According to the Australian Institute of Health and Welfare, hip pain is a common issue for people over the ages of 60.[1]. Around 15% and 6.6% of men and women, respectively, over the age of 50 are diagnosed with trochanteric bursitis,[2]. Women are at a higher risk of developing this condition due to their wider hip structure.
Bursa are slippery fluid-filled sacs which sit over the bone's surface. They are often found around the joints to allow for soft tissue (e.g., tendons, muscles) to easily move over the bone. During this condition, these bursa become inflamed which causes pain and discomfort especially during specific movements.
Read on to understand what you should know about hip bursitis; the risk factors, treatment options and expected recovery time.
What is Hip Bursitis?
Hip bursitis (trochanteric bursitis) is a painful hip condition typically felt around the outer hips. Inflammation of the bursa (fluid-filled sac) occurs around the greater trochanter (widest part of the hip bone). Typically, this condition develops gradually over time through overuse or excessive pressure over it.
What are the symptoms of hip (trochanteric) bursitis?
Symptoms of hip bursitis include pain on the outside of the hip, thigh or buttock. These symptoms are worse when lying on the affected side, getting up from a low chair or during activities such as standing, walking or running.
Common symptoms of hip bursitis
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Pain and tenderness on the outside (lateral) part of the hip
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Snapping sensation on the hip
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Hip pain when ascending stairs
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Lateral hip pain when lying on the injured side
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Lower back pain
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Hip pain when running
What causes hip bursitis?
Hip bursitis can be caused by an acute injury, such as a fall; however, it is more likely caused by a long-term issue, such as running or riding a bike for long periods. It can also occur with long term poor posture, such as sitting at a desk.
Common causes of hip bursitis
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Injuries from a fall directly hitting the hipbone
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Lying on one side for a prolonged time
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Overuse repetitive activities such as running, bicycling, and stair climbing
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Previous hip surgery
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Tendon injuries
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Arthritis and gout
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Thyroid disease
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Leg length discrepancies
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Increased friction around the area of the greater trochanter (Iliotibial band syndrome)
How is hip bursitis diagnosed?
There are several options available when it comes to diagnosing your hip pain as bursitis. One of the more common and most recommended by Australian GPs is an assessment from a physiotherapist.
Physiotherapists are highly qualified medical professionals that specialise in diagnosing and treating joint injuries like trochanteric bursitis. The process of physiotherapy assessment is straightforward yet comprehensive.
Like visiting a GP, your assessment will start with your physiotherapist asking you vital questions about your health. This is referred to as a consultation and will last for about 30-60 minutes. It would be best if you took the time to discuss relevant issues relating to your hip.
After establishing the background of your condition, your physiotherapist will perform specific physical tests to determine the best possible cause of your pain and rule out other conditions.
Following your initial assessment, your physiotherapist will provide you with a tailored treatment plan based on your condition.
From here, your physiotherapist will give you the details of your treatment program; this will include:
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Number of treatment sessions
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List of exercises you need to do at home
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Strategies to manage the pain
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Timeline of your total recovery
How is hip bursitis treated?
Having hip pain can be frustrating. Your mobility may be drastically affected and limit you from doing the things you love to do. Pain medication may help, but only physical interventions can treat structural problems and muscular imbalances.
There are several options when it comes to treating hip bursitis. One of the more common, and the treatment option that is referred by Australian GPs the most frequently, is physiotherapy.
Trochanteric bursitis is an injury that physiotherapists come across regularly, and the process of treating it is straightforward. Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.
A combination of specific movement exercises, flexibility exercises, and pain modulation will be given to you by your physiotherapist. Physiotherapists are experts in dealing with pain and musculoskeletal conditions.
Depending on the severity of your trochanteric bursitis, a physiotherapist may provide you with a combination of the following types of treatments:
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Therapeutic Exercises - Focused on reducing pain and symptoms.
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Manual Therapy - Hand-on techniques used to reduce muscle spasm in and around the hip.
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Balance and Proprioception Training - This will help increase the strength and stability of the hip for long term gain.
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Stretching - Helpful in reducing muscle stiffness and pain.
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Joint Mobilisation - Specific techniques used to reduce stiffness.
