Quick Guide To: Bursitis of the Hip

Updated: Dec 5, 2019


Bursitis can be a pain in the butt. And in this case, I do mean that literally.


Unfortunately for us ladies, bursitis of the hip is 4 times more common in women than men. (1) No one quite knows why for sure. It's probably got something to do with that nice wide child bearing pelvis you've got. Love it or hate it, it's just the way we were made.


So ladies, this one's for you.


Happy reading!


Nicola




Bursitis of the Hip


Also known as Trochanteric Bursitis an inflammation of the trochanteric bursa of the hip.


Think of a bursa as a fluid filled sac just like a water balloon. The purpose of a bursa is to reduce friction between a bone and the tendons that attach to it during movement. When the trochanteric bursa becomes inflamed, it swells and causes pain on the side of the hip, that refers down the side of the thigh.


The How and Why

In the majority of cases, trochanteric bursitis arises in conjunction with other pathologies of the hip, in particular, damage to the surrounding muscles, tendons and fascia. For this reason it is often now referred to as Greater Trochanteric Pain Syndrome. (1)


Many bursitis cases arise as a result of abnormal biomechanics in the lower limb. These changes alter the loads and stresses placed on the muscles around the hip joint, resulting in compression and subsequent swelling of the bursa. In such cases, the bursal inflammation is secondary to muscle imbalance around the hip.


What will I experience or feel like?

Trochanteric bursitis presents as an intermittent achy pain on the side of your hip, localised over the bony prominence known as the greater trochanter. Pain and tingling can refer down the outside of your thigh to just below your knee.


Your pain may be aggravated by:

  • Prolonged weight bearing

  • Moving from sitting to standing

  • Climbing stairs

  • Lying on the affected side

  • Impact activities such as running and jumping.

As your condition resolves, you may find you experience most pain at night or first thing in the morning, and that once you are up and moving your pain settles.



How can I help fix it?

In many cases, manual and physical therapy alone are sufficient to resolve the condition. (2) Both therapies aim to correct the abnormal lower limb biomechanics that cause compression and inflammation of the bursa. Therapy may involve increasing joint ranges of motion, reducing muscle tension and strengthening weakened muscles.


To give yourself the best chance of recovery, avoiding aggravating factors such as:

  • Crossing your legs at the knee or ankle

  • Sitting cross legged

  • Sitting with the knees higher than the hips. eg: low couches and car seats

  • Impact activities such as running and jumping.

  • Walking, sitting or standing for longer than is comfortable.

Always change position or activity before or when your pain starts to increase. Placing a pillow between or under your knees at night can make sleeping more comfortable.



In persistent cases corticosteroid injections can be utilised. Corticosteroid is an anti-inflammatory medication that can be inserted directly into the bursa. Injections have been found to be effective in 70% of cases, however 1 in 4 people will experience a relapse and a second injection required, which still may not be effective.(1) If a corticosteroid injection is used, it is still a good idea to use physical therapy to correct the underlying altered mechanics, that caused the bursitis in the first place.


How long will I take to recover?

The condition is considered self-limiting, meaning that it will eventually resolve of its own accord. (1) Acute episodes can last a few days followed by a gradual easing of symptoms. However, chronic low grade discomfort, or recurring episodes of pain may persist for weeks, months or years.


Continuing a maintenance program of your physical therapy exercises regularly, even after your pain has resolved, will reduce your risk of reoccurrence and if pain does reoccur will help shorten the length of the episode.





Please be mindful that the information contained above is general in nature and is not intended to provide a diagnosis, nor replace the direct care and instructions of a healthcare professional.


If you have any questions about your symptoms or the recommended treatments and management plans, please contact us and we will be more than happy to discuss your case with you further.


1. Ferri, F., 2019. Ferri's Clinical Advisor. 1st ed. US: Elsevier.

2. Lustenberger, D, 2013. Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review. Clinical Journal of Sports Medicine, 21/5, 447-453.

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Ph: (08) 9774 5630

 reception@ariseosteopathy.com.au

3/28 Station Rd, Margaret River, WA.

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