A bursa is a fluid filled sac that is in position over an area of great pressure. For example, between a bone and a muscle. A Trochanteric bursitis is the inflammation of the bursa that lies between the neck of the femur (the large bone of the upper leg) and the large tendon of the Tensor fascia latae muscle.
Trochanteric bursitis is the most common bursa in the hip. There are many muscles such as gluteus maximus, tensor fascia latae, and the iliotibial band that surround this bursae. Irritation of the bursae will occur if any of these structures become tight and cause excessive pressure directly on the bursae.
- Localized pain on the side of the upper thigh at the hip joint level.
- Gradual onset of discomfort.
- Pain with daily activities such as climbing stairs, crossing legs, lying on the affected side.
- Painful to move leg out to side.
- A lump or swelling over the area.
- The pain is aggravated by walking, climbing stairs, lying on the affected side in bed, and may disturb sleep.
Reasons for developing a trochanteric bursitis
The following are possible causes of a trochanteric bursitis:
- Stiffness of the iliotibial band, the muscles and tough ligament type fascia on the outside of the thigh.
- Habitual standing on one leg or a shorter leg on one side.
- An imbalance between the muscles that work to pull the leg out to the side and the muscles that work to pull the leg inwards.
- A broad pelvis therefore common in Ladies.
- Running sports such as football that requires repeated movements of the leg towards the body.
Trochanteric bursitis usually appears gradually therefore it is important to avoid the activities that aggravate or worsen the injury.
Using contrast bathing ( a bag of frozen peas in a tea towel for 5 mins, followed by a hot water bottle in a towel for 5 mins, keep alternating and repeating for 25 minutes), may be helpful to reduce the inflammation.
Avoid overuse of joints in sports or heavy work.
Do appropriate warm-up and cool-down exercises.
Lose weight if needed.
Keep the flexibility of the hip muscles.
How Can Osteopathy Help Me?
There are a variety of causes that may contribute to a trochanteric bursitis. An Osteopath is skilled in assessing the possible causes of the injury. A proper treatment and management plan will be designed to address the cause and help recovery. Specific exercises will be prescribed to speed the recovery process and prevent it coming back.
Laser therapy is also helpful in treating trochanteric bursitis and pain down the outside of the thigh.
see evidence below
Greater trochanter bursitis and infrared laser therapy: a case series Janz, Stephen Kenmore Centre for Health Suite 7 1st floor Kenmore Village Brookfield Rd., Kenmore, Australia. firstname.lastname@example.org +61 7 38784477 Abstract Introduction: Greater trochanter bursitis is a common and debilitating pathology causing lateral hip pain. Greater trochanter bursitis is usually managed with iliotibial band stretching, non-steroidal anti-inflammatory drugs and where persistent, steroid injections. Conventional therapy is often unrewarding with many cases resulting in a chronic pain syndrome and corresponding reduction in quality of life. This paper discuses the successful treatment of two contrasting patients using a 150 mW 808nm infrared laser. Case presentation: Two cases of trochanter pain syndrome are presented. The first case is a 56 year old Caucasian woman with a complicated five year history of greater trochanter bursitis confirmed by ultrasound. Symptoms responded initially to acupuncture and later steroid injections and point injection therapy but were unresponsive upon recurrence. The introduction of infrared laser resulted in almost complete remission and a return to daily activities. The second patient is a 33 year old Caucasian female with a three year history of escalating severe superficial trochanter pain unresponsive to massage therapy, Bowen therapy and chiropractic. Two treatments of infrared laser were given resulting in a marked reduction in pain which lasted for more than 3 months. Conclusion: Infrared laser offers a safe, non-invasive and effective treatment method for greater trochanter bursitis and trochanteric pain syndrome. Laser is often used as part of a comprehensive treatment program making it difficult to determine its effectiveness alone. The extensive treatment used in case one gives a clear indication of the role of laser compared to acupuncture, point injection therapy and standard care. The second case indicates lasers effectiveness when used in relative isolation from other treatment. This therapy shows merit even in long standing intransigent cases and should be considered a first line treatment for trochanteric pain syndrome. Further research could be conducted to determine the optimal dosage and distribution of treatment points required to achieve a lasting therapeutic result. Keywords: Greater trochanter bursitis, trochanteric