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Myofascial Release - A specialised hands-on technique, similar to massage.
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Dry Needling - Similar to acupuncture, dry needling can help reduce tightness in the hip.
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Taping techniques - In acute pain situations, taping can be useful to help manage pain.
A typical physiotherapy session with your local physiotherapist will last anywhere between 30-60 minutes. I is not uncommon for patients to feel the benefits in just one session.
Next step: Creating a treatment plan for you
Following your initial appointment, the physiotherapist will craft a tailored treatment plan that will highlight the course of action required, including what exercises you need to do at home and provide you with a timeline for how long it should take for a full recovery.
Self-care for hip bursitis
If you think you have trochanteric bursitis, here are the best things you can do.
Things to do:
Apply a cold compress for about 10 to 15 minutes and repeat every two to three hours. This will reduce the amount of pain and inflammation in your hip.
Allowing your body to rest and giving it time to heal are vital parts of the recovery process.
Gentle massage on hips, thigh, and lower back muscles can help relieve tension in the area and decrease pain.
Assistive devices such as crutches, walkers, and a cane can help you move around while also decreasing the load and tension on your hip. This allows sufficient room for your hip to heal appropriately.
Things to avoid:
- Avoid activities that worsen the pain
Take rest and consult a physiotherapist as soon as possible. Avoid putting heavy loads on your hip and avoiding activities requiring repetitive use of your hip, such as running and cycling in the early phase of the injury.
Do I need a specialist or surgery?
In some cases, patients need to have a cortisone injection at the site of the hip to control inflammation.
Diagnostic imaging may be done, such as X-ray, ultrasound, or MRI, to rule out other possible causes of your pain.
In rare cases, surgery is required if the bursa is not responding to treatment and beyond repair.
What is the recovery time / prognosis for trochanteric bursitis?
Ultimately, recovery time is dependent on being proactive and seeking professional treatment and the severity of your hip pain and injury.
Most cases of hip bursitis can recover within six weeks. Physiotherapy generally leads to a good outcome and a faster recovery for patients with hip pain.
Important factors in recovery include:
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Sticking to your rehabilitation program and regularly exercising
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Resuming your sports activity gradually
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Paying attention to pain, and resting as necessary.
You may immediately feel signs of relief during physiotherapy. However, you will be asked to continue your program to strengthen your muscles and improve your joint mechanics to prevent relapse and future injuries.
Can trochanteric bursitis be prevented?
Guaranteeing prevention can be very difficult, however you can decrease the risk of hip bursitis through some of the following techniques. These preventative strategies listed are also quite useful tips for rehabilitation and recovery if you have already injured yourself.
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Warm-up before doing activities: Preparing your body before an intense workout is crucial in preventing injuries. Do stretching and warm-up exercises for the whole body before engaging in sports.
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Manage your weight: Losing weight can help reduce the stress and pressure on your hip joints.
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Phase your activities: Repetitive use of your hips can lead to overuse injuries. Allow a sufficient amount of rest in between if you are running or cycling.
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Get stronger: Building proper strength on the muscles around the hip joint can significantly decrease the risk of having bursitis. Your physiotherapist will provide you with appropriate strengthening programs to help stabilise your hip and prevent injuries.
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Wear properly fitting shoes: Poorly cushioned shoes can increase pressure on the hip joint and bursa.
Outlook and the main takeaways
When dealing with hip bursitis, the most important thing to do is listen to your body and take action once you have pain. There are many causes, symptoms and severities of hip bursitis, and it is critical to get the right treatment as soon as possible. Speak to your local physiotherapist today about an appointment!
Anatomy of the trochanteric bursa
A bursa is a sac filled with fluid located near a joint. It functions as a cushion to minimise friction between the soft tissues or bones.
The trochanteric bursa lies over the bony knob at the upper portion of the thigh bone (greater trochanter). It is located deep to the butt muscles (gluteus maximus) as it inserts into the iliotibial band. It is the largest bursae near the greater trochanter.
Too much friction due to inefficient gliding of the surrounding muscles and tendons on the greater trochanter and trochanteric bursa may cause trochanteric bursitis. Direct trauma may also cause inflammation of the bursa.
