Trochanteric bursitis is inflammation of the bursa (fluid-filled sac near a joint) at the part of the hip called the greater trochanter. When this bursa becomes irritated or inflamed, it causes pain in the hip. This is a common cause of outer hip pain.
Trochanteric bursitis can result from one or more of the following events:
- Injury to the point of the hip. This can include falling onto the hip, bumping the hip into an object, or lying on one side of the body for an extended period.
- Play or work activities that cause overuse or injury to the joint areas. Such activities might include running up stairs, climbing, or standing for long periods of time.
- Incorrect posture. This condition can be caused by scoliosis, arthritis of the lumbar (lower) spine, and other spine problems.
- Stress on the soft tissues as a result of an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint).
- Other diseases or conditions. These may include rheumatoid arthritis, gout, psoriasis, thyroid disease or an unusual drug reaction. In rare cases, bursitis can result from infection.
- Previous surgery around the hip or prosthetic implants in the hip.
- Hip bone spurs or calcium deposits in the tendons that attach to the trochanter.
Bursitis is more common in women and in middle-aged or elderly people. Beyond the situations mentioned above, in many cases, the cause of trochanteric bursitis is unknown.
Trochanteric bursitis typically causes the following symptoms:
- Pain on the outside of the hip and thigh or in the buttock.
- Pain when lying on the affected side.
- Pain when you press in on the outside of the hip.
- Pain that gets worse during activities such as getting up from a deep chair or getting out of a car.
- Pain with walking up stairs.
Treatment goals include reducing pain and inflammation, preserving mobility, and preventing disability and recurrence.
Treatment recommendations may include a combination of rest, splints, heat, and cold application. More advanced treatment options include:
- Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen.
- Physical therapy that includes range of motion exercises and splinting. This can be very beneficial.
- Low-energy shock wave therapy. Acoustic shock waves are passed through the skin with a targeted device. One analysis showed that more than two-thirds of patients given shock wave therapy were cured or greatly improved after 4 months.
Injection may be beneficial for this condition. They may include:
- Cortisone (Corticosteroid)
- Platelet Rich Plasma (PRP)
- Trigger Point Injections
Surgery is rarely needed and most patients recover with conservative and injection therapies. If needed, the bursa can be removed if it is beyond repair. It’s usually an outpatient procedure, meaning no overnight hospital stay. A surgeon will use an arthroscope and tiny instruments to perform this operation.