Bursae are small jelly like sacs that are located throughout the body. They contain small amounts of fluid and act as cushions, reducing friction between bones and soft tissues. Bursae are located around the hips, shoulder, knees, elbows, and heels. Bursitis is the inflammation of the bursa.
The trochanteric bursa is the bursa that overlies the greater trochanter of the femur. This is the bony prominence you may be able to feel on the outside of your upper leg. When this bursa becomes inflamed, it is a condition known as trochanteric bursitis.
The main symptom of trochanteric bursitis is pain on the outside (lateral) part of the hip or thigh. Pain may get worse with repetitive or prolonged activities such as sitting, walking, or squatting. Often, the pain is worse at night or when lying on the affected side.
Trochanteric bursitis is more common in women and elderly people. While in some cases the cause is unknown, there are certain risk factors that are associated with developing trochanteric bursitis. Some common risk factors are:
- Repetitive stress or overuse- repetitive activities such as running, cycling, squatting can cause inflammation of the bursa
- Injury-direct injury such as fall onto the hip or leg
- Stress on the soft tissues as a result of an abnormal or poorly positioned joint or bone. This can be the result of leg length discrepancies or arthritis in the hip joint
- Conditions such as Rheumatoid arthritis or Gout can also lead to inflammation of the bursa
- Bone spurs of calcium deposits in the tendons that attach to the greater trochanter
The goals of treatment are to reduce pain and inflammation as well as preserve mobility and prevent recurrence. Initial treatment of trochanteric bursitis includes:
- Activity modification and rest. Avoid the activities that worsen symptoms.
- Nonsteroidal anti-inflammatory medications to reduce pain and inflammation
- Physical therapy that includes strengthening and range of motion exercises
A cortisone injection into the bursa may be considered if these initial options fail to provide relief. Surgery is rarely needed to treat trochanteric bursitis and is only considered if all other non surgical treatments have been attempted and the bursa remains painful and inflamed.
Although bursitis can not be prevented in all cases, there are often steps you can take to avoid your risk of developing bursitis or to keep the inflammation from getting worse. Underlying conditions such as leg length discrepancy, poor posture, or incorrect technique when performing exercises or sports must be corrected. Some strategies to help prevent bursitis are:
- Avoid repetitive activities that put stress on the hips.
- Lose weight if you need to.
- Get a properly fitting shoe insert for leg-length differences.
- Maintain strength and flexibility of the hip muscles.