Trochanteric Bursitis

Trochanteric bursitis can be a really frustrating problem to suffer from. This condition causes pain on the side of the hip and makes it very tender to touch and painful to lie on. The pain generally increases on standing for long periods of time or from walking, sometimes even just short distance.

There is normally a small pocket of fluid over the bony bit on the side of your hip. This is called a bursa. The bony bit of your hip is called the Greater Trochanter (GT). This pocket of fluid acts to allow tissues to glide over each other during movement. We have these all over our body (e.g. knee, elbow, shoulder). In this location, a tight band of tissue called the IT Band or Fascia Lata runs over the GT. It is common for the bursa between the GT and the IT Band to become inflamed and it can be difficult to get this back under control.

The most common reason for this happening is muscle weakness around the hips and the core. The abdominal muscles, the muscles alongside the spine and the muscles around your buttocks and hips are vital for how your hips function. Often, we can think we are fit but still have a lot of weakness in these muscles. When they are weak, our posture is poor and how we use the hips and the other muscles in this region becomes disordered. This can lead to a clunking sensation on the side of the hip and some people even feel as though the hip is popping out. In fact, it is just this tight IT Band snapping backwards and forwards over the GT.

In clinic, part of my examination will be getting you to do some simple strength and conditioning tests. These include – standing on one leg, doing a gentle squat on one leg, ‘Bridging’ and single leg ‘Bridging’. These are good tests for establishing if there is muscle weakness.

The best treatment for Trochanteric Bursitis is strengthening exercise. There are a whole host of exercises that will help and we will go through some in the clinic. Unfortunately, this is a no pain, no gain situation. It takes a few months of working hard to see the results.

I usually advise that all patients with this problem attend Pilates classes. This is excellent exercise for this problem (amongst other things) and although it will make you more sore to start with, you will see the benefits in time.

To make this condition more manageable it is likely that you will need to take painkillers and anti-inflammatories regularly. For many patients, it is necessary to perform a steroid injection using ultrasound to reduce the inflammation. This will reduce your pain while you are undertaking strengthening work.