What is Trochanteric Bursitis?

Our hips are marvels of flexibility. When we walk, they give us power and stability. When we jump, they can handle the impact. The hip joint is one of the largest and strongest joints in the human body.

But the hip can take a beating, and when that happens, we may feel pain.

One of the primary causes of hip pain is bursitis, which is an inflammation of the bursa. These fluid-filled sacs are found around the body and serve as cushions between bones and soft tissues such muscles, tendons, and skin.

Each hip has two major bursae. The outside point of the hip, which is called the greater trochanter, has a bursa called the trochanteric bursa. (The other bursa, on the inside of the hip area, is called the iliopsoas bursa.)

When that outside hip bursa gets inflamed, you have trochanteric bursitis. Also known as greater trochanteric pain syndrome (GTPS), it is a common condition and easily treatable.

What Causes Trochanteric Bursitis?

You’ll find bursa sacs at many of the body’s major joints, including the elbow, shoulder, and knee. The small pouches are filled with a thick fluid and are meant to lubricate joints and protect body parts from friction.

The trochanteric bursa, like other bursae, may become inflamed if the hip is overused or injured. Trochanteric bursitis affects about five of every 1,000 adults and generally occurs in middle-aged or older people, though people of any age may get the condition.

Active adults who regularly walk, run, or cycle may be susceptible to trochanteric bursitis. The side of the leg includes a long piece of connective tissue called the iliotibial band (ITB), which runs from the hip to the knee. If the ITB is tight from hard use, it may rub against the trochanteric bursa and cause irritation, leading to bursitis.

Other causes of trochanteric bursitis include:

• muscle tears
• hip injuries
• hip surgery complications
• poor posture
• diseases such as gout (a form of arthritis with sudden, sharp attacks of pain, often at the base of the big toe)

Symptoms

You’ll first notice trochanteric bursitis when you feel pain at the outside of your hip.

At first, the pain may be sharp, but with time, it may turn into a dull ache. Moving your hip, particularly going down stairs, might make the pain worse.

If left untreated, the pain may start going down your upper leg. You’ll likely feel it when you lay on the side of your affected hip and when getting up from a chair. The joint becomes stiff, and the bursa itself is sensitive to touch.

In extreme cases, your hip joint may become red and swollen and you may even have a fever.

If you’ve had these symptoms for more than 2 weeks without improvement, you should see a doctor.

Diagnosis

When you visit your doctor, they’ll most likely do a physical exam, focusing on how long you’ve had the condition and specific movements that cause the pain.

They may order X-rays to rule out other issues, since bursitis itself doesn’t show up on X-rays. You could get an ultrasound test, and you may get an MRI if your hip isn’t responding to treatment.

In some cases, your doctor may inject your bursa with an anesthetic. If the pain goes away at once, you most likely have trochanteric bursitis.

Treatment

Treatments are generally nonsurgical and easy to do at home. They might include:

• Ice. Apply ice packs to your hip every 4 hours for 20 to 30 minutes at a time. Cold numbs the area, which can reduce pain and may cut down on swelling and inflammation.
• Anti-inflammatory medications. Over-the-counter medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve), and prescription pain relievers such as celecoxib (Celebrex) can reduce pain and swelling. Be sure to check with your doctor before taking them, however.
• Rest. If you can stay off your hip, you can give it time to heal. Using walkers, crutches, and other tools may help as well.
• Physical therapy. An expert therapist can give you exercises to improve flexibility and strengthen your muscles.

Other treatments require a trip to the doctor’s office. They might include:

• Cortisone shots. Cortisone is a powerful anti-inflammatory medication. Athletes sometimes use these to reduce swelling and pain.
• 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.
• Surgery. Though surgery is rarely 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 -- a kind of camera -- and tiny instruments, as with common knee and elbow surgeries.

Prevention

You can stop trochanteric bursitis from becoming worse -- or never have it at all -- if you take care of your hips (and the rest of your body) properly. Among the things you can do:

• Exercise the right way. It’s great being active, but train properly. That means stretching, warming up, and listening to your body.
• Wear proper orthotics or inserts. One cause of trochanteric bursitis is having one leg shorter than the other. Inserts can even out your gait.
• Drop some pounds if you’re overweight. It’s a sure way of taking pressure off your hips.

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