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What to know about trochanteric bursitis

Trochanteric bursitis occurs when small, fluid-filled sacs in the hip called bursa become irritated. Bursitis is one of the most common causes of hip pain.

Bursa are small, fluid-filled sacs found near joints. Bursa help joints move more easily by allowing muscles and tendons to glide over bone and other structures. The human body has over 150 bursae.

When bursa become inflamed, they cause a condition known as bursitis. Trochanteric bursitis or greater trochanteric pain syndrome gets its name because it affects an area of bone called the trochanter. The trochanter is located in a specific area of the hip, at the tip of the thigh bone.

Read on to learn about the causes and symptoms of trochanteric bursitis, as well as how to treat it. While there is no cure, there is a range of treatment options available that can improve mobility and reduce hip pain.

Symptoms

trochanteric bursitis in person sitting on bed holding their hip
Moving or pressing the outside of the hip or thigh can cause pain in the hip when a person has trochanteric bursitis.

Trochanteric bursitis is a common cause of outer hip pain in active middle-aged women.

Trochanteric bursitis can cause significant hip pain, especially if a person puts pressure on their hip. It can also cause the following symptoms:

  • pain in the hip that usually occurs outside of the hip or thigh
  • pain that worsens with physical activity
  • pain when a person walks up the stairs
  • pain when lying on the affected side
  • pain when touching or pressing on the hip

The pain related to trochanteric bursitis is usually worse at night, especially when a person is lying down or has been lying on their side for some time. If the tendons around the hip bone are also inflamed, symptoms may be worse.

Gluteus medius tear

The symptoms of trochanteric bursitis can be similar to those caused by a tear of the gluteus medius, which is a muscle that attaches to the same area. However, a tear of the gluteus medius causes weakness when trying to bring the hip or leg away from the body. If symptoms persist and a person suspects a tear of the gluteus medius, they should see a doctor as this injury may require surgery.

Causes of trochanteric bursitis

Man cycling on road
Running or biking regularly may increase the risk of trochanteric bursitis.

Some of the causes associated with the condition include:

  • Trauma. A history of falls or bumping the hip hard against something can cause trochanteric bursitis.
  • Overuse. People who perform repetitive physical activities, such as running or biking, can cause inflammation of the bursa sacs in the hip.
  • Poor posture. Sitting in a curved posture or another poor-posture position can place extra strain on the hips. Posture-related conditions, such as scoliosis, can also cause trochanteric bursitis.
  • Bone spurs or calcium deposits. Sometimes a person may develop bony growths called bone spurs on the trochanter. These can rub against the bursa, resulting in inflammation.
  • History of certain chronic diseases. People who have chronic diseases, such as gout, thyroid disease, psoriasis, and rheumatoid arthritis, might be at higher risk of developing trochanteric bursitis.
  • Previous surgery. A person is more likely to get trochanteric bursitis if they have had surgery on their hip in the past, including a hip replacement. Between 3 to 17 percent of people who have had a hip replacement have trochanteric bursitis. Sometimes, hip surgeries can result in a slight difference in leg length, which can also contribute to trochanteric bursitis.
  • Being overweight. Excess weight or obesity can also contribute to trochanteric bursitis. This is because the excess weight places greater strain on the hip and area around it.

Treatments

Some of the methods used to treat trochanteric bursitis include:

  • Resting to allow time for the inflamed bursa sacs to heal. Sometimes a person may need assistive walking devices, such as a cane or crutches.
  • Taking over-the-counter OTC anti-inflammatory medications, such as Ibuprofen or Naproxen.
  • Applying a heating pad, cooling pad, or ice pack to the affected area. This can reduce inflammation and help manage pain.
  • Engaging in physical therapy exercises to improve range of motion and strengthen the muscles around the hip.
  • Having corticosteroid injections, if recommend by a medical provider. These injections help to reduce pain and inflammation.
  • Losing weight if a person is overweight. Excess weight can put extra strain on the hips, resulting in trochanteric bursitis pain.

If a person tries treatment methods at home and still has pain, a doctor may recommend surgery. A doctor will not usually suggest surgery unless a person s symptoms have not improved with 12 months of at-home and medical treatments.

In extreme cases, a person can have their bursa removed through minimally invasive techniques. This surgery can often be accomplished on an outpatient basis where a person does not have to stay in the hospital overnight.

Diagnosis

Doctors pointing at x-ray of pelvis.
An X-ray may be carried out to diagnose trochanteric bursitis.

A doctor will begin diagnosing trochanteric bursitis by first reviewing a person s medical history and symptoms. The doctor will perform a physical examination of the hip, feeling for tender areas close to where the bursa are likely to be.

A doctor would most likely expect the pain from trochanteric bursitis to be worse at the lateral or side portion of the hip. Sometimes, a doctor will feel areas of bulging tissue on the lateral hip, which can indicate trochanteric bursitis.

As well as a physical exam, a doctor may recommend additional imaging studies to check for abnormalities associated with the bursa. These include:

  • X-rays
  • bone density scans
  • magnetic resonance imaging MRI

A doctor will consider not only the symptoms that point to trochanteric bursitis but will also try to rule out other similar conditions. For example, someone who has difficulty putting on shoes and socks or has a gait where walking causes then pain from the first step may have osteoarthritis rather than trochanteric bursitis.

The symptoms of trochanteric bursitis may be similar to or confused with:

Outlook

Trochanteric bursitis can be a troublesome and painful condition. Usually, OTC treatments can help ease a person s symptoms. Surgery is the last treatment method recommended for those with persistent painful symptoms.