05-02-2024, 03:31 AM
What Is Trochanteric Bursitis?
Medically Reviewed by Jabeen Begum, MD on December 14, 2023 Written by Kathryn Whitbourne
10 min read
Trochanteric bursitis is a type of inflammation that affects your hips.
When your outside hip bursa gets inflamed, you have trochanteric bursitis. (Photo credit: Tetiana Pavliuchenko/Dreamstime)
When your outside hip bursa gets inflamed, you have trochanteric bursitis. (Photo credit: Tetiana Pavliuchenko/Dreamstime)
Our hips are marvels of flexibility. When we walk, they give us power and stability. When we jump, they can handle the impact. The hip joint is one of the largest and strongest joints in the human body.
But the hip can take a beating, and when that happens, we may feel pain.
One of the primary causes of hip pain is bursitis, which is an inflammation of the bursa. These fluid-filled sacs are found around the body and serve as cushions between bones and soft tissues such as muscles, tendons, and skin.
Each hip has two major bursae. The outside point of the hip, which is called the greater trochanter, has a bursa called the trochanteric bursa. (The other bursa, on the inside of the hip area, is called the iliopsoas bursa.)
When that outside hip bursa gets inflamed, you have trochanteric bursitis , also known as greater trochanteric pain syndrome (GTPS). It's a common condition, which is easily treatable.
FEATURED
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How to Choose an OTC Pain Reliever
What Causes Trochanteric Bursitis?
You’ll find bursa sacs at many of the body’s major joints, including the elbow, shoulder, and knee. The small pouches are filled with a thick fluid and are meant to lubricate joints and protect body parts from friction.
The trochanteric bursa, like other bursae, may become inflamed if the hip is overused or injured. Trochanteric bursitis affects about 5 of every 1,000 adults. It often occurs in women and middle-aged or older people, though people of any age may get the condition.
Active adults who regularly walk, run, or cycle are more likely to get trochanteric bursitis. The side of the leg includes a long piece of connective tissue called the iliotibial band (ITB or IT band), which runs from the hip to the knee. If the IT band is tight from hard use, it may rub against the trochanteric bursa and cause irritation, leading to bursitis.
Other causes of trochanteric bursitis include:
Muscle tears
Hip injuries
Hip surgery complications
Poor posture
Diseases such as gout (a form of arthritis with sudden, sharp attacks of pain, often at the base of the big toe)
Prosthetic implants in the hips
Thyroid disorders
Bone spurs (small bony growths on the edges of your bones) in the hip or thighbone
Legs that aren't the same length
Trochanteric Bursitis Symptoms
You’ll first notice trochanteric bursitis when you feel pain at the outside of your hip.
At first, the pain may be sharp, but with time, it may turn into a dull ache. Moving your hip, particularly while going downstairs, might make the pain worse.
If left untreated, the pain may start going down your upper leg. You’ll likely feel it when you lie on your affected hip or when you get up from a chair. The joint becomes stiff, and the bursa itself is sensitive to touch. Pain may get worse at night after you've been lying in the same spot for some time. You might also feel pain in your bottom.
In extreme cases, your hip may become red and swollen and you may even have a fever.
If you’ve had these hip bursitis symptoms for more than 2 weeks without improvement, see a doctor.
What can be mistaken for trochanteric bursitis?
The symptoms of GTPS may be confused with those of other conditions, such as:
Osteoarthritis of the hip
Lumbar spine referred pain
Fibromyalgia
Snapping hip syndrome
A tear in the gluteus medius, a muscle in the same hip area
One test your doctor may use to spot the difference between arthritis and trochanteric bursitis is to ask you whether you can put on socks and shoes, as that's a task that people with trochanteric bursitis can do, but people with arthritis of the hip can't.
