Hip bursitis


What is hip bursitis

Hip bursitis (trochanteric bursitis) is an inflammatory process that affects the bursa of the greater trochanter (trochanter) of the thigh bone.

The greater trochanter of the thigh plays a fundamental role in lower extremity dynamics because it forms the insertion of the extensors (e.g., gluteus maximus, gluteus maximus + minimus) and external rotators of the hip (e.g. , pear muscle , piriformis ).
There are three bursae at the level of the femoral trochanter; their position is:

  • between the greater trochanter of the femur and the connective tissue sheath fascia lata (most commonly affected);
  • between the tendon of the gluteus maximus and the bone;
  • within the tendon of the gluteus minor.

The bone is superficial, so the inflammation of the bursa is not deep.
Trochanteric bursitis occurs in middle-aged or elderly patients; Women are more commonly affected, as are people with an unbalanced body position, such as when one leg is shorter than the other (heterometry).
Bursitis is equally likely to occur on the right or left side, often bilateral.

If the inflammation is the result of trauma , the capillaries can be damaged and blood will spill into the sac; in this case it is a hemorrhagic bursitis.

Bursitis of the hip includes tronchaderic bursitis and enthesitides, or insertional tendinitis of the muscles that insert at the greater trochanter such as the external rotars of the hip.
This condition often affects athletes, especially goalkeepers, who often fall on their hips.
Hip bursitis is not a serious condition, but it can limit certain activities.
As a rule, adults or the elderly are affected, children only in rare cases.

What are the causes of hip bursitis?

The causes of bursitis are trauma, repeated micro-traumatization and functional overload of the tendons that run along the bag.
A muscular and anatomical imbalance can trigger this condition; for example, a shorter leg, a twisted pelvis, and improper footfall create more friction at the bursa.
Incorrect or excessive training behavior can also trigger the inflammation because the structure is irritated by constant rubbing.
Knee problems or hip surgery can change the position of the joint and cause trochanteric bursitis.
A soccer goalkeeper can develop hip bursitis because he often falls sideways on his hips while playing.

What are the symptoms of hip bursitis?

With hip bursitis, pain occurs in the upper, outer part of the thigh, especially with palpation and finger pressure, walking, and changing direction.

In the acute phase, it is possible for the patient to limp, have difficulty walking and climbing stairs.
Non-load bearing movements are painful with abduction and flexion of the hip beyond the right angle, and range of motion may be limited.
Swelling can be observed on the side of the hip.

The pain can also occur at night, especially when sleeping on the affected side.
Painful stitches can appear at the level of the glutes, on the right or left flank, or on the outer thigh.
If left untreated, trochanteric bursitis can become chronic or long-lasting.

Which examination methods are suitable for trochanteric bursitis?

If there is discomfort at the level of the trochanter, an X-ray will help rule out bone disorders, such as fractures or bone edema.
The ultrasound shows a thickening of the bursa and its contents, and the condition of the tendons can also be analyzed.

How is trochanteric bursitis diagnosed?

Usually one visit to a specialist is sufficient to diagnose hip bursitis, signs and symptoms are very distinctive.
The orthopedist or physiatrist may order further tests to confirm the suspicion or to analyze the pain area in more detail.
In the differential diagnosis, tendinitis of the pear muscle and other muscles that attach to the greater trochanter of the femur, hip arthrosis , hip fractures and bone edema, as well as bruises and the like. to consider.

What treatment is suitable for trochanteric bursitis?

In the acute phase, the most important measures are cold treatment and immobilization, but this is not always sufficient.
Hip bursitis is supposed to heal on its own; if this has not happened several days after it occurs, the doctor may prescribe anti-inflammatory drugs such as diclofenac (Voltaren) or suction the fluid from the bursa and then give cortisone injections .

Physiotherapy can help with the use of Tecar – ® and laser therapy, ultrasound treatment or shock wave therapy .
If the cause of the discomfort is anatomical in nature or the result of poor posture, the imbalance must be corrected with shoe inserts or manual pelvic correction.
The rehabilitation and stretching exercises can be an effective complement to physical therapy or osteopathy to relieve joint blockages.
Osteopathy is helpful because it improves circulation, loosens joints, and relieves nerve compression.
If the conservative forms of therapy do not lead to the desired success, the bursa can be surgically removed.
Good treatment also includes prevention, because if the primary causes are not eliminated, the symptoms are likely to recur.
The training must be adapted to the needs of the athlete; the following is important:

  • ideal coordination of stress and relief phases;
  • Avoiding exercises that would put too much strain on the bursa.

These measures are of great benefit and can prevent relapses.

Possible sports include swimming if it does not cause discomfort; Cycling, on the other hand, can increase inflammation and should therefore be avoided.

Natural Remedies

As a natural remedy, the affected area can be rubbed with arnica ointment.
Acupuncture is not particularly effective for hip bursitis.

How long does hip bursitis last? The healing prognosis

There is no telling how long trochanteric bursitis will last. If it was triggered by trauma, the pain can subside in a short time; in some cases, the inflammation becomes chronic and, with careless treatment, healing can take months or years.

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