Physical Therapy Guide on The Recovery of Trochanteric Bursitis – Expert Review
Trochanteric bursitis is the swelling of the trochanter bursa (fluid-filled sac near hip joints) at the outer edge of the hip. When due, for some reason, this bursa becomes irritated, it can cause pain in the hip. Trochanteric Bursitis is a popular and common medical condition that is easily treatable.
Trochanteric Bursitis occurs when the large bursa near the top of the femur bone becomes inflamed. The common symptoms of trochanteric bursitis can be pain outside the thigh and the buttock, knee, low back, etc. The patient may feel pain on one side while lying, but this symptom is not present in all cases.
What Must You Know About Trochanteric bursitis?
Bursitis has an inflamed component, but other inflamed components like a tumor are not present. Trochanteric Bursitis only has primary signs of inflammation. Trochanteric Bursitis is a general term that covers four other types.
- Iliopsoas Bursitis
- Trochanteric bursitis
- Greater Trochanteric Bursitis
- Ischial Bursitis
What Do You Need to Know About Greater Trochanteric Bursitis?
Greater trochanteric bursitis (GTB) is a swelling of the bursa on the top of the greater trochanter, which is bony prominence at the top of the femur. The bursa is present in every big joint of the body. It acts as a cushion to reduce friction between bones and weak muscles attached with bone—bursitis forms when the bursa outside of the hip bone becomes irritated or inflamed. GTPS is a condition that includes inflammation of the tendons in the muscles beneath the bursa.
Usually, greater trochanter bursitis occurs due to repeated friction to the bursa due to weak muscles and tightness on the top of the hip. This medical condition is usually treated with physical therapy to improve and restore the function of these muscles.
Various factors result in greater trochanter bursitis (GTP):
- Hip tissue tightness
- Weakness of Gluteal muscle
- Abnormal growth of hip or knee bones
- Use of improper footwear
- Improper repetitive movements and activities
- Abnormal hip or knee movements
- A change in sports or exercise routine activities
Epidemiology of Greater Trochanteric Bursitis:
Trochanteric bursitis develops over time as inflammation of the bursa is a slow process. Usually, they are formed due to friction, increased pressure, overuse, and any direct injury.
Bursitis is categorized into two types:
- Acute bursitis arises as a result of any direct trauma or excess burden. The symptoms of acute bursitis, swelling, pain, and inflammation can be noticed when touching the affected area after a few days of trauma. In this condition, it is very painful to move joints.
- Chronic bursitis occurs due to extreme movements or activities, overuse, increased pressure on bones, and friction. Another reason for chronic bursitis may be the wrong strain on muscles. The permanent symptom is present in all patients in pain.
What Are the Causes Trochanteric Bursitis?
Trochanteric bursitis can occur due to one or more following reasons:
- Stress or increased pressure on soft tissues due to abnormal or poor postural structure and positioning, i.e., arthritis or leg length difference
- Injury to the hip muscles or bone results due to falling onto the hip, lying on one side for a long period, or bumping of hip into any heavy object
- Incorrect body posture due to other medical conditions like arthritis of the lower spine, scoliosis (curve at the shoulder and back), and other spinal cord problems.
- Sports or work activities include overuse of these joints that cause increased friction or injury. These may be due to activities like standing in the same position for a long time, climbing, running upstairs, etc.
- Other diseases and medical conditions should be controlled, like arthritis, rheumatoid arthritis, thyroid disease, psoriasis, and other drug reactions.
- Calcium deposits in hip tendons that are attached to the trochanter of hip bone spurs
Trochanteric Bursitis is usually more commonly affecting women, middle-aged or elderly people. In many cases, the cause of trochanteric bursitis is not any of the above-mentioned reasons, and the core cause is unknown.
What are the Symptoms of Greater Trochanteric Bursitis?
The main sign and symptom of trochanteric bursitis is pain in the outer area of the hip. The patient may feel inflammation and pain when you press that area or when you lie on that side. The pain increases with activities like walking, running, or climbing, etc. patients may feel pain proceeding down towards the thigh or spine.
The common symptoms and signs of trochanteric bursitis are following:
- Pain or inflammation on the outside of hip, buttock, or thigh
- Pain when you touch or lying on that side
- Inflammation and pain when you press the top of your hip
- Pain that gets worse with activities or sports like walking, running, climbing or sitting, or getting up from the chair
How Can It Be Treated?
Trochanteric bursitis can be treated with many treatment techniques to reduce inflammation and relieve pain in that area. Avoiding excess activities and sports because of trochanteric bursitis can help to recover from this condition by providing time to heal. Other than that following treatment can be used to treat this medical condition:
- The use of Nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Naproxen can help to relieve pain and reduce swelling. But long term use of these anti-inflammatory drugs can affect the stomach, causing pain and bleeding. These drugs should not be used for a long time.
- Steroids Injection: Injections of corticosteroid medicine can be used to reduce pain and inflammation.
- Physical therapy: Different physical therapy techniques can be used to retain and restore the flexibility and strength of hip muscles. Physical therapists also use other treatments like manual therapy, massage, ultrasound, heat or ice therapy, etc.
- Assistive devices: support providing assistive devices like cane or crutches can be used to reduce stress and pressure on hip muscles which gives them time to heal
- Surgery: If any treatment like physical therapy, pain relievers, or other treatments does not work to reduce pain and inflammation, doctors may recommend surgery to remove the bursa from your hip. This surgery is done laparoscopically in which doctors use small incisions with the use of the camera. The patient can recover within a few days of surgery.