Risk Factors for Trochanteric Bursitis
People most at risk for getting trochanteric bursitis include:
Athletes (tightness in the IT bands strains the bursa during repetitive motions such as running and jumping)
SUGGESTED QUESTIONS
Smokers (smoking delays tissue healing)
Sedentary or bedbound patients (lying or sitting in the same spot puts pressure on your joints)
Older people who've fallen and inflamed the bursa
People with spine problems such as scoliosis or arthritis of the lumbar spine
People who've had hip surgery
People who have rheumatoid arthritis
People who're overweight or obese (extra weight puts stress on hip joints)
People doing repetitive or manual labor
Trochanteric Bursitis Diagnosis
When you visit your doctor, they’ll most likely do a physical exam, focusing on how long you’ve had the condition and specific movements that cause the pain. Your doctor may ask you to raise your leg up straight or to perform a log roll (rotate your leg from the hip while lying down) to see if you feel pain while doing either of these things.
They may order X-rays to rule out other issues because bursitis itself doesn’t show up on X-rays. You could get an ultrasound test, a bone density scan, or an MRI if your hip isn’t responding to treatment.
In some cases, your doctor may inject your bursa with an anesthetic. If the pain goes away at once, you most likely have trochanteric bursitis.
Trochanteric Bursitis Treatment
Treatments are generally nonsurgical and easy to do at home. They might include:
Ice. Apply ice packs to your hip every 4 hours for 20-30 minutes at a time. Cold numbs the area, which can reduce pain and may cut down on swelling and inflammation.
Anti-inflammatory medications. Over-the-counter medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve), as well as prescription pain relievers such as celecoxib (Celebrex) can reduce pain and swelling. Be sure to check with your doctor before taking them, however.
Rest. If you can stay off your hip, you can give it time to heal.
Physical therapy. An expert therapist can give you exercises to improve flexibility and strengthen your muscles. Physical therapy for trochanteric bursitis can be very effective.
Assistive devices. Use a walking cane, walker, or crutches to reduce hip pressure when walking.
Other greater trochanteric pain syndrome treatments require a trip to the doctor’s office. They might include:
Corticosteroid shots. Steroids such as cortisone are a powerful anti-inflammatory medication. Athletes sometimes use these to reduce swelling and pain.
Low-energy shock wave therapy. Acoustic shock waves are passed through the skin with a targeted device. One analysis showed that more than two-thirds of patients given shock wave therapy were cured or greatly improved after 4 months.
Surgery. Although surgery is rarely needed, the bursa can be removed if it's beyond repair. (Your hip can function normally without a bursa.) Trochanteric bursitis surgery is usually an outpatient procedure, meaning no overnight hospital stay is required. A surgeon will use an arthroscope -- a kind of camera -- and tiny instruments, as with common knee and elbow surgeries.
Trochanteric Bursitis Prevention
You can stop trochanteric bursitis from becoming worse -- or never have it at all -- if you take care of your hips (and the rest of your body) properly. Among the things you can do:
Exercise the right way. It’s great being active, but do train properly. That means stretching, warming up, and listening to your body.
Stretch your hamstrings and quadriceps before exercising. Even if you don't exercise much, stretch your hamstrings every day if they're tight, to make everyday activities (such as climbing stairs) easier.
Wear proper orthotics or inserts. One cause of trochanteric bursitis is having one leg shorter than the other. Inserts can even out your gait.
Drop some pounds if you’re overweight. It’s a sure way of taking pressure off your hip.
Consider swimming rather than running or cycling for exercise. If you must run, do it on a track rather than on a cement sidewalk.
Avoid lying on one side for too long.
Avoid falls. Use a cane if necessary. Wear rubber-soled shoes and make sure you can see where you're going. You may need to update your eyeglass prescription.
Take breaks if you're doing something repetitive.
Trochanteric Bursitis Exercises
Here are some exercises recommended by the American Association of Hip and Knee Surgeons (AAHKS). Stretching and strengthening are key to preventing trochanteric bursitis pain. Aim to do these two or three times a day, and as you get more flexible, you can reduce its frequency to once a day. It may take 4-6 weeks to see results.
Do these exercises slowly and aim to hold for 30 seconds. If that's too long, start at 5 seconds and work your way up. Take a breath and relax for 5 seconds between repetitions (reps). The goal is 3 sets of 5-10 reps of each exercise. But do what you can.
Stretching exercises
Piriformis stretch
This keeps hip muscles from getting too tight. You can do this several times a day as needed.
