Trochanteric bursitis also called “hip bursitis” is a common problem caused by inflammation of the bursa the overlies the greater trochanter (bony prominence on the outer side of the hip). The bursa is a small sac filled with fluid which acts as a cushion and allows smooth motion by reducing the friction between the muscles and the bone. The condition causes pain in the outer portion of the upper thigh.
Trochanteric bursitis commonly affects runners and athletes participating in soccer and football. It is more common among women and middle-aged or elderly people. The risk factors for developing trochanteric bursitis include:
- Repetitive stress or overuse injury to the hip joint that may occur because of running, climbing stairs, or standing for a long period of time
- Hip injury resulting from a fall onto your hip, blow to the hip, or from lying on the same side as the affected hip for a long time
- Improper posture as a result of scoliosis, arthritis of the lumbar portion of the spine, and other spinal diseases
- Leg length differences may affect your walking pattern and can cause irritation of the hip bursa
- Disease conditions such as rheumatoid arthritis, gout, and psoriasis may lead to inflammation of the bursa
- Previous hip fracture surgery or prosthetic implants in the hip can cause irritation of the bursa
- Bone spurs or calcium deposits formed in tendons that attach to the trochanter may cause irritation to the bursa
Pain in the outside portion of the hip, thigh area, or buttock is the pain symptom of trochanteric bursitis. The pain may be worse in the night, when lying on the affected side, during activities such as prolonged walking, climbing stairs, squatting. Pain may also aggravate while standing up after being in sitting position for a long time.
A detailed medical history and physical examination will be performed to diagnose trochanteric bursitis. Additional diagnostic studies including X-rays, CT and MRI scans may be necessary to rule out the possibility of injury or other conditions. The initial phase of treatment for trochanteric bursitis is non-surgical and includes simple lifestyle changes such as avoiding activities that make symptoms worse (activity modification), use of anti-inflammatory medication to control pain, use of an ambulatory support including a cane or crutches. Corticosteroid injection into the bursa is also effective in relieving pain.
Surgical treatment involves an endoscopic procedure to remove the inflamed bursa. This may be recommended if pain and inflammation in the bursa does not resolve with conservative treatment approaches.