Greater trochanteric bursitis is a common condition of the hip joint. The hip bursa is a small sac filled with a slippery fluid that allows tendons and muscles to move and glide smoothly over each other. Bursa are like oil cans in the body. The greater trochanter is the large bump that can be felt on the outside of the femur or upper leg bone. It’s more superficial than other bursa around the hip joint area. Muscles attach to this bony prominence so the hip joint is able to move. When this bursa becomes inflamed and causes pain it’s called trochanteric bursitis.
What Causes Trochanteric Bursitis?
There are many potential causes for bursitis located in the hip joint area. The causes include:
- Trauma Directly Over the Bursa – Bumping the hip on a table edge, countertop or protruding object can be an onset for hip pain.
- Biomechanical Cause – Foot, ankle or knee issues that create an abnormal gait can be factors for hip joint bursitis. Unequal leg length stresses the hip joint causing pain from the abnormal gait.
- Inflammatory Arthritis – Rheumatoid arthritis is an inflammatory condition of the joints.
- Degenerative Hip Joint Disease – The integrity of the hip joint space is compromised by hip joint degeneration over a period of time. Bone spurring and calcium deposits may irritate the bursa tissue causing inflammation.
- Post Surgical – Surgical intervention to the hip that includes implementing a prosthesis to the joint may cause irritation and inflammation to the hip area bursa.
- Activities of Daily Living – Normal repetitive daily hip joint stress including sporting activities and work strain may precipitate hip bursa inflammation.
Symptoms of Trochanteric Bursitis
Trochanteric bursitis can strike anyone but seems more prevalent in females and senior patients. Pain is concentrated on the outside of the hip joint. It may extend down the outside of the leg towards the knee. The pain can be intense and may alter gait or walking. Lying on the hip at night is very painful. Normal activities such as getting up from a chair or going up steps may aggravate the symptoms. Putting pressure over the trochanter with your finger increases the pain. Stiffness may develop around the hip joint.
Other bursa are present around the hip to include the iliopsoas bursa. The pain from this bursa is more on the inside of the groin and not on the outside of the leg. Both bursa conditions are treated similarly.
Treatment of Trochanteric Bursitis
Conservative management for bursitis is the first step in the care and treatment of this condition. If this fails to adequately resolve the problem, more aggressive and invasive procedures may be necessary. The goals of treatment are to reduce the pain, restore function and prevent reoccurrence. Conservative management includes:
- Cryotherapy – Ice application helps reduce the inflammation and decrease the pain.
- Correcting or Stabilizing Biomechanical Issues of the Lower Extremity – Adding orthotics, balancing leg length inequality and obtaining proper footwear are essential to minimize the return of symptoms.
- Correcting Pelvic and Lower Back Biomechanics – Abnormal motion of the lumbar spine and sacroiliac joints may contribute to an altered gait that stresses the hip joint. Chiropractic manipulation to the lumbar spine and pelvis will help improve biomechanics.
- Physical Modalities and Exercises – Exercises can begin as soon as the acute pain subsides. Changing the muscle balance and action can be accomplished by various forms of treatment to include muscle relaxation techniques, physical therapy devices and massage.
- Discontinuing Repetitive Activities to the Hip Joint – Repetitive activity day after day stresses the hip joint and may be a precursor to bursitis.
- Support Devices – Occasionally a cane or crutches may be needed for a short period of time.
If conservative treatment is not effective, more invasive treatment may be needed. Changes in daily activities may be necessary to prevent reoccurrence.The doctors at Coon Rapids Chiropractic Office have experience in the care and treatment of hip joint bursitis. Call today for your appointment.