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Dr Saleem Hussenbocus - Orthopaedics SA

Trochanteric Bursitis

Trochanteric bursitis or hip bursitis is a condition most often found in middle aged or elderly people. It is however; not uncommon in athletes and football or soccer players where extended periods of running are required.

Bursae are found throughout the body, particularly in the shoulder, knee, ankle and hip joints. They are small sacs of fluid, which cushion and lubricate the areas between the bones, muscles and tendons of the joints. When these bursae or sacs become irritated or inflamed, more fluid accumulates in the bursa, and will result in bursitis. Inflammation of the trochanteric bursa is a common cause of hip pain.

  • Pain is the main symptom of trochanteric bursitis
  • The pain will be felt whenever the joint is used and usually extends over the outside or lateral aspect of the hip and often may radiate down the outside of the thigh to the knee
  • The pain is typically described as a burning and tingling along the outside of the thigh
  • Lying down or rolling onto the affected side increases the level of pain
  • People with trochanteric bursitis will experience pain when sitting, standing for long periods of time and when climbing stairs
  • Those affected often will have disturbed sleep patterns due to pain experienced at night
  • Limping
  • Overuse of the joint (repetitive stress)
  • A direct fall onto the hip
  • Prolonged pressure on the hips from standing for long periods
  • Prolonged lying on one side of the body
  • Prosthetic hip implants or hip surgery

If trochanteric bursitis is suspected, your Doctor will conduct a physical examination of your hip joints. A medical history will also be taken to highlight any significant injury or past surgery to the hip joints.

If required, your Doctor will arrange for a x-ray or ultrasound of your hip. These help in the diagnosis by revealing any bony spurs, calcium deposits or other problems, which may be contributing to the bursitis.

Very occasionally a MRI scan (Magnetic Resonance Imaging) may be needed.

Following the examination and the results of any x-rays or scans, your Doctor will discuss with you the most likely cause of your bursitis. They may prescribe:

  • Rest (short term only) to assist in reducing the inflammation of the bursa. This will also mean identifying the actions or activities which cause you discomfort and making changes where necessary
  • Weight loss is encouraged if it is a significant contributing factor to the bursitis
  • Conservative treatments such as ultrasound, acupuncture and massage therapy have been found to be of benefit
  • Icing the affected area for 15 minutes up to three times per day can also be beneficial. Wrap the ice in a tea towel before using and never apply ice directly to the skin
  • Your Doctor will discuss pain relief with you. If tolerated, non-steroidal anti-inflammatory medications may be prescribed

Once the symptoms are controlled a physiotherapist can help with hip and back strengthening/stretching exercises for you. These are important as often bursitis is related to ‘wear and tear’ of the adjacent gluteal tendons – strengthening helps the tendons and thus the bursitis.

If conservative steps do not bring relief then your Doctor may arrange a corticosteroid/local anaesthetic injection into the affected area. This injection can be repeated a few months later.

Surgery is considered a last resort in the treatment of trochanteric bursitis, and may also involve the worn/torn gluteal tendons.

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