Trochanteric Bursitis

FAQs on Trochanteric bursitis

 

Trochanteric bursitis or hip bursitis is common inflammatory disorder in people aged over 40 years. One in every 30 US residents suffer from shoulder, elbow, heel or hip bursitis. Trochanteric bursitis turns painful impacting the thigh, back, and buttock and giving rising to greater trochanteric pain syndrome, a condition that impact almost 10% of men and 25% of women above 50.

What is bursitis?

Bursitis indicates inflammation of the bursa, a small jelly-like sac located close to the friction points of knee, hip, shoulder, heel, and other joints in your body. It contains synovial fluid, a thick lubricant that lubricates muscles, tendons, and cartilage, which cushion and activate bones at friction points. Contraction and relaxation of the bursa also dissipates the force on the joint and allows bones to slide on each other.

When bursa becomes irritated, it enlarges and becomes subject to inflammation, and swelling. The condition is known as bursitis.

What is trochanteric bursitis?

Trochanteric bursitis occurs when the inflammatory disorders impacts the trochanteric bursa positioned at the outer part of the hip. The particular bursa is located between the gluteal or buttock muscles that move the hip and the greater trochanter, a bump at the top of the femur.

As we jump, run, squat, or walk, the gluteals contract exposing the trochanteric bursa, the shock observer, to absorb pressure. If the direct impact caused by the pressure is excessive, the bursa becomes subject to irritation and inflammation.

Traumatic hip bursitis takes over the bursa when one fall onto the outer hip. Bursa is also inflamed if overlaying muscles and tendons cause recurring rubbing. Biomechanical abnormalities and weak hip abductors cause the bursa subject to increased friction and trochanteric bursitis.

What are the symptoms of trochanteric bursitis?

  • Sharp pain in the hip and buttock
  • Aching pain radiating to the outer thigh area
  • Pain worsens when sleeping on the hip or stair climbing or squatting
  • Pain with prolonged standing or walking
  • Pain when pressing the outer hip or following prolonged rest
  • Swelling on the side of the hip

What are the main causes of trochanteric bursitis?

  • Direct impact causing injury to trochanteric bursa
  • Repetitive rubbing of superimposed muscles and tendons
  • Overuse or excessive stress on trochanteric bursa over a period of time
  • Fall onto the hip
  • Spine disorders, such as lumbar arthritis and spinal curvature
  • Leg-length inequality
  • Excessive calcium deposits in the hip
  • Rheumatoid arthritis
  • Prosthetic hip implants
  • Bone spurs in the hip joint
  • Incorrect posture causing stress on the soft tissues around the joint
  • Hip osteoarthritis
  • Disorders, such as gout and psoriasis
  • Weak hip muscles
  • Gluteal tendinopathy

Who are at the risk of trochanteric bursitis?

Middle aged, elder people are at increased risk of hip bursitis. Those with leg-length inequality, lumbar arthritis, osteoarthritis of the hip, or rheumatoid arthritis also face the potential risk of the problem. Almost one in four women or 10 men suffers from trochanteric bursitis in their fifties.

How is trochanteric bursitis diagnosed?

Physical examination of the hip bursitis symptoms is the most common method to diagnose the disorder. Imaging tests including MRI and x-ray may be recommended if the disorder is not clear.

What are the treatment methods available for trochanteric bursitis?

  • Medication: NSAID are the most prescribed drugs to treat hip bursitis. It subdues inflammation and pain.
  • Self-Care: Rest is the most important way to overcome the disorder. Avoid activities that cause pain sensation. Daily application of ice to the inflamed area improves the condition. Shed a few pounds if you are overweight to reduce pressure on the hip bursa. It is recommended to use assistive device, including walking cane, for a few days following the diagnosis of trochanteric bursitis.
  • Physiotherapy: Intended to enhance hip strength and flexibility and speed up the healing process, it includes
  • Stretching exercises to reduce hip tension and hip joint friction
  • joint mobilization workouts
  • Hip strength and stability improving workouts
  • Rolling therapy massage
  • Electrotherapy
  • soft tissue massage
  • dry needling
  • Chiropractic intervention
  • Posture improving exercises
  • Gait abnormality correction
  • Surgical Intervention: Surgery is the last option and rarely used. The most common surgical procedure is bursectomy or removal of the bursa. Repair is done wherever possible or the bursa is completely removed. The use of arthroscopic technique allows making small incisions in the hip through which the inflamed bursa is removed.
  • Steroid Injection: Corticosteroid and local anesthetic shots relieve symptoms on semi-permanent basis aiding in the recovery of hip bursitis.
  • PRP injections: A study endorsed by the American Academy of Surgeons highlights high efficacy of platelet-rich plasma injections in overcoming chronic and severe trochanteric bursitis. Based on regenerative mechanism, the treatment helps in regeneration of the damaged bursa, soft tissues, gluteal tendons, and cartilage in the hip joint.

References

Long SS, Surrey DE, Nazarian LV. Sonography of Greater Trochanteric Pain Syndrome and the rarity of primary bursitis. American Journal of Roentgenology. 2013; 201(5): 1083-1086.

Quiroz, Cristian, Ruta, Santiago, Rosa, Javier, Navarta, David A., Garcia-Monaco, Ricardo, Soriano, Enrique R.; Ultrasound Evaluation Of The Greater Trochanter Pain Syndrome: Bursitis Or Tendinopathy? [abstract]. Arthritis Rheum 2013;65 Suppl 10 :855DOI: 10.1002/art.2013.65.issue-s10

Sofat N. Kuttapitiya A. Future directions for the management of pain in osteoarthritis.Int J Rheumatol. Apr 2014; 9(2): 197–276.

Jörn Funck. It’s A Wide Wide World. Journal of Prolotherapy. Volume 1 : Issue 4 : November 2009

Klauser AS, Martinoli C, Tagliafico A, et al. Greater trochanteric pain syndrome. Semin Musculoskelet Radiol. 2013;17(1):43-48.

Crespo M, Pigrau C, Flores X, et al. Tuberculous trochanteric bursitis: report of 5 cases and literature review. Scand J Infect Dis. 2004;36(8):552-558.

Fox, JL (2002). “The role of arthroscopic bursectomy in the treatment of trochanteric bursitis”. Arthroscopy 18 (7): 1–4. doi:10.1053/jars.2002.35143

Shbeeb MI, O’Duffy JD, Michet CJ, et al. Evaluation of glucocorticosteroid injection for the treatment of trochanteric bursitis. J Rheumatol. Dec 1996;23(12):2104-6.

 

 

JOIN OUR E-MAIL LIST!