The hip or trochanteric bursa is a small fluid filled sac underneath the glute tendons. It acts to decrease friction of the tendons on the underlying bone. Irritation of the bursa occurs with overload to the area often going hand in hand with glute tendon pain. It normally occurs around 50 to 60 years of age and is much more common in women. The condition may develop gradually or after a sudden increase in load with pain and stiffness around the hip with walking, hills and laying on the effected side are the most common symptoms.
Bursitis of the hip is generally easily diagnosed in the clinic by your physio. This is done based on your history, the location of pain, a battery of testing to reproduce pain. Imaging such as ultrasound can be useful to confirm the diagnosis but is rarely required.
Management of trochanteric bursitis is a multimodal approach that should be based on the assessment findings in the physiotherapy consult. Common management strategies include:
- Education surrounding the causes and management of bursitis.
- Activity modification to reduce load and compression on the bursa.
- Analysis of gait for any abnormal biomechanics.
- A graded strength program to improve control of the hip joint.
- Manual therapy such as release work, stretching or dry needling may help to decrease compression of the bursa.
- Possible footwear changes.
- Medication to control pain and inflammation can be helpful and in more severe cases, steroid injections can be used.
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