Hip pain - trochanteric bursitis

Trochanteric bursitis sometimes called hip bursitis is a common problem that causes pain over the outer side of the upper thigh.  The bursa is a fluid filled sac that allows smooth motion between the bone of the hip and the more superficial tissues such as the tendons and muscles.  

Trochanteric bursitis is commonly seen in runners or athletes and those who participate in running orientated sports such as football and rugby.  The bursa can be injured in falling onto the outer side of the thigh and this causes what is called a traumatic bursitis.  More rarely patients who have had surgery such as hip fracture surgery or hip replacement may complain of pain over the outside of the hip and these symptoms may be caused by irritation to the bursa or changes in walking style.  

The diagnosis of trochanteric bursitis is made most reliably by physical examination with tenderness over the bony prominence of the top of the femur and swelling of the bursa.  The diagnosis can be confirmed by ultrasound or MRI investigation.  

Treatment of trochanteric bursitis is usually started with some simple conservative measures such as changes in patterns of walking or sporting activity and wearing of loose clothing which does not irritate the outer side of the thigh, anti inflammatory medications and regular 15 minute spells of ice pack over the affected area.  

Osteopathy or physiotherapy to reduce the tension in the muscles around the bursa and the use of therapeutic ultrasound can be helpful as well as a review of walking and running style.  Aggressive measures would include draining the bursa, local steroid injections such as those given by Dr Simon Harley can be helpful to reduce the inflammation within the bursa, or, more rarely, surgical removal of the bursa which is usually considered to be the last resort.