Overview

Has hip pain been making you feel miserable?

Trochanteric bursitis is a very common hip problem which causes pain along the outer thigh. This type of hip inflammation can affect anyone, but tends to be more prominent in older or more active people. Are you suffering from this? You will be pleased to know it is treatable, and that most people can return to the activities they enjoy. 

Knowing how to navigate trochanteric bursitis is important, both to reduce the risk of long-term complications and to improve general well-being. The purpose of this article is to help you understand the condition and how it can be managed. This article gives an overview of trochanteric bursitis, its impact on mobility, how it can affect quality of life if left untreated, and strategies for prevention and management. 

Key points

• Trochanteric bursitis can progressively impair one’s quality of life if left untreated
• Early treatment and proper management can prevent other long-term complications, from emotional distress to worsening posture
• There are many strategies available to treat persistent trochanteric bursitis
• It is important to note that hip pain has different causes, so seeking medical advice for persistent hip pain is crucial¹

What is trochanteric bursitis? 

Just as leaves float effortlessly along a river, the gliding surfaces which reduce friction within our joints are formed of fluid-filled sacs, called bursae. Trochanteric bursitis is the inflammation of the bursa which surrounds the outer bony prominence (called the trochanter) of your hip.²

When this happens, it causes pain on the outer side of the hip. The pain may be experienced as short episodes of sharp, intense pain or a persistent, dull ache which can move down the thigh. This can make simple things like walking, sitting cross-legged, and transitioning from sitting to standing extremely difficult. Increased pressure on the hip when lying down can also cause pain, commonly affecting sleep quality.³

Trochanteric bursitis can have many causes, which means it is important to consult a medical professional if you are experiencing persistent hip pain. Common causes include:^1,3

• Overuse of the hip: Repetitive activities like running, cycling, or remaining in one position for long periods of time
• Muscle weakness: Weakness of the pelvic floor and hip muscles can place more pressure on the trochanter
• Injury to the hip: Hitting your hip bone or tearing a hip tendon (i.e. from a fall) can cause inflammation of the trochanteric bursa
• Obesity: Increased pressure on the joints can overburden the hip
• Surgical intervention: Due to complications from hip surgery or prosthetic hip implants
• Leg length discrepancies: Having legs of unequal lengths can affect one’s gait, placing increased pressure on the hip

Trochanteric bursitis predominantly affects females, elderly people, and people who are highly active. Other medical conditions associated with this condition include arthritis, spinal problems, gout, diabetes, and thyroid disease.

Since this issue may be related to other underlying conditions, it is important to seek early diagnosis and treatment for the condition. A medical professional may use the following methods to evaluate your pain:^3,4

• Palpation: Your healthcare provider will use their hands to feel for tenderness, swelling, and abnormalities
• Ultrasound imaging: Along with palpation, an imaging test which uses high-frequency sound waves to look at the internal tissues may be used to assist with clinical evaluation
• Aspiration: A thin needle is used to remove fluid from the inflamed bursa to examine whether the inflammation is due to infection or gout
• Blood testing: Laboratory testing may be done to determine if the inflammation is due to other conditions
• Magnetic resonance (MRI) and x-ray imaging: A combination of imaging tests may be conducted so that your healthcare provider can see the internal structure of the hip

Deterioration of quality of life

Many people may refrain from visiting a medical professional, thinking the pain will go away by itself. Some people may get used to living with the pain. However, untreated trochanteric bursitis can impact mobility and significantly impair one’s quality of life in many ways:^5,6,8

• Persistent discomfort affects daily activities: The chronic pain associated with trochanteric bursitis affects routine movements such as walking and sitting. This discomfort can lead to the avoidance of certain activities, worsening one’s physical limitations
• Sleep disturbances due to pain: It is not uncommon for those suffering from trochanteric bursitis to experience poor sleep quality. This is because hip pain intensifies when lying on the affected side or lying in one position for too long. This causes difficulties with finding a comfortable way to sleep, resulting in fatigue, low mood, and reduced daytime performance
• Emotional and psychological effects: The persistent pain and functional limitations imposed by trochanteric bursitis can lead to significant emotional distress. This should not be overlooked! The chronic nature of the condition can result in frustration and depression, as well as worsening one’s psychological state with increased feelings of helplessness
•  Reduced participation in social and recreational activities: Due to the pain and mobility challenges, people with untreated trochanteric bursitis may gradually withdraw from social engagements and the things they enjoy. This withdrawal can lead to social isolation and a decline in overall life satisfaction

This is why addressing trochanteric bursitis promptly is crucial to prevent these adverse effects and maintain a fulfilling life.

