What is Trochanteric Bursitis?

What is Trochanteric Bursitis?

This is a type of bursitis also known as the greater trochanteric pain syndrome. The condition causes pain and inflammation of the bursa located around the trochanter of femur in the hip. The hip connects the hip muscles and bones to other parts like the buttocks. 
Bursa is a sac filled with fluid which acts as a cushion between joints around tendons, muscles or bones in the body. There are around 160 bursae in the body of a person. When the bursa is irritated and inflamed, it swells and causes a lot of pain. If this bursa is the tronchanteric bursa it will cause pain in the hip.

The term trochanteric is used to refer anything pertaining to the trochanter of the femur. The trochanter is the anterior end of the femur that fits into the hip joint. However it is important to note that this does not include the head or the neck. This part known as the trochanter can also be found in arthropods as the second segment of the leg in between the femur and the basal limb segment known as the coxa. However, trochanteric bursitis is not known to affect arthropods.

What is Bursitis?

This type of bursitis is also known as the greater trochanteric pain syndrome (GTPS). The term GTPS is more commonly used. It is a better label to this condition since regional pain and tenderness that may arise are commonly associated with myriad causes apart from bursitis. These causes may include:

1. Tendinopathy
2. ITB disorders
3. Tendinitis
4. Muscle tears
5. Tendinosis
6. Trigger points
7. Pathology that surrounds the tissue

Trochanteric bursitis is commonly associated with the act of running that may result into falling or the physical contact with the trochanter. Surgeries involving the hip laterally as well as some existing conditions are also associated with bursitis of the trochanter.

There are several other bursae that may characterize pain in the same regions of the trochanteric bursa. Between the gluteus medius tendon and the anterior-superior aspect of lateral greater trochanter lays the sub gluteus medius bursa. Sub gluteus minimus bursa and the sub gluteus maximus bursa are also located within the same region.

What Causes Trochanteric Bursitis?

• Bad posture: The condition can be brought about by the way you stand or sit. If you have a bad posture, it could apply pressure on the bursa which can cause inflammation. Spine complications brought about by poor posture can also be a cause.
• Body structure: This refers to your body. People with inequality in leg-length may suffer from this condition. This is because one of the hip carries more weight than the other.
• Awkward movements around the hip muscles: Some people especially in sports make careless movements like twisting around the hip which can cause inflammation. This also applies to individuals who run on banked surfaces as the length of one of the legs is somewhat stretched as the contact of the other foot with the ground is minimal.
• Anatomy: In some individuals, the greater trochanter is very broad in width when compared to the width of the crest of iliac. These individuals have a greater risk of trochanteric bursitis.
• Health conditions: There are a number of other health infections or conditions that may lead to trochanteric bursitis. These may include osteoarthritis, fibromyalgia, arthritis and iliotibial band syndrome.
• Injuries: These are injuries that mostly target the point of the hip. Such injuries might be as a result of excess vibration of the hip, falling or overuse of the hip. An example of overuse is cycling, running or stair climbing.
• Accumulation of calcium: When there is excess deposit of calcium around the bones it causes irritation and inflammation of the bursa.
• Surgery: If you have undergone previous surgery around the hip, you may experience pain and irritation. However, the pain may reduce with time.

Trochanteric Bursitis Symptoms

You may begin to experience pain around the hip area. This is common despite the fact that the hip is not involved with trochanteric bursitis in any way. This is the case in most bursitis patients. Basically most of the symptoms associated with this type of bursitis are painful sensations.

You may experience symptoms that interfere with other parts of your body.

• Pain when you undertake some simple normal activities. For example, when you stand up from a deep chair, walk or sit with your legs crossed.
• The greater trochanter becomes tender.
• A very sharp pain around the hip and tenderness.
• You will experience pain when lying on one side of the hip.
• Localized pain around the thigh, knees and buttocks.
• As the condition continues, there is so much pain that you cannot sleep on that side of the hip.
• Swelling may be visible on the affected bursa though this is rather hard to identify as it may be invisible.
• The skin starts to turn red.
• The aggravated pain around the hip area may lead to a painful experience while walking. Hence the patient may start limping.
• The skin is warm once it is touched.

How is Trochanteric Bursitis Diagnosed? 

No laboratory work is necessary to diagnose trochanteric bursitis. However, to rule out doubts or other conditions, doctors may use X-ray or some plain radiographs of the femur and the hip.

This may help in detecting possible fractures to these regions as well as bony lesions, deposition of calcium in the soft tissue in the greater trochanteric bursa and also possible degenerative arthritis.

Bone scans may also be used to rule out other possible diseases.

The use of magnetic resonance imaging (MRI) enables the practitioner to see the trochanteric bursa if present.

Treatment

1. Taking a break: Give your hip some time to rest in order to stop the inflammation and pain.
2. Physical therapy
3. Medication: You may use painkillers to relieve pain. It is also advisable to use anti-inflammatory medicine to reduce the swelling.
4. Application of ice packs to cool the area. This will relieve the pain and reduce inflammation.
5. Use of steroid injections. Steroids helps the bursa to reduce inflammation and also relieve pain.
6. Exercises to strengthen the muscles and to stretch the hip.

Prevention

• Always avoid doing strenuous activities which may overuse the hip.
• Reduce the amount of pressure subjected to the hip. You can do this by trying to lose weight.
• Stretching and exercising to strengthen the muscles around the hip.
• Wear shoes that can support your weight properly.
• Use crutches when necessary.