Pain on the side of your hip? It could be due to trochanteric bursitis. This is the inflammation or swelling of the bursa (fluid-filled sack) that sits in between your greater trochanter bone and tendon on the outside of your hip. The role of the bursa is to reduce the friction between the bone and the surrounding tissue including tendons, ligaments and skin. If the bursa becomes inflamed or irritated, it can then cause pain. There are more than 140 bursae in the body but the hip bursa that is most prone to bursitis is the trochanteric bursa.
Symptoms of trochanteric bursitis include:
- Pain on the outside of your hip or in the buttock
- Pain when lying on that side
- Painful over the general area
- Pain with walking or stairs
So why does the trochanteric bursa become inflamed or irritated? There are a number of different causes:
- An injury
- Repeated friction
- Excessive pressure
- Tears or inflammation in the gluteus medius tendon
Physiotherapy for Bursitis
Your physiotherapist can diagnose bursitis through a clinical assessment, and it can also be diagnosed with an ultrasound. Physiotherapy treatment is focused around reducing compression and offloading the area to reduce pain. Soft tissue techniques such as massage, dry needling and trigger point therapy can be effective at easing symptoms.
Your physiotherapist will be able to identify and correct any issues that have caused the bursa to become inflamed, such as poor postural control, increased load or strength deficits. Having a good exercise program is key in the treatment of bursitis to prevent it reoccurring. This includes a graded loading of the gluteal muscles, as well as other stabilising muscles surrounding the joint.
For cases where bursitis does not respond to physiotherapy management, injections such as cortisone or platelet rich plasma (PRP) can be used, however this will be discussed with yourself, your physiotherapist and GP first.
Positions to reduce the shear load on your hip
There are several positions that increase the shear load through your greater trochanter that you should avoid if you have bursitis. These are:
- Sitting cross legged
- Standing with all your weight on the affected leg
- Standing with legs crossed
- Positions where your hips are rotated inwards (knees coming together
If you have hip pain and think it may be bursitis or another hip condition, consult your physiotherapist for diagnosis, management and rehabilitation plan.