Trochanteric bursitis is a common hip syndrome that causes pain and tenderness at the bony, outside point of the hip.
What is Trochanteric Bursitis?
Trochanteric Bursitis refers to the inflammation of the bursa at the lateral (outer) point of the hip, known as the greater trochanter. The bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between moving tissues in your body.
The gluteal muscles originate from the pelvis and insert into the top of the thigh bone overlying the greater trochanter. As the glutes contract during walking, climbing or jumping, friction is placed on the trochanteric bursa.
Patients typically experience sharp, intense pain in the outer aspect of the hip; the pain may also radiate down the outer part of the thigh, right down to the knee. You typically also experience tenderness with direct pressure such as lying on the affected side.
Painful activities include prolonged standing, squatting or climbing stairs. The pain can get worse when you’re getting up from a deep seat or getting out of the car.
What causes Trochanteric Bursitis?
Trochanteric bursitis can result from one or more of the following events:
- Direct injury to the greater trochanter – this includes falling onto the hip, bumping the hip into an object, or lying on one side for an extended period
- Repetitive friction or compression of the bursa by the soft tissues that glide over itThere are multiple factors that lead to this excessive compression
- Osteoarthritis of the hip/low back
- Tightness of the ITB – the iliotibial band crosses over the bursa, so when it’s constricted, it causes extra friction on the bursa
- Weak hip abductors (glutes medius and gluteus minimus) – these muscles prevent your leg from going inwards when walking and stop your hip from dropping. Having weak hip abductors will signify poor hip stability and biomechanics, placing more pressure on the bursa.
- Tight or overactive tensor fascia latae – this mucle attaches onto the ITB and when it works too hard to compensate for weak hip abductors, it cause extra tension on the ITB.
- Leg length discrepancy – this causes a muscle imbalance and glute dysfunction in the pelvis
Women are 4 times more likely to suffer from Trochanteric Bursitis.
This is due to the decreased oestrogen post-menopause, reducing muscle tone and broader hips and a narrow stance in women.
When should you seek medical advice?
Most cases of bursitis improve without any treatment over a few weeks. However, if you are experiencing pain that interferes with your daily activities or have soreness that doesn’t improve despite self-care measures, you should make an appointment with a physiotherapist. In more severe cases, patients also report a fever or the affected area appearing red, swollen or warm.