Sit upright in a chair.
Slowly bring the affected leg across the other.
Slowly pull the knee towards your opposite shoulder with your hands. You should feel a stretch along the back of your hip and buttocks.
Try to hold for 30 seconds.
Slowly return to the starting position.
IT band stretch
A tight IT band is often the source of knee or leg pain. Do this on both legs, even if only one is affected.
Start by standing up.
Cross one leg over the other.
Lean forward trying to tough your toes until you feel a tolerable stretch outside of your hip. Keep the opposite knee straight.
Try to hold for 30 seconds.
Slowly return to the starting position and repeat on the other leg.
Hamstring stretch
Lie on your back. Keep one leg straight and bend the other so the knee is up, but your foot is on the floor.
Place a towel, yoga strap, or cord around the bottom of the foot that is straight.
Slowly pull your leg in an upward direction using the towel or strap to pull the leg closer to you. Keep your knee straight. You'll feel a stretch along the muscles in the back of your thigh.
Try to hold for 30 seconds.
Slowly return to the starting position.
After one set of reps, switch to the other leg.
Note: You can also stretch the IT band with this exercise by bringing the leg with the strap across your other leg and holding the position.
Rehabilitative exercises
These are for strengthening and rehabilitation. The AAHKS recommends that you do the stretching exercises first and then the strengthening ones. Perform these slowly and steadily. Hold positions for up to 5 seconds and rest for 1-2 seconds. You might feel discomfort doing these exercises at first, but you shouldn't feel pain. If you do, switch to another exercise or modify it.
Wall stretch
This is an isometric exercise that's important for reducing trochanteric pain.
Lie on the ground next to a wall. Have one leg rest against the wall.
Try to push your entire leg outward into the wall. You should feel your outer hip muscles contract but the leg should not move.
Try to hold for 5-10 seconds before relaxing.
After one set of reps, switch to the other leg. Do 3 sets of 5-10 reps.
Note: you can do this standing next to a wall as an advanced exercise.
Straight leg raise
This works the hips and buttocks.
Lie on your back with one leg bent at the knee and your foot on the floor.
Lift the other leg off the ground with your thigh muscles tightened and your toes pointed to the ceiling. Keep your knee straight.
Try to bring your leg up to the same level as your bent leg, so the thighs are at the same level.
Try to hold for 5 seconds.
Slowly return to your starting position.
Do 3 sets of 5-10 reps, then switch to the other leg, or alternate legs after each set.
Bridges
Bridges work all the muscles attached to the trochanteric region of the hip.
Lie on a flat, comfortable surface, like a carpet or yoga mat.
Bend both legs with your feet on the floor about shoulder-width apart.
Keep your hands at your side while you slowly lift your bottom off the floor by tightening your leg and stomach muscles.
Lift as high as you can until your stomach is in line with your knees. Keep your stomach contracted.
Hold for 5 seconds, then slowly return to the starting position.
Do 3 sets of 5-10 reps.
Note: You can make these harder by squeezing a ball or pillow between your knees as you lift.
Cool down: You may find it helpful to apply ice around your hip joint for 5-10 minutes after your exercise routine.
You can find more exercises at the AAHKS website. Pick the ones that work for your needs. Be sure to check with your doctor or physical therapist before beginning any routine to see what they recommend.
Takeaways
Trochanteric bursitis is a common condition that causes hip pain. Athletes, the elderly and people who are overweight are at particular risk for it. It can be easily treated with over-the-counter pain relievers, steroid injections, and exercise. Doing stretching and strengthening exercises regularly will keep the pain at bay.
Trochanteric Bursitis FAQs
Does trochanteric bursitis ever go away?
Yes, after a few weeks of rest and treatment. However, it can return if you go back to doing the same things that caused it in the first place, such as running on a hard surface.
What is the fastest way to get rid of hip bursitis?
That depends on how bad it is. Over-the-counter pain relievers and ice can provide relief. So can a corticosteroid injection for more painful cases. However, limit how many steroid injections you get, as too many may damage the tissues surrounding the bursa.
