What is it?
This is most commonly experienced as pain and tenderness over the outer or lateral bony prominence of the hip joint (greater trochanter). It occurs when the bursa (fluid-filled lubricating sac) becomes inflamed, and it is often referred to as trochanteric pain syndrome .
Why does it occur?
Trochanteric bursitis can occur in anybody, but is more common in women in as they get older. It often occurs as a result of repetitive injury in runners, who may have tight iliotibial bands, which is the thick strip of connective tissue connecting several muscles in the thigh. The underlying cause is thought to be microscopic tears within the tendons around top of the thigh bone, causing irritation and inflammation of the bursa overlying them.
What are the symptoms?
Symptoms include pain over the outer aspect of the hip, sometimes radiating down the thigh and or into the buttocks.
How is it diagnosed?
A full history and physical examination will be required, and it may be necessary for imaging such as x-rays, ultrasound or MRI scans, to be used to confirm the diagnosis.
How is it treated?
Non-operative measures can include lifestyle modification and appropriate analgesia. Injections of steroid or occasionally platelet-rich plasma (PRP) can be very effective, and walking aids can be used to help relieve pain temporarily. A targeted rehabilitation programme, which focuses on avoiding certain postures and some core and hip strength and stretching exercises, can be used to reduce symptoms.
Surgery is not usually required, but may be recommended, for example, to a patient with a tight iliotibial band (running from the hip down to the knee) which has not responded to physiotherapy. In this case, surgery would involve lengthening the iliotibial band, often further down the leg from the site of the pain.
Platelet-rich plasma treatment
The One Orthopaedics team specialists
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Hip and Knee
Consultant Orthopaedic Surgeon FRCS (Tr&Orth), Knee and Hip