Trochanteric bursitis

A bursa is a fluid-filled sac that acts as a cushion between muscles, tendons, bone, and joints. Bursitis is the swelling and irritation of a bursa. The bursa that covers the outside of your hip is called the greater trochanter bursa.

Trochanteric bursitis occurs when the bursa in your hip becomes swollen and irritated. This is a common cause of hip pain.

Causes

Trochanteric bursitis can be caused by:

• Overuse or stress on the hip from exercising or standing for long periods
• Hip injury, such as from a fall
• Having one leg that is longer than the other
• Bone spurs on the hip
• Spine problems, including scoliosis and arthritis of the spine

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• Muscle imbalance that puts more stress around the hip muscles
• Infection (rare)

Certain health problems can also cause hip bursitis, including:

• Rheumatoid arthritis

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• Gout

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• Pseudogout

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• Diabetes
• Thyroid disease

Bursitis is more common in older adults. Being out of shape or overweight may put you at greater risk for hip bursitis.

Symptoms

Common symptoms include:

• Pain at the side of the hip, which may also be felt on the outside of the thigh
• Pain that is sharp or intense at first, but may become more of an ache
• Difficulty walking
• Joint stiffness
• Swelling and warmth of the hip joint
• Catching and clicking sensation

You may notice the pain more when:

• Getting out of a chair or bed
• Sitting for a long time
• Walking up stairs
• Sleeping or lying on the affected side

Tests and Exams

Your doctor will do a physical exam and ask about your symptoms.

To rule out other conditions that could be causing your symptoms, you may have tests such as:

• X-rays
• Ultrasound
• MRI

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Treatment

Many cases of hip pain go away with rest and self-care. Try these tips:

• Use an ice pack 3 to 4 times a day for the first 2 or 3 days.
• Take pain relievers such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) to help relieve pain and swelling.
• Avoid activities that make the pain worse.
• When sleeping, do not lie on the side that has bursitis.
• Avoid standing for long periods of time.
• When standing, stand on a soft, cushioned surface. Put an equal amount of weight on each leg.
• Placing a pillow between your knees when lying on your side can help decrease your pain.
• Wear comfortable, well-cushioned shoes with a low heel.
• Lose weight if you are overweight.
• Strengthen your core muscles.

As the pain goes away, your health care provider may suggest exercises to build strength and prevent muscle atrophy. You may need physical therapy if you have trouble moving the joint.

Other treatments include:

• Removing fluid from the bursa
• Steroid injection

If none of the treatments work, your doctor may suggest surgery to remove the bursa. This is rarely needed. If you have surgery, your hip will function just fine without the inflamed bursa. A new bursa sac will grow back.

Prevention

Overuse is the most common cause of hip bursitis. To help prevent hip pain:

• Always warm up and stretch before exercising and cool down afterward. Stretch your quadriceps and hamstrings.
• Don't increase the distance, intensity, and amount of time you exercise all at the same time.
• Avoid running straight down hills. Walk down instead.
• Swim instead of running or cycling.
• Run on a smooth, soft surface, such as a track. Avoid running on cement.
• If you have flat feet, try special shoe inserts and arch supports (orthotics).
• Make sure your running shoes fit well and have good cushioning.

When to Call the Doctor

Call your provider if symptoms come back or do not improve after 2 weeks of treatment.

Get medical help right away if you have any of the following:

• Your hip pain is caused by a serious fall or other injury
• Your leg is deformed, badly bruised, or bleeding
• You are unable to move your hip or bear any weight on your leg