Medically Reviewed by Jabeen Begum, MD on December 14, 2023 Written by Kathryn Whitbourne
10 min read
Trochanteric bursitis is a type of inflammation that affects your hips.
When your outside hip bursa gets inflamed, you have trochanteric bursitis. (Photo credit: Tetiana Pavliuchenko/Dreamstime)
When your outside hip bursa gets inflamed, you have trochanteric bursitis. (Photo credit: Tetiana Pavliuchenko/Dreamstime)
Our hips are marvels of flexibility. When we walk, they give us power and stability. When we jump, they can handle the impact. The hip joint is one of the largest and strongest joints in the human body.
But the hip can take a beating, and when that happens, we may feel pain.
One of the primary causes of hip pain is bursitis, which is an inflammation of the bursa. These fluid-filled sacs are found around the body and serve as cushions between bones and soft tissues such as muscles, tendons, and skin.
Each hip has two major bursae. The outside point of the hip, which is called the greater trochanter, has a bursa called the trochanteric bursa. (The other bursa, on the inside of the hip area, is called the iliopsoas bursa.)
When that outside hip bursa gets inflamed, you have trochanteric bursitis , also known as greater trochanteric pain syndrome (GTPS). It's a common condition, which is easily treatable.
FEATURED
Pain Clinics: Things You Should Know
Could Changing Your Diet Help Your Fibromyalgia Pain?
How to Choose an OTC Pain Reliever
What Causes Trochanteric Bursitis?
You’ll find bursa sacs at many of the body’s major joints, including the elbow, shoulder, and knee. The small pouches are filled with a thick fluid and are meant to lubricate joints and protect body parts from friction.
The trochanteric bursa, like other bursae, may become inflamed if the hip is overused or injured. Trochanteric bursitis affects about 5 of every 1,000 adults. It often occurs in women and middle-aged or older people, though people of any age may get the condition.
Active adults who regularly walk, run, or cycle are more likely to get trochanteric bursitis. The side of the leg includes a long piece of connective tissue called the iliotibial band (ITB or IT band), which runs from the hip to the knee. If the IT band is tight from hard use, it may rub against the trochanteric bursa and cause irritation, leading to bursitis.
Other causes of trochanteric bursitis include:
Muscle tears
Hip injuries
Hip surgery complications
Poor posture
Diseases such as gout (a form of arthritis with sudden, sharp attacks of pain, often at the base of the big toe)
Prosthetic implants in the hips
Thyroid disorders
Bone spurs (small bony growths on the edges of your bones) in the hip or thighbone
Legs that aren't the same length
Trochanteric Bursitis Symptoms
You’ll first notice trochanteric bursitis when you feel pain at the outside of your hip.
At first, the pain may be sharp, but with time, it may turn into a dull ache. Moving your hip, particularly while going downstairs, might make the pain worse.
If left untreated, the pain may start going down your upper leg. You’ll likely feel it when you lie on your affected hip or when you get up from a chair. The joint becomes stiff, and the bursa itself is sensitive to touch. Pain may get worse at night after you've been lying in the same spot for some time. You might also feel pain in your bottom.
In extreme cases, your hip may become red and swollen and you may even have a fever.
If you’ve had these hip bursitis symptoms for more than 2 weeks without improvement, see a doctor.
What can be mistaken for trochanteric bursitis?
The symptoms of GTPS may be confused with those of other conditions, such as:
Osteoarthritis of the hip
Lumbar spine referred pain
Fibromyalgia
Snapping hip syndrome
A tear in the gluteus medius, a muscle in the same hip area
One test your doctor may use to spot the difference between arthritis and trochanteric bursitis is to ask you whether you can put on socks and shoes, as that's a task that people with trochanteric bursitis can do, but people with arthritis of the hip can't.
