Trochanteric Bursitis: Causes of Hip Bursitis

Trochanteric bursitis is inflammation of the bursa on the outer side of the hip, and it is the most common type of hip bursitis. A bursa is a small, fluid-filled sac that cushions the space between bone and the muscles and tendons around it. When the bursa over the bony point of the outer hip becomes irritated, the result is pain on the outside of the hip, often the first thing people notice. Understanding what causes it is the key to treating it and keeping it from coming back.

If you have nagging pain on the outer side of your hip, it helps to know what is behind it. The board-certified and fellowship-trained hip specialists at Resurgens Orthopaedics diagnose and treat hip bursitis at locations across metro Atlanta.

What Is Trochanteric Bursitis?

On the outer, upper edge of the thighbone is a bony bump called the greater trochanter. A bursa sits over it, cushioning the muscles and tendons, including the iliotibial band, that glide across the bone as you move. When that bursa becomes irritated and inflamed, the condition is called trochanteric bursitis, and the main symptom is pain on the outside of the hip. The hip has a second major bursa on the inner, groin side, called the iliopsoas bursa, which can also become inflamed, though that is less common. Because the outer-hip pain of trochanteric bursitis can mimic other hip problems, it is worth having the cause pinned down.

What Causes Trochanteric Bursitis?

Trochanteric bursitis usually comes from repeated friction or pressure on the bursa, though a single injury can also set it off. Common causes and risk factors include:

Repetitive stress from activities like running, cycling, stair climbing or standing for long periods
A tight iliotibial band, which rubs over the bursa and irritates it
A fall or a direct blow to the outside of the hip
Being female and middle-aged or older, since hip bursitis is more common in women and in middle-aged or older people, though younger people can be affected too
A previous hip injury, hip surgery or an implant in the hip
Bone spurs or calcium deposits on the greater trochanter
Weak muscles around the hip, which can change how the joint moves and add friction on the bursa
Differences in posture, gait or spine alignment, such as scoliosis or a leg-length difference

Extra body weight can add to the strain on the hip as well. Often, more than one of these factors is at work, which is why getting to the underlying cause matters for treatment.

Trochanteric Bursitis Symptoms

The hallmark of trochanteric bursitis is pain on the outer side of the hip. Common symptoms include:

Pain on the outside of the hip that can spread down the outer thigh
Pain that is sharp at first and later becomes more of a dull ache
Pain when lying on the affected side, often worse at night
Pain when getting up after sitting, climbing stairs or walking a long way
Tenderness when pressing on the bony point of the outer hip

Please Note: Outer hip pain has several possible causes, including tendon problems and arthritis, so trochanteric bursitis is sometimes mistaken for other conditions. Redness, warmth, swelling or fever can point to an infection rather than simple irritation and should be checked promptly. If outer hip pain does not improve with rest or keeps returning, a hip specialist can confirm what is causing it and guide treatment.

How Trochanteric Bursitis Is Diagnosed

A hip specialist can usually diagnose trochanteric bursitis with a physical examination. Your physician will ask about your symptoms and what activities make them worse, then press over the bony point of the outer hip, where tenderness is the most telling sign. Imaging is used mainly to rule out other causes of hip pain rather than to confirm the bursitis itself. An X-ray can show bone spurs or signs of arthritis, while an ultrasound or MRI can show a swollen bursa or point to a different problem when the diagnosis is not clear.

Trochanteric Bursitis Treatment

Most cases of trochanteric bursitis improve with non-surgical care aimed at calming the inflammation and easing the friction on the bursa.

Non-Surgical Treatment

Conservative care is almost always the starting point:

Rest and activity changes to avoid the movements that aggravate the hip
Ice to the outer hip to ease pain and swelling
Over-the-counter anti-inflammatory medication for pain and inflammation
Physical therapy to stretch a tight iliotibial band and strengthen the muscles that support the hip
A cane or walking aid for a while to take pressure off the hip
A corticosteroid injection into the bursa to reduce inflammation when pain persists

When Surgery Is Considered

Surgery is rarely needed for trochanteric bursitis. If the bursa stays inflamed and painful after a fair trial of non-surgical care, your physician may discuss removing the bursa, often through a minimally invasive endoscopic procedure done on an outpatient basis or releasing a tight iliotibial band to reduce friction. The hