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Hip pain from Bursitis: Diagnosis & Treatment

Trochanteric bursitis is a condition that occurs when the bursa, a small fluid-filled sac that acts as a cushion between a bone and a tendon or muscle, becomes inflamed, swollen and painful. The bursa that is located near the outside of the hip, on the upper thighbone (femur). This condition can cause pain and discomfort over the outside of the hip and the upper thigh. It is often the result of overuse or injury, in addition to being associated with hip arthritis and hip abductor muscle wear & tear (Gluteal Tendinopathy)

What are the symptoms and signs of Trochanteric Bursitis?

The most common symptoms of Trochanteric Bursitis include pain and tenderness on the outside of the hip, difficulty sleeping on the affected side, and difficulty walking or standing for long periods of time. Other symptoms may include swelling, stiffness, a snapping or popping sensation when moving the hip, and a feeling of warmth in the affected area. If you experience any of these symptoms, it is important to see a doctor who would carry out special clinical tests and imaging to get a diagnosis and start treatment.

What is the role of ultrasound in Trochanteric Bursitis?

Ultrasound is a type of imaging test that uses sound waves to produce images of the inside of the body (watch this video from ACTIVATE to learn more about Ultrasound scans). In the case of Trochanteric Bursitis, ultrasound can be used to help diagnose the condition by providing images of the bursa and the surrounding soft tissue structures. Ultrasound can also be used to guide the doctor during an injection into the bursa, which can help reduce inflammation and pain. Additionally, ultrasound can be used to monitor the progress of treatment and determine whether bursitis had settled.

How can we treat Trochanteric Bursitis?

Treatment options for trochanteric bursitis may include rest, physiotherapy, and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation, and eventually pain and swelling. In more resistant cases, a doctor may recommend an injection or surgery to remove the inflamed bursa, although surgery for trochanteric bursitis is rarely performed.

What is the role of physiotherapy in Trochanteric Bursitis?

Physiotherapy is an important part of the treatment of trochanteric bursitis. It can help improve range of motion, and strengthen the muscles that support the hip joint, especially the abductors (Gluteal muscles). This can help prevent bursitis from recurring and can also improve overall function and mobility. Common physiotherapy treatments for trochanteric bursitis may include exercises to stretch and strengthen the hip muscles, shockwave therapy, and heat or cold therapy to help manage pain. Your physiotherapist will work with you to develop a personalised treatment plan that is tailored to your individual needs. It can also be delivered via a Digital Personalised Physiotherapy Prescription.

What are the injections used in Trochanteric Bursitis?

Injections are an effective management option for Trochanteric Bursitis. The most common injection used to treat this condition is a corticosteroid injection, which can help reduce inflammation, swelling and pain. Corticosteroid injections are usually given directly into the bursa, using ultrasound guidance to ensure the medication is delivered to the correct location. Other medications that may be injected into the bursa include a local anaesthetic, which can help provide temporary pain relief, and hyaluronic acid, which can help lubricate the bursa and reduce pain from friction.

Can Hyaluronic Acid injection help in Trochanteric Bursitis?

Hyaluronic acid injections may be helpful in the treatment of Trochanteric Bursitis. Hyaluronic acid is a naturally occurring substance that is found in the body, and it plays an important role in lubricating and cushioning the joints. Injections of hyaluronic acid into the bursa can help improve the function of the bursa and reduce pain and discomfort by minimising friction. This treatment is often used in combination with other treatments, such as physiotherapy, to help manage the symptoms of Trochanteric Bursitis. It is important to discuss the use of hyaluronic acid injections with your doctor to determine if they are appropriate for your individual situation. At ACTIVATE, we provide Hyaluronic Acid injections for management of musculoskeletal conditions.

Can arthritis of the hip cause Trochanteric Bursitis?

In the case of hip arthritis, the bursa can become inflamed due to the chronic irritation and overload of the hip abductor muscles. Patients often feel pain in the groin from hip arthritis in addition to trochanteric pain. Symptoms usually resolve following a total hip replacement operation.

If you are experiencing symptoms of Trochanteric Bursitis, get in touch for clinical and ultrasound diagnosis and non-surgical treatment.

About the Author: Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent.


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