Risk Factors for Trochanteric Bursitis
People most at risk for getting trochanteric bursitis include:
Athletes (tightness in the IT bands strains the bursa during repetitive motions such as running and jumping)
SUGGESTED QUESTIONS
Smokers (smoking delays tissue healing)
Sedentary or bedbound patients (lying or sitting in the same spot puts pressure on your joints)
Older people who've fallen and inflamed the bursa
People with spine problems such as scoliosis or arthritis of the lumbar spine
People who've had hip surgery
People who have rheumatoid arthritis
People who're overweight or obese (extra weight puts stress on hip joints)
People doing repetitive or manual labor
Trochanteric Bursitis Diagnosis
When you visit your doctor, they’ll most likely do a physical exam, focusing on how long you’ve had the condition and specific movements that cause the pain. Your doctor may ask you to raise your leg up straight or to perform a log roll (rotate your leg from the hip while lying down) to see if you feel pain while doing either of these things.
They may order X-rays to rule out other issues because bursitis itself doesn’t show up on X-rays. You could get an ultrasound test, a bone density scan, or an MRI if your hip isn’t responding to treatment.
In some cases, your doctor may inject your bursa with an anesthetic. If the pain goes away at once, you most likely have trochanteric bursitis.
Trochanteric Bursitis Treatment
Treatments are generally nonsurgical and easy to do at home. They might include:
Ice. Apply ice packs to your hip every 4 hours for 20-30 minutes at a time. Cold numbs the area, which can reduce pain and may cut down on swelling and inflammation.
Anti-inflammatory medications. Over-the-counter medications such as ibuprofen (Advil, Motrin) and naproxen (Aleve), as well as prescription pain relievers such as celecoxib (Celebrex) can reduce pain and swelling. Be sure to check with your doctor before taking them, however.
Rest. If you can stay off your hip, you can give it time to heal.
Physical therapy. An expert therapist can give you exercises to improve flexibility and strengthen your muscles. Physical therapy for trochanteric bursitis can be very effective.
Assistive devices. Use a walking cane, walker, or crutches to reduce hip pressure when walking.
Other greater trochanteric pain syndrome treatments require a trip to the doctor’s office. They might include:
Corticosteroid shots. Steroids such as cortisone are a powerful anti-inflammatory medication. Athletes sometimes use these to reduce swelling and pain.
Low-energy shock wave therapy. Acoustic shock waves are passed through the skin with a targeted device. One analysis showed that more than two-thirds of patients given shock wave therapy were cured or greatly improved after 4 months.
Surgery. Although surgery is rarely needed, the bursa can be removed if it's beyond repair. (Your hip can function normally without a bursa.) Trochanteric bursitis surgery is usually an outpatient procedure, meaning no overnight hospital stay is required. A surgeon will use an arthroscope -- a kind of camera -- and tiny instruments, as with common knee and elbow surgeries.
Trochanteric Bursitis Prevention
You can stop trochanteric bursitis from becoming worse -- or never have it at all -- if you take care of your hips (and the rest of your body) properly. Among the things you can do:
Exercise the right way. It’s great being active, but do train properly. That means stretching, warming up, and listening to your body.
Stretch your hamstrings and quadriceps before exercising. Even if you don't exercise much, stretch your hamstrings every day if they're tight, to make everyday activities (such as climbing stairs) easier.
Wear proper orthotics or inserts. One cause of trochanteric bursitis is having one leg shorter than the other. Inserts can even out your gait.
Drop some pounds if you’re overweight. It’s a sure way of taking pressure off your hip.
Consider swimming rather than running or cycling for exercise. If you must run, do it on a track rather than on a cement sidewalk.
Avoid lying on one side for too long.
Avoid falls. Use a cane if necessary. Wear rubber-soled shoes and make sure you can see where you're going. You may need to update your eyeglass prescription.
Take breaks if you're doing something repetitive.
Trochanteric Bursitis Exercises
Here are some exercises recommended by the American Association of Hip and Knee Surgeons (AAHKS). Stretching and strengthening are key to preventing trochanteric bursitis pain. Aim to do these two or three times a day, and as you get more flexible, you can reduce its frequency to once a day. It may take 4-6 weeks to see results.
Do these exercises slowly and aim to hold for 30 seconds. If that's too long, start at 5 seconds and work your way up. Take a breath and relax for 5 seconds between repetitions (reps). The goal is 3 sets of 5-10 reps of each exercise. But do what you can.
