the knees keep the muscles around the bursa relaxed. If someone is struggling to walk, then it is advised to use a crutch or a walking stick to avoid aggravating the affected hip.
Your Physiotherapist will guide you through a rehabilitation program to restore the length and strength of your muscles, joints of your hip and lower back. They will also assess your balance and walking or running patterns. Our bodies are amazing mechanisms that fire certain muscle group to turn on at the right time and in the correct order. In order to produce a pain-free movement of your hip, there is a pattern that muscle fibers fire, that is, first deep followed by intermediate and lastly superficial muscle groups.Your physiotherapist will assess for any muscle recruitment abnormalities will assign particular exercises to address the issue such as:
Surgery is not a common path. However, in persistent cases, arthroscopic excision of the bursa; also known as a bursectomy, forms an option.
Iliotibial band stretch
Gluteal stretch exercise
Wall hamstring stretch
Hip extension strengthening
Hip abduction strengthening
The following measures can be adopted to avoid developing a trochanteric bursitis:
Wear appropriate footwear to prevent any imbalance related to biomechanics.
Develop better muscle strength and stress endurance, as muscle fatigue and weakness are major predisposing factors for bursitis recurrence.
Maintain a healthy body weight to reduce the load on your hip joints and surrounding muscles.
Regular warm up before exercise, stretching your lower limbs and maintaining good posture throughout your day.
Physiotherapy or Chiropractic treatment is effective in treating trochanteric bursitis but is paramount to identify the cause and remove the aggravating factor. Trochanteric bursitis usually requires six weeks of rehabilitation for a full recovery but may vary depending on the severity and if other conditions are overlapping.