Inside your joints are about 140 small, fluid-filled sacs called bursae. When all is going well, these sacs reduce friction in the joints, providing a cushion between bone and soft tissues. But when one of these bursae becomes irritated and inflamed, the result is a painful condition called bursitis.
The most common type of bursitis of the hip is called trochanteric bursitis. It’s named after the greater trochanter, a bony ridge at the top of the femur (thigh bone) where the hip joint attaches to certain muscles. The most common symptoms of trochanteric bursitis are pain and tenderness on the outer hip.
Who develops trochanteric bursitis?
About five of every 1,000 adults develop trochanteric bursitis. The condition tends to strike active people who are middle-aged or older. The condition typically develops over time and becomes progressively painful. Some common causes include:
- Overuse injuries, which can be caused by intense exercise or repetitive movements, such as pedaling a bike
- A tear in a muscle or tendon near the hip joint
- A traumatic injury caused by a car crash, fall, etc.
- Sleeping on your side on a hard surface
- Poor posture or being overweight
- Bone spurs or calcium deposits on the femur, which can harden over time and irritate the bursa
People who have other inflammatory conditions, such as rheumatoid arthritis, are more likely to develop bursitis.
How do I know whether I have trochanteric bursitis?
The first sign of trochanteric bursitis is typically a sharp pain on the outside of the hip. The pain may become more of a dull ache, and it could radiate down the thigh. Other tell-tale signs can include:
- Pain and stiffness when you are climbing stairs, getting out of a chair after sitting for a long time or lying on the affected side of your hip.
- Pain that is worse after exercise or after sleeping
- Hip tenderness
If you have any of the above symptoms plus a fever and/or visible redness and swelling at the hip, contact your primary care provider. This can be a sign of infection and should be treated right away.
Can I treat trochanteric bursitis at home?
Many people find that their hip pain goes away with at-home treatment. Here are some things to try—even if you aren’t sure what’s causing the problem.
- Apply an ice pack to your hip every four hours for about 20 minutes each time to bring swelling down and provide pain relief.
- Over-the-counter medications. Ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) can reduce pain and swelling. Topical medications containing salicylates, such as Aspercreme and Biofreeze, can temporarily reduce inflammation and relieve pain. Be sure to use these medications only as directed on the label.
- Give your hip a break by not exercising for a week or so, and use crutches if that helps.
If your symptoms don’t improve after a week or two, consider seeing an orthopedic surgeon. These doctors specialize in treating problems such as trochanteric bursitis—usually without surgery.
How do doctors diagnose trochanteric bursitis?
You might be amazed by how many conditions cause hip pain — osteoarthritis, a stress fracture, tight muscles and pinched nerves, to name a few. Diagnosing the root cause of your hip pain will require your doctor to use a combination of technology and good observational skills.
The first step is a physical exam and a conversation about your symptoms and how they’re affecting your life. Medical imaging, such as X-ray, ultrasound or magnetic resonance imaging, can help diagnose trochanteric bursitis and/or rule out other conditions.
It’s possible the doctor will recommend doing an aspiration—using a needle to drain fluid from the inflamed bursa. This can relieve pressure in the hip and make you more comfortable, although it may be just a short-term fix.
If the doctor is concerned about a possible infection in the bursa, he or she may send the fluid to a lab for testing. Blood tests can be helpful too, if the doctor suspects you might have another inflammatory condition, such as rheumatoid arthritis or gout.
What are the treatment options for trochanteric bursitis?
Your doctor may recommend non-surgical therapies to treat trochanteric bursitis. These therapies can include physical therapy to strengthen the muscles and tissues surrounding the greater trochanter, a corticosteroid shot to relieve inflammation and pain, or shock wave therapy, which uses sound waves to promote healing.
If these don’t provide enough pain relief, your doctor may recommend one or more of the following surgical procedures, depending on the root cause of your symptoms.
- Surgery to remove the bursa
- Surgery to repair soft tissues around the greater trochanter so that there is less friction and stress on the bursa
- Surgery to cut away some of the greater trochanter bone, if it seems to be aggravating the hip area
These surgeries are usually done through tiny incisions, which means shorter recovery times and less pain.