Stretching exercises
Piriformis stretch
This keeps hip muscles from getting too tight. You can do this several times a day as needed.
Sit upright in a chair.
Slowly bring the affected leg across the other.
Slowly pull the knee towards your opposite shoulder with your hands. You should feel a stretch along the back of your hip and buttocks.
Try to hold for 30 seconds.
Slowly return to the starting position.
IT band stretch
A tight IT band is often the source of knee or leg pain. Do this on both legs, even if only one is affected.
Start by standing up.
Cross one leg over the other.
Lean forward trying to tough your toes until you feel a tolerable stretch outside of your hip. Keep the opposite knee straight.
Try to hold for 30 seconds.
Slowly return to the starting position and repeat on the other leg.
Hamstring stretch
Lie on your back. Keep one leg straight and bend the other so the knee is up, but your foot is on the floor.
Place a towel, yoga strap, or cord around the bottom of the foot that is straight.
Slowly pull your leg in an upward direction using the towel or strap to pull the leg closer to you. Keep your knee straight. You'll feel a stretch along the muscles in the back of your thigh.
Try to hold for 30 seconds.
Slowly return to the starting position.
After one set of reps, switch to the other leg.
Note: You can also stretch the IT band with this exercise by bringing the leg with the strap across your other leg and holding the position.
Rehabilitative exercises
These are for strengthening and rehabilitation. The AAHKS recommends that you do the stretching exercises first and then the strengthening ones. Perform these slowly and steadily. Hold positions for up to 5 seconds and rest for 1-2 seconds. You might feel discomfort doing these exercises at first, but you shouldn't feel pain. If you do, switch to another exercise or modify it.
Wall stretch
This is an isometric exercise that's important for reducing trochanteric pain.
Lie on the ground next to a wall. Have one leg rest against the wall.
Try to push your entire leg outward into the wall. You should feel your outer hip muscles contract but the leg should not move.
Try to hold for 5-10 seconds before relaxing.
After one set of reps, switch to the other leg. Do 3 sets of 5-10 reps.
Note: you can do this standing next to a wall as an advanced exercise.
Straight leg raise
This works the hips and buttocks.
Lie on your back with one leg bent at the knee and your foot on the floor.
Lift the other leg off the ground with your thigh muscles tightened and your toes pointed to the ceiling. Keep your knee straight.
Try to bring your leg up to the same level as your bent leg, so the thighs are at the same level.
Try to hold for 5 seconds.
Slowly return to your starting position.
Do 3 sets of 5-10 reps, then switch to the other leg, or alternate legs after each set.
Bridges
Bridges work all the muscles attached to the trochanteric region of the hip.
Lie on a flat, comfortable surface, like a carpet or yoga mat.
Bend both legs with your feet on the floor about shoulder-width apart.
Keep your hands at your side while you slowly lift your bottom off the floor by tightening your leg and stomach muscles.
Lift as high as you can until your stomach is in line with your knees. Keep your stomach contracted.
Hold for 5 seconds, then slowly return to the starting position.
Do 3 sets of 5-10 reps.
Note: You can make these harder by squeezing a ball or pillow between your knees as you lift.
Cool down: You may find it helpful to apply ice around your hip joint for 5-10 minutes after your exercise routine.
You can find more exercises at the AAHKS website. Pick the ones that work for your needs. Be sure to check with your doctor or physical therapist before beginning any routine to see what they recommend.
Takeaways
Trochanteric bursitis is a common condition that causes hip pain. Athletes, the elderly and people who are overweight are at particular risk for it. It can be easily treated with over-the-counter pain relievers, steroid injections, and exercise. Doing stretching and strengthening exercises regularly will keep the pain at bay.
Trochanteric Bursitis FAQs
Does trochanteric bursitis ever go away?
Yes, after a few weeks of rest and treatment. However, it can return if you go back to doing the same things that caused it in the first place, such as running on a hard surface.
What is the fastest way to get rid of hip bursitis?
That depends on how bad it is. Over-the-counter pain relievers and ice can provide relief. So can a corticosteroid injection for more painful cases. However, limit how many steroid injections you get, as too many may damage the tissues surrounding the bursa.
