Trochanteric Bursitis

Trochanteric bursitis, also called greater trochanteric pain syndrome (GTPS), is a widespread condition associated with persistent discomfort along the outer buttock, hip, and thigh. It is typically caused by irritation or injury to the soft tissues surrounding the outer thigh bone, including tendons, muscles, and bursae.

Symptoms

Trochanteric bursitis typically develops slowly over weeks or months. Early episodes of pain may subside with rest, but over time, they become more frequent and persistent with less relief.

Common symptoms include:

• Discomfort on the outer hip, which may radiate to the buttock and downwards to the leg.
• Pain when lying on the affected side that often interferes with sleep and worsens at night.
• Pain that increases with activities like prolonged cycling, standing, walking, or running.
• Different walking patterns caused by pain or muscle weakness.
• Tenderness and swelling over the outer hip bone.

Causes

Several factors can contribute to the development of trochanteric bursitis, including:

• Direct impact or injury: Outer hip trauma like falling onto a solid surface.
• Excess, repetitive motions (overuse): Running, cycling, stair climbing, or prolonged standing without steady increases in intensity can strain the soft tissues.
• Prolonged or excessive stress: Pressure injuries caused by lying on hard surfaces, prolonged sitting in low chairs, or frequently crossing the legs.
• Bone spurs/calcification: The formation of abnormal bone tumors or calcifications in the tendons that connect the gluteal muscles and greater trochanter, leading to irritation and inflammation.

Diagnosis

Diagnosing trochanteric bursitis involves a combination of clinical assessment and imaging studies to confirm the condition and rule out other possible causes of pain.

Treatment

The primary approach to treating trochanteric bursitis is non-surgical, with surgery being rarely an option.

Non-surgical treatment options include:

• Physiotherapy: The primary goals of physiotherapy are to stretch the iliotibial band, evaluate and rectify any deviations in gait, and strengthen the muscles surrounding the hip.
• Targeted steroid and local anaesthetic injections: The injection’s steroid will treat the trochanteric bursa’s inflammation, resulting in a decrease in discomfort and irritation. This will make it easier and less painful for you to move through your physiotherapy rehabilitation.
• Shockwave therapy: Pulsed sound waves are delivered to the inflammatory bursa during shockwave therapy. It stimulates the healing response and improves vascularity in the underlying tissue within the inflammatory area.

Surgical repair of the abductor tendon

A tear in the abductor muscles may be the source of some chronic episodes of lateral trochanteric discomfort. An MRI or ultrasound scan can show this. In this situation, the torn abductor tendon can be repaired.

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