Trochanteric Bursitis: Causes, Symptoms, Treatment, and Natural Remedies

Author: Dr. Doan Minh Huy | Estimated Reading Time: 12 minutes

Trochanteric bursitis, a common condition that affects the outer hip, occurs when the greater trochanteric bursa becomes inflamed. This bursa helps reduce friction between the bones and the surrounding muscles, but when irritated, it can cause significant pain and discomfort.
Although it may seem like a simple issue, trochanteric bursitis can lead to chronic pain if left untreated, affecting one’s mobility and quality of life. In this article, we’ll explore the causes, symptoms, effective treatments, and natural remedies for trochanteric bursitis, along with preventive measures to keep your hips healthy.

What Is Trochanteric Bursitis?

Trochanteric bursitis refers to the inflammation of the bursa located at the outer hip, near the greater trochanter, the bony prominence at the top of the thigh bone.
The bursa's role is to cushion the tendons and muscles around the hip, helping to prevent friction. However, when it becomes inflamed, typically due to overuse or trauma, it can cause intense pain, particularly when moving or applying pressure to the hip.

Reproduced and adapted from The Body Almanac. (c) American Academy of Orthopaedic Surgeons, 2003, p. 151. (source: Hip Bursitis - OrthoInfo - AAOS)

The condition is most often associated with repetitive motion (e.g., running, cycling) and can occur in people of all ages, but it is more common in those aged 40 and above. In older adults, the likelihood of developing bursitis increases due to age-related muscle weakness and changes in tendon flexibility.

Greater Trochanteric Pain Syndrome (GTPS) is a condition characterized by pain on the outer side of the hip, primarily around the greater trochanter of the femur. It is often caused by inflammation of the trochanteric bursa and tendinopathy of the gluteus medius and minimus muscles. GTPS is most common in patients aged 40–60, particularly in women and those with repetitive hip movements, such as runners and cyclists.

Symptoms include pain when lying on the affected side, difficulty climbing stairs, and pain radiating down the thigh. Treatment typically involves rest, ice therapy, and physical therapy to strengthen the hip muscles and reduce strain. Natural remedies like collagen peptides and omega-3 fatty acids can also help reduce inflammation and support recovery.

Keep reading to learn more about possible causes, symtoms and treatments.

What Causes Trochanteric Bursitis?

Several factors can lead to the development of trochanteric bursitis, including:

1. Overuse and Repetitive Movements

People who engage in activities that involve repetitive motion—such as running, cycling, or climbing stairs—are at higher risk for this condition. These repetitive actions place additional strain on the bursa, causing it to become inflamed.

2. Poor Posture and Muscle Imbalances

Muscle imbalances, often resulting from poor posture or inadequate strengthening exercises, can lead to uneven distribution of pressure on the hip joint. This increases the likelihood of bursitis.

3. Trauma or Injury

A sudden impact or injury to the hip can directly irritate the bursa, leading to bursitis. Falls, sports injuries, or accidents may cause this.

4. Age and Medical Conditions

As we age, tendons and muscles become less flexible, increasing the risk of degenerative conditions. Medical issues like arthritis can also contribute to the development of trochanteric bursitis, making the hip joint more prone to inflammation.

Symptoms of Trochanteric Bursitis

The primary symptom of trochanteric bursitis is hip pain, often located on the outer side of the hip and sometimes extending down the thigh. Other common symptoms include:

• Pain when lying on the affected side
  
• Pain during activities such as climbing stairs, sitting-to-standing transitions, or walking on inclines
  
• Tenderness over the greater trochanter
  
• Radiating pain that extends down the outer thigh but rarely goes below the knee
  
• Stiffness and limited range of motion in the hip joint

Pain in the hip due to inflammation of the bursae, fluid-filled sacs that cushion the joints. (Source: https://www.prestigehealthwellness.com/conditions/hip-bursitis/ )

These symptoms often worsen with activity and may improve with rest, though chronic inflammation can cause persistent discomfort.

How Is Trochanteric Bursitis Diagnosed?

If you experience symptoms of trochanteric bursitis, your healthcare provider will typically conduct a physical exam to confirm the diagnosis. The process may include:

• Palpation: The doctor may press on the affected area to check for tenderness over the greater trochanter.
  
• Muscle strength testing: They will assess the strength of the hip muscles, especially the abductors, which can be weak in individuals with bursitis.
  
• Gait assessment: To check for changes in walking patterns due to pain or discomfort.
  

In some cases, the doctor may recommend imaging tests like MRI or ultrasound to rule out other conditions like fractures or arthritis.

Trochanteric Bursitis Treatment 

After being diagnosed by a doctor, most cases of trochanteric bursitis can be effectively treated with conservative management. Here are some of the main treatment options:

1. Rest and Activity Modification

Resting the affected hip is essential to reduce inflammation. It is important to avoid movements that trigger pain, such as standing for long periods or engaging in high-impact activities.

2. Ice Therapy

Applying an ice pack to the affected area for 15-20 minutes several times a day can help reduce swelling and numb the pain.

3. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Over-the-counter NSAIDs, like ibuprofen or naproxen, can help reduce pain and inflammation. However, these medications should be used with caution due to potential side effects, particularly with long-term use.

4. Physical Therapy

A physical therapist can help you improve strength and flexibility through specific exercises. These exercises focus on stretching tight muscles (like the hip flexors) and strengthening weaker ones (like the gluteal muscles) to reduce strain on the bursa.

5. Corticosteroid Injections

For persistent pain, a corticosteroid injection may be administered directly into the bursa. This can provide temporary relief by reducing inflammation and pain.

6. Surgery (Last Resort)

In very rare cases, if conservative treatments do not work, surgical intervention may be necessary. The procedure typically involves removal of the inflamed bursa (Bursectomy)

Bursectomy, source: sportsrehabu

Tendon Recovery Protocol For Trochanteric Bursitis Patients: Step-by-step Treatment Methods

(GTPS CLINICAL PRACTICE GUIDELINE - OSUWMC)

Phase 1: Pain Reduction and Load Management

• Symptoms: Pain during or after activity (greater than 3/10, lasting more than 24 hours), inability to maintain normal activity levels due to pain, and tenderness at the tendon
  
• Treatment:
  
  • Reduce pressure on the tendon by avoiding over-stretching and using assistive devices if needed.
    
  • Engage in light activities (swimming, biking) to avoid further strain.
    
  • Perform isometric exercises (muscle contractions without compressing the tendon) to relieve pain and improve function.
    
• Progression: Move to the next phase when pain decreases and you can perform daily activities without issues.
  

Understanding Load Management: Exercise vs Rest - Square One Active Recovery
Source: squareone.com

Phase 2: Strengthening and Loading Progression

• Symptoms: Weak muscles and pain during exercise.
  
• Treatment:
  
  • Perform strength-building exercises, gradually increasing intensity.
    
  • Focus on exercises within a safe range of motion to avoid compressing the tendon.
    
  • Include functional exercises like squats, leg lifts, and hip abductions.
    
  • For chronic pain, cognitive behavioral therapy can help manage long-term pain.
    
• Progression: Move to the next phase once you can perform strengthening exercises with minimal pain and no increase in pain lasting longer than 24 hours.

Phase 3: Energy Storage and Lyometric Progression

• Symptoms: Balanced strength on both sides and ability to tolerate energy storage exercises (e.g., jumping or hopping) with minimal pain.
  
• Treatment:
  
  • Perform plyometric exercises to build strength and flexibility.
    
  • Gradually increase the intensity and volume of sports-specific exercises.
    
  • Focus on functional corrections like squats, lunges, and single-leg movements while keeping the pelvis stable and avoiding hip adduction.
    
• Progression: Move to the next phase when you can perform plyometric exercises with minimal pain and at a volume that mirrors your sport’s demands.
  

Total-Body Plyometrics Workout | Expert Fitness Articles | Source: ACE

Phase 4: Return to Sport/Activity

• Symptoms: Ability to engage in sport-specific activities without pain.
  
• Treatment:
  
  • Reintegration into sports or activities with a gradual increase in intensity.
    
  • Continue strengthening exercises and plyometric work at least twice per week.
    
  • Implement a long-term self-management program to maintain progress and avoid reinjury.
    
• Progression: Discharge from rehab when you have full range of motion, strength, and pain-free performance in high-load resistance exercises, and can return to sports or activities without pain.

Corrective Interventions:

• Modify posture to reduce hip adduction during activities like sitting, sleeping, and transfers
  
• Refrain from lying on the affected side
  
• Avoid crossing the legs
  
• Skip stretching of the piriformis, ITB, and adductors
  
• Prevent uneven weight-bearing on the lower extremities
  
• Avoid running on uneven surfaces

Natural Remedies for Trochanteric Bursitis

In addition to conventional treatments, many individuals turn to natural remedies to support recovery and reduce inflammation. Here are some natural options that may provide relief:

1. Collagen Peptides

Collagen is essential for cartilage repair and joint health. Supplementing with collagen peptides has been shown to reduce joint pain and improve flexibility, making it a great addition to your recovery plan. Studies suggest collagen peptides support cartilage regeneration and may alleviate pain in individuals with bursitis and osteoarthritis (PubMed, 2023).

2. Turmeric and Ginger

Turmeric contains curcumin, a potent anti-inflammatory compound that reduces pain and swelling. Similarly, ginger has natural compounds like gingerols that block inflammation, making it a great natural remedy for managing bursitis pain. These herbs can be consumed as part of a diet or taken as supplements.

3. Omega-3 Fatty Acids

Omega-3s, found in foods like salmon, flaxseeds, and chia seeds, have powerful anti-inflammatory effects. These fatty acids help reduce joint stiffness and improve joint lubrication, contributing to pain relief.

4. Acupuncture

Acupuncture can help improve circulation and reduce pain signaling, offering relief for some individuals dealing with musculoskeletal conditions like trochanteric bursitis.

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Prevention of Trochanteric Bursitis

Preventing trochanteric bursitis is crucial, especially if you've had it in the past. Here are some strategies to keep your hips healthy and avoid future flare-ups:

• Maintain good posture: Avoid slouching or uneven weight-bearing while sitting or standing.
  
• Strengthen gluteal muscles: Regularly performing exercises that target the glutes and hip abductors helps reduce strain on the hip joint.
  
• Avoid repetitive strain: Take regular breaks if your daily activities involve repetitive movements that place pressure on the hip.
  
• Wear supportive footwear: Shoes with good arch support help maintain proper alignment and reduce pressure on your hips.
  

Conclusion

Trochanteric bursitis is a painful condition that can disrupt your daily activities, but with the right treatment and preventive measures, most people can recover fully. Incorporating rehabilitation exercises, natural remedies, and lifestyle adjustments into your routine can significantly improve recovery and reduce the risk of future flare-ups.

If you are experiencing persistent hip pain or difficulty with movement, it's important to consult a healthcare provider to develop a personalized treatment plan.