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Consensus among experts confirms that bursitis tends to develop in areas near joints subjected to repetitive motion. Hence, providing adequate rest to the affected joint can aid in the healing process. However, it's common to experience episodes of heightened pain, stiffness, inflammation, and swelling around the affected joint. Trochanteric bursitis specifically occurs due to inflammation in the fluid-filled sacs, known as bursa, that cushion the joint where the femur connects to the pelvis. Research indicates that this condition can lead to hip and thigh pain on the affected side, which may exacerbate after periods of sitting, lying down, or physical activity. Despite the frustrating nature of the pain, effective management of bursitis is achievable.
Procedures
Altering Activities and Exercises
Avoiding Overuse Injuries. One of the primary contributors to hip bursitis, as well as bursitis in other major joints, is repetitive movements that strain tendons and cause inflammation in the underlying bursa sacs. This can occur with activities such as excessive jogging, cycling, stair climbing, kicking, or prolonged standing, particularly on hard surfaces. Therefore, it's essential to avoid excessive strain both at work and during physical exercise.
- If you're a jogger, consider running on softer surfaces like grass or using a treadmill, and decrease your mileage if hip pain develops.
- For cyclists experiencing hip pain, adjustments to the bike seat or obtaining better suspension may be necessary.
- If you have a job that requires prolonged standing, such as a cashier, consider placing a rubberized or cushioned mat on the floor to provide shock absorption.
Adopt Proper Posture. Poor posture stands as a major contributor to hip bursitis. Consistently leaning to one side while standing, crossing legs habitually while seated, having scoliosis in the spine, suffering from hip or knee arthritis, having flat feet, or experiencing a leg length discrepancy significantly increase the likelihood of developing trochanteric bursitis.
- Ensure to maintain upright posture while standing and sitting, as leaning exerts extra pressure on the hip joints on the leaning side.
- A notable discrepancy in leg lengths, whether due to injury, arthritis, or fallen arches, disrupts normal walking patterns, leading to irritation in hip joints.
- Utilize shoe orthotics to support arches and correct leg length discrepancies, reducing the risk of hip bursitis.
Explore Yoga Classes. Engaging in exercises and stretches targeting the muscles around the hips can alleviate pressure on the joints and associated bursa sacs. Gentle yoga practices have the potential to alleviate trochanteric bursitis by enhancing flexibility and reducing muscle tension surrounding the hip joints. Inquire at local fitness centers, community hubs, religious institutions, or chiropractic clinics about available yoga sessions. Alternatively, search online for certified yoga instructors offering introductory classes.
- Prior to joining a yoga class, consult with a healthcare professional to ensure the suitability of movements for your bursitis condition. Certain postures may need modification, and the instructor can provide guidance on focus areas and limitations.
- Avoid intense 'hot yoga' sessions, as they might exacerbate bursitis symptoms due to their vigorous nature and elevated temperatures.
- Other mild exercises such as Pilates and Tai Chi can also enhance muscle and ligament strength around the hips, reducing tension and inflammation caused by repetitive motions.
Managing Trochanteric Bursitis at Home
Utilize Cold Therapy. Given that bursitis entails inflammation, applying cold compresses to the affected area helps alleviate swelling and associated discomfort. Locate the tender area around the outer hip or top of the buttocks and apply a bag of crushed ice or ice cubes for approximately 15 minutes until numbness ensues. Repeat this process three to five times daily or as necessary.
- In the absence of ice, frozen fruit or vegetable bags can serve as alternatives for cold therapy.
- Always cover ice packs or gel packs with a thin cloth to prevent skin frostbite.
Consider Anti-inflammatory Medications. In addition to cold therapy, addressing inflammation and pain associated with bursitis can be achieved through over-the-counter anti-inflammatory drugs like ibuprofen (Advil) or naproxen (Aleve). Administer these medications prior to engaging in activities. However, their usage should remain short-term to mitigate potential side effects.
- Possible side effects of anti-inflammatories include stomach irritation, diarrhea, skin rash, blurred vision, and decreased kidney function.
- Take anti-inflammatory drugs with food and adhere to recommended dosages advised by a healthcare provider—do not exceed the daily recommended dose.
Utilize a Walking Cane. When managing trochanteric bursitis, you might find it beneficial to utilize supportive aids like a walking cane. Temporary usage of a cane can alleviate pressure on the hip, aiding in the reduction of inflammation and pain. Ensure the cane is appropriately sized, allowing for full elbow extension when supporting your weight.
- If bursitis affects both hips, an uncommon scenario, consider employing crutches or a supportive walker instead of a cane.
- Walking canes are readily available at most pharmacies and medical supply stores. Consult your healthcare provider for further guidance.
Embark on Weight Loss. Weight loss serves as a long-term strategy to manage trochanteric bursitis effectively, particularly in cases of chronic or recurring bursitis. Excessive body weight increases pressure on the hip joints, elevating the risk of arthritis and bone spurs, significant contributors to hip bursitis.
- Weight-bearing exercises like walking can exacerbate bursitis pain; therefore, swimming, offering weightless movement in water, is an ideal alternative for weight loss.
- Alongside increased physical activity, adopt a calorie-controlled diet comprising fresh vegetables, lean fish, low-fat dairy, and whole grains, while minimizing processed foods and sugary beverages.
- Hydrate adequately by drinking more water and reducing consumption of soda and energy drinks.
Seeking Medical Intervention for Trochanteric Bursitis
Discuss Steroid Injections with Your Doctor. If conservative measures fail to alleviate hip bursitis within a few weeks, your healthcare provider may suggest corticosteroid injections directly into the hip bursa to alleviate inflammation and pain swiftly. Corticosteroid injections offer rapid relief and can last for months with minimal side effects.
- These injections are administered in a clinical setting and often provide long-lasting relief after a single dose.
- If symptoms recur, additional injections may be administered, with several months between treatments recommended to mitigate potential side effects.
- Possible side effects include tendon/muscle weakening, localized infection, fluid retention, weight gain, and compromised immune function.
Receive Referral for Physical Therapy. In cases where steroid injections are not advised or prove ineffective, your doctor may refer you to a physical therapist. The therapist can introduce tailored exercises to strengthen the hip joint and demonstrate stretches to enhance flexibility. Additionally, therapeutic ultrasound may be employed to alleviate symptoms and reduce bursa inflammation.
- Special emphasis will be placed on IT band stretching and strengthening exercises, addressing the primary source of inflammation in trochanteric bursitis.
- A typical physiotherapy regimen involves three sessions per week over three to four weeks to achieve significant improvement.
- Once familiarized with the exercises, continue them at home if they prove effective.
Keep Surgery as a Last Resort. In severe and persistent cases of trochanteric bursitis, surgery might become necessary. Surgical interventions typically involve open or arthroscopic debridement of the bursa, lengthening of the IT band, or creating a window in the IT band to prevent friction between the IT band and the greater trochanter itself.
Recognizing Common Symptoms
Be Aware of Lateral Hip Pain. The primary symptom of trochanteric bursitis manifests as sharp, stabbing pain on the outer (lateral) part of the hip, near the upper buttocks. This pain may develop gradually over a day or two, often due to overuse or incidents like falling on the hip.
- There are two bursae in the hip joint, with inflammation of the one covering the greater trochanter being most common.
- The other bursa, the iliopsoas bursa, located on the inner side of the hip joint (groin area), causes groin pain when inflamed.
Take Notice of Activity-Induced Hip Pain. Hip bursitis pain typically feels better in the morning (unless aggravated during sleep), worsening with activities like walking, running, or lifting and twisting. Thus, icing, stretching, and taking anti-inflammatory medication are recommended in the morning to alleviate symptoms.
- Hip pain during activity can also be indicative of inflammatory arthritis (rheumatoid arthritis), which is occasionally mistaken for bursitis.
- In both rheumatoid and osteoarthritis of the hip, morning pain and stiffness are common, typically more pronounced in rheumatoid arthritis and lasting over 30 minutes before easing, compared to osteoarthritis with stiffness for less than 10–15 minutes upon waking.
- An x-ray of the hip is usually performed to assess the role of arthritis or joint damage in bursitis.
Check for Hip Swelling. Swelling or a soft, swollen sensation on the outer side of the hip joint is another key indication of bursitis. Pressing on the outer hip should elicit pain and leave a temporary indentation due to swelling—similar to pitting edema in the ankles.
- The greater trochanter's proximity to the skin's surface makes the inflamed bursa easily palpable and visible.
- While hip bursitis may be mistaken for a hip infection, it doesn't typically cause fever.
- It's important not to confuse bursitis with a large boil, rash, or bruise, as bursitis generally doesn't cause skin discoloration.
Useful Tips
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To alleviate nighttime discomfort, opt for sleeping on your back or the non-inflamed side.
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Avoid exacerbating bursitis by refraining from crossing your legs while seated; keep both feet flat on the floor.
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Previous hip surgeries may lead to bursa irritation and subsequent bursitis.
