Pain in the area of the greater trochanter (the prominent bone on the side of the hip) can originate from the inflamed trochanteric bursa or inflamed gluteal tendons. A bursa is like a fluid filled sack that sits over bony prominences or near joints and acts as a shock absorber and movement interface. If the bursa gets inflamed, this can cause pain – a condition called bursitis. Bursitis can be a painful problem in many areas of the body. If this affects the bursa on the side of the hip this is called trochanteric bursitis. The gluteal tendons connect the big gluteal muscles to the greater trochanter. Like other tendons in the body, they can become painful as a result of microtearing and/or inflammation.
The most common cause of trochanteric bursitis is repetitive strain and overuse – think about muscles and tendons in the area constantly rubbing on the prominent trochanter. Contributing factors can include poor posture, muscle imbalances, leg length discrepancies, scarring from previous surgery and bony spurs. Direct trauma and prolonged pressure on the area can cause bursitis. Diseases like rheumatoid arthritis, psoriasis, thyroid disease and gout can also result in inflammation of the bursa, while infection is a rather rare cause. Other pain sources in this area include the gluteal tendons and muscles, this is called gluteal tendinitis. The causes are similar to trochanteric bursitis (repetitive strain, overload, muscle imbalances, postural abnormalities, leg length discrepancies etc).
In both conditions the pain is typically located on the outer side of the hip, just where the bone is most prominent. The area is often tender to touch. Patients may have difficulty sleeping on the affected side and simple daily activities like stair climbing or getting up from a chair can be painful.
Simple measures like rest, anti-inflammatory medication and ice can help. An experienced Physiotherapist will usually address issues like muscle imbalances and poor posture with a range of strengthening and stretching exercises. Runners may benefit from having their gait and shoe wear assessed in a video analysis. Steroid injections can provide short term pain relief, but there are increasing concerns that repeated injections can damage the soft tissues and tendons in the area.
Patients who continue to suffer from pain despite best efforts with Physiotherpay may benefit from injection treatment with PRP (Platelet Rich Plasma) or ACP-Tendo. The injection of concentrated growth factors and cytokines stimulate and support a long-lasting healing response from the body. The treatment has been shown to safe and effective.
Our experts at the Orthobiologics Clinic are happy to assess your condition and to discuss the various treatment options including injection treatment with PRP.