Greater trochanteric bursitis also called hip bursitis is a common problem caused by inflammation of the bursa that overlies the greater trochanter (bony prominence at the outer side of the hip). A 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.
Greater trochanteric bursitis most 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 that increase the chances of developing trochanteric bursitis include:
- Repetitive stress or overuse injury to the hip joint that may occur because of running, climbing stairs, cycling 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 of the body for a long period
- 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 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 in the buttock is the main symptom of greater trochanteric bursitis. The pain may become 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.
Dr. Stilwell will perform a physical examination of the hip area and may order diagnostic tests such as X-rays, bone scan and MRI scan to rule out possibility of injury or other conditions. The initial phase of treatment of greater 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, and use of support from walking cane or crutches while walking. Corticosteroid injection into the bursa is also effective in relieving pain. Regenerative therapies like Platelet-Rich Plasma and Stem Cell injections are another option.
Surgical treatment that involves removal of the bursa may be recommended if the pain and inflammation in the bursa does not resolve with conservative treatment approaches.