A bursa is a fluid filled sac that lines and forms a cushion between bones, ligaments and tendons. In the hip there are several bursa located around the outer area of the hip, near the portion of the thighbone (femur) called the greater trochanter. The greater trochanter is a broad, flat area of bone that anchors several large muscles.

If these muscles or tendons rub over the bursa and cause friction against the thigh bone then the bursa will become inflamed and cause hip pain.

Possible causes of trochanteric bursitis include:

•    Repetitive stress (overuse) injuries.
•    Multiple minor traumatic injuries.
•    Lumbar (low back) spine disease such as scoliosis.
•    Differences in leg length
•    Arthritis
•    Lying on one side of the body for an extended period (perhaps due to another injury or illness).
•    Excessive or prolonged pressure on the hip such as from standing too long.
•    An acute trauma such as a fall.
•    Previous hip surgery

Symptoms

There is usually and aching pain on the outside of the hip that may be focussed at the point of the hip. In some cases the pain can spread down the thigh as far as the knee. Pain usually worsens with pressure on the hip (eg. lying on the affected side) and at night it may be difficult to sleep. Walking, sitting or standing to long and climbing stairs will all be painful.

Diagnosis and treatment

Your physiotherapist will be able to diagnose and treat trochanteric bursitis. In some cases you may require and x-ray to rule out any bony damage or disease. Initial physiotherapy management would focus to reduce pain and inflammation. This would involve the use of electrotherapeutic modalities, ice, massage, and rest from aggravating activities. Following this treatment would move onto correction of any predisposing factors. This may involve strengthening of hip/back stability muscles, stretching and decreasing activity of tight/overactive muscles, proprioceptive (balance) exercises and correction of any abnormal lower limb biomechanics. Your physiotherapist would then guide you in a gradual progression to sport.