Long-term complications

At this point, it must be clear that not seeking medical evaluation for trochanteric bursitis can seriously affect our ability to enjoy life. As well as creating emotional and social difficulties, this condition can lead to several long-term complications that may adversely affect your health and daily functioning:^5,6,7

• Development of hip and back problems: Chronic hip pain often results in an altered gait to compensate for reduced hip mobility. This imposes stress on the hip and lower spine. Over time, these adaptations may lead to other musculoskeletal issues, including lower back pain, poor posture, and hip joint dysfunction. Since poor posture is related to a wide range of health problems (such as difficulties breathing due to improper mobility of the chest), it is vital that persistent hip pain is managed properly
• Increased risk of ostearthitis at the hip joint: Persistent inflammation and mechanical stress associated with untreated trochanteric bursitis can contribute to degenerative changes in the hip joint. While direct causation requires further research, long-term inflammation and altered biomechanics of the hip may result in joint degeneration over time
•  Loss of independence (especially in elderly people): Mobility limitations can lead to a decline in functional independence. This is because of difficulties in performing activities such as walking, dressing, and bathing and may lead to the person requiring assisted living arrangements sooner than expected. The resultant reduction in autonomy can significantly impact one’s quality of life
• Impact on professional life: The persistent pain and functional impairment can hinder performance at work, especially in roles requiring physical activity. This may lead to decreased productivity, increased absenteeism, and even job loss
• Decreased social well-being: Chronic discomfort can deter participation in recreational and social activities, leading to social isolation and a diminished sense of well-being

Strategies for prevention and management

Effective management of one’s symptoms involves a combination of medical interventions and committing to lifestyle changes:⁴

• Physical therapy: Structured exercise programmes which focus on strengthening the gluteal muscles and improving hip flexibility improve trochanteric bursitis symptoms over time.⁹
• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain and inflammation. In cases where NSAIDs are insufficient, corticosteroid injections may provide short-term relief. However, the benefits of corticosteroid injections are often temporary, and repeated use may have adverse effects. Your healthcare provider will help determine what is best for you.¹⁰
• Weight ,anagement: Maintaining a healthy weight reduces the mechanical load on the hip joint, potentially decreasing symptom severity.

Home remedies and preventative measures

If you are someone who suffers from repeated bouts of hip pain, integrating activities into your life to help prevent trochanteric bursitis may be beneficial for you:

• Stretching and strengthening exercises: Regularly performing targeted exercises can enhance hip stability and alleviate discomfort.
• Ice/heat therapy: Depending on what suits you, applying ice packs during flare-ups can reduce inflammation, whilst heat therapy can relax and soothe tight muscles.
• Activity adjustments: Modifying activities to avoid repetitive hip strain, such as reducing excessive stair climbing or prolonged standing, can prevent exacerbation of symptoms.

Surgical considerations for severe cases

In severe cases, when other treatments fail to provide relief, surgical options such as bursectomy (removal of the affected bursa) or iliotibial band release may be considered.

Summary

Hip pain is often a neglected aspect of well-being. We may tell ourselves it will get better and slowly acclimatise to the pain. However, untreated trochanteric bursitis can lead to significant long-term complications, including more serious musculoskeletal issues, potential progression to osteoarthritis, loss of independence, and diminished enjoyment in everyday life. Early diagnosis and a multifaceted treatment approach are essential. If you are experiencing persistent hip pain, please seek medical evaluation. 

Key points

• Trochanteric bursitis is inflammation of a bursa, a fluid-filled sac that reduces friction between the internal structures of our body (i.e. bone to muscle)
• The most common causes of trochanteric bursitis are injury and overuse. However, it can also be caused by infection. It mostly affects females, elderly people, and highly active people.
• Pain, swelling, and tenderness are the most common signs of trochanteric bursitis
• If left untreated, trochanteric bursitis can result in long-term complications and severely reduce one’s quality of life
• Trochanteric bursitis can be treated with rest, medication, and lifestyle changes to help with the inflammation. If other interventions fail, surgery may be considered
• You can prevent bursitis by doing things like warming up before exercise, using protective padding for your hips, taking rest breaks often, and stopping activities which cause pain