Trochanteric bursitis fundamentals
Trochanteric bursitis is a common cause of leg pain and is an inflammation of the bursa (a small, cushioning sac located where tendons pass over the areas of bone around the joints), which lies over the prominent bone on the side of your hip (femur). Trochanteric bursitis usually affects middle-aged or elderly people, and women more often than men, but it can develop in younger people too.
Trochanteric bursitis may occur as a result of direct trauma and falls on the side of the hip, as experienced by ice skaters or dancers, athletic overuse, or multiple traumatic impacts of a lesser severity. It may co-exist in people who have osteoarthritis (degenerative joint disease) of the hips or lower back. It may also occur in some people who have scoliosis or unequal leg length. In many cases, the cause of the condition is unknown.
What causes the pain of trochanteric bursitis?
With the condition, if the inflammatory process is ongoing, it may cause reactive tissue to form within the bursa. With repetitive stress, the bursae of the hip will become inflamed, and will be aggravated by any activity involving the surrounding muscles.
Bursitis may develop gradually or dramatically. Symptoms may include:
- Pain occurring over the side of the hip that travels down the thigh and may continue down the knee.
- Pain when sleeping on the affected hip.
- Pain upon getting up from a deep chair or after sitting in a car.
- Pain when climbing stairs.
- Increased pain when walking or standing for long periods of time.
Keep in mind that surgical scars, previous trauma, or prosthetic implants may provoke trochanteric bursitis.
A careful evaluation of your medical history and a physical examination of your hip and back will help your Cleveland Clinic health care providers determine if you have trochanteric bursitis. Your physician will also ask you about your medical history. While you are lying on your unaffected side, your physician will carefully examine the greater trochanteric bursa area. If you feel tenderness over the bursa or pain when pressure is applied, a diagnosis is confirmed.
What are the benefits of treatment?
In many cases, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are prescribed. They serve as analgesics (pain relievers) and as anti-inflammatories (to decrease inflammation).
The Cleveland Clinic Spine Institute recommends an injection of a local anesthetic (pain-relieving medication) mixed with one or more cortisone preparations to decrease inflammation in the bursa and to relieve pain. The injection may need to be repeated in two to four weeks to achieve maximum symptom relief.
If you receive a bursa injection, your physician may recommend that you apply ice to the area to decrease inflammation. It is recommended that you apply a large ice pack on the affected area for 20 to 30 minutes. You should repeat the ice application twice a day for two to three days.
Weight loss may be recommended if you are overweight. Shoe lifts may be ordered for individuals with unequal leg length. If trochanteric bursitis is recurrent, physical therapy exercises, as prescribed by a therapist, may be helpful.
Surgery may be advised by your doctor, only as a last resort, if the treatment prescribed fails to bring relief. The surgical procedure may involve releasing the iliotibial band in the trochanteric area, and removing the bursal sac and any calcified tissue.
The prognosis for recovery is very good. Most people with trochanteric bursitis respond well to treatment. But successful long-term treatment will involve effort from the patient to change his or her lifestyle, occupation or activities. In addition, improving health through weight loss or exercise is usually an aspect of treatment.
What are the risks of treatment?
Unforeseen complications may develop that are associated with anesthesia, such as respiratory or cardiac malfunction. In addition, complications may arise with an infection, injury to nerves and blood vessels, fracture, weakness, stiffness or instability of the joint, pain, or the possibility of needing more surgeries.
How frequently should I schedule follow up appointments with my doctor following surgery?
Depending on their medical condition and whether they require surgery for trochanteric bursitis, patients should schedule their first evaluation within the recommended timeframe indicated by their surgeon.
This information is provided by Cleveland Clinic and is not intended to replace
the medical advice of your doctor or health care provider.
Please consult your health care provider for advice about a specific medical condition.
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