Do you suffer from hip pain?
You may have trochanteric bursitis. This condition is inflammation of the fluid filled sac located on the posterior prominence of the femur where it connects to the pelvis. While this is an inflammatory condition, swelling at the hip is not usually noticeable.
Symptoms of trochanteric bursitis
Symptoms of trochanteric bursitis include:
– Pain reproduced when pushing on the side and back of the hip;
– Pain with lying on the side of the sore hip;
– Pain with walking/running up hills, stairs, uneven surfaces or long distances;
– Pain with standing for long periods; and
– Walking with a limp.
Why does it occur?
Trochanteric bursitis may result from trauma such as a fall or sporting injury. However, it is more often considered an overuse injury common in runners and those that spend a long time standing such as those who work in kitchens or in retail. Middle aged men and older women are most commonly affected.
The condition is thought to occur as a result of gluteus medius and/or minimus tendinopathy. Imagine these muscles which are considered abductors of the hip. To achieve this action they contract like a pulley, decreasing the distance from where they attach onto the pelvis to where they insert as tendons on the top of the femur. When these tendons become short and contracted, inflamed or injured, they can compress the underlying bursa causing inflammation. Often, this predisposing tendinopathy follows pelvic imbalance caused when the forces of gravity are asymmetrical as they travel up the legs, resulting with increased pressure to one hip.
What else can it be?
The osteopath will consider alternate causes of pain to the hip before they reach your diagnosis. Other causes of pain to the posterior hip may also include piriformis syndrome, referred pain from the back or sacroiliac joints, lumbar disc irritation, stenosis of the spinal canal, secondary tumours and other more serious pathologies. If the pain occurs suddenly or occurs with bowel or bladder changes, tingling or weakness of the legs, fever, or abdominal pain, contact a health care provider immediately.
How can osteopaths help?
Osteopaths evaluate and correct underlying gait and posture abnormalities to take pressure off the sore hip. They use techniques such as soft tissue massage, myofascial release, hip traction and manipulation, dry needling and articulation to decrease pain and increase function at the hip joint. Management of trochanteric bursitis may include relative rest to avoid the aggravating activity especially walking up hills and stairs, or lying on the affected side. Athletes are educated on the importance of ITB stretching and hip abductor strengthening.
Generally, no surgical intervention is required because most patients respond well to conservative treatment. The prognosis of this condition is a healing time of 2 weeks to 3 months depending on the severity of the condition and resolution of the underlying cause. Steroid injections may be indicated if conservative treatment fails however results are mixed. If you or a family member suffer from hip pain see an osteopath for treatment of this condition.
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This post was written by Dr Jessica Davies.
You can find out more about Jess here or book an appointment online here.
Alternatively, you can call the clinic on 03 9908 2844.
References
- Carnes, M., Vizniak, N. A. (2012). Quick reference evidence-based conditions manual (3rd). Canada, Professional Health Systems Inc.
- Murtagh, J., Rosenblatt, J. (2015). John Murtagh’s General Practice (6th). NSW, Australia, McGraw-Hill Education (Australia) Pty Ltd.
- Deanm D. D., Gonzalez, P. (2016). Trochanteric bursitis treatment and management. Retrieved from http://emedicine.medscape.com/article/309286