Tips for Preventing Further Injury:
The patient should avoid the following things to prevent any future injury while healing:
- Avoid overuse of hip: The patient should avoid activities that involve excess and repetitive use of the hip, like running, jogging, climbing stairs, etc.
- Avoid injury or falls: To recover and heal faster, patients should prevent such activities where there is a chance of injury or fall.
- Maintain normal Weight: Reducing excess weight if a person is overweight can help to reduce stress and pressure on hip joints.
- Use proper footwear or shoe inserts: If a person has the problem of leg length difference, he should use shoe inserts after consulting with orthopedist and proper footwear to avoid any pressure on joints.
When Should You Seek Medical Advice?
In many cases, the trochanteric bursitis is improved by a few weeks of treatment. If a person has the following signs or symptoms, he should visit his doctor:
- Experience pain that increases on a daily basis and prevents you from performing daily activities actively.
- Experience any inflammation or soreness that is not improving with all self-care measurements
- Have a high fever, or feel any swelling, redness, or heat in that area when touching
- Have any history of bursitis
Is it Effective to Consult a Physical Therapist?
Greater trochanteric bursitis (GTB) is one of the most common reasons for hip pain affecting most people worldwide. Both active might can experience this medical condition, but it usually affects women, middle-aged, and less active people.
Physical therapists can treat it with the help of exercises and other treatments to reduce pain and inflammation of the hip joint. They teach people stretching, strengthening, and specific movements to improve posture, which help to restore and restrain the strength and reduce pain and inflammation.
Can This Injury or Condition Be Prevented?
GTB can arise due to increased body weight, body condition in which there is a difference in leg length, etc. A physical therapist can help guide and teach you exercises and treatments that can help you increase muscle strength and restore flexibility
Improvement in muscle strength and body posture and adopting a suitable exercise routine can help to reduce GTB. Especially paying attention to exercise activities and their changes and avoiding such activities that involve overuse of hip joints and increasing stress or pressure on them can help prevent GTB.
A physical therapist can help guide and teach you exercises and treatments that can help you increase muscle strength and restore flexibility. Also, help you to develop the right body posture that can help to reduce pressure on hip joints and give them more time to heal faster.
How Do Physical Therapists Help in Determining and Treating Trochanteric Bursitis?
A few medicines can diminish agony and growth in a patient with trochanteric bursitis. There isn’t a ton of proof detailing the advantages of physiotherapy or the modalities utilized; however, it is a typical mediation when the agony is a dominating variable.
The bursa irritation can be treated with ice treatment and strategies or activities that decrease the aggravation structures. There are additionally different medicines that a physiotherapist can utilize electrotherapy, needle therapy, taping methods, delicate tissue kneads, and the impermanent utilization of versatility to help to off-load the influenced side.
The Initial Stage:
The first stage is to support the patient’s solidarity and reestablish the typical ROM. The physiotherapist will likewise further develop the muscle length and resting strain, the proprioception, equilibrium and walk through an administered and exhaustive exercise restoration program.
Middle Stage of Recovery:
The following period of recovery is the rebuilding, all things considered. Numerous patients foster Trochanteric Bursitis because of their normal everyday exercises like running, strolling, and so on. The objective of the physiotherapist is to give a particular program to the patient to work on the development. In this way, you can overcome the aggravation. After that, the patient can play out his day-by-day exercises with less trouble.
The last stage is to prevent a backslide. It could be just about as basic as preparing your center muscles or creating foot orthotics to address any biomechanical deficiencies in the lower appendages.
The specialist will look at your hip security and capacity by tending to any shortfalls in the center strength and equilibrium. Moreover, he will likewise show the patient some self-recovery methods. A definitive objective is to see the patient securely getting back to his previous donning or recreation exercises.
Frequently Asked Questions (FAQs):
1. Can the Trochanteric Bursitis go away?
Hip bursitis will frequently improve all alone as long as it isn’t brought about by contamination. To mend your hip bursitis, you should rest the influenced joint and shield it from any further mischief. Most patients feel better within half a month with appropriate treatment.
2. What occurs in case bursitis is left untreated?
Trochanteric bursitis is a constant issue that can increase with time if you are unable to treat it. Untreated bursitis can prompt a lasting thickening or amplification of the bursa, which can cause persistent aggravation and torment. In some cases, it can cause muscle decay as well. Long-term diminished utilization of joints can prompt hidden active work and loss of empowering muscle.
3. Does non-intrusive treatment work for hip bursitis?
Well! As per the recent research on physical health, people prefer to follow physical therapy guidance to treat any issue. Trochanteric bursitis can be easily treated by physical therapy treatment, which is also known as a non-intrusive treatment. It can be a successful treatment for hip bursitis to diminish torment, expanding, firmness, and any related shortcoming in the hip, back, or lower limit.
4. How does a physical specialist help with treating Trochanteric or hip bursitis?
Physical specialists treat that patient who is experiencing the GTB with a mix of extending, preventing, and developing. Some retraining exercises and workout plans are useful for a disturbance in the hip, resolving torment, and assisting with reestablishing typical capacity.
5. Can you consider the possibility that Trochanteric bursitis doesn’t disappear?
Bursa shots should be possible in the workplace and don’t expect somebody to take you home thereafter. A couple of cortisone infusions can regularly clear up bursitis. However, when it will not disappear or continue to return, hip arthroscopy or suctioning out the bursa might be important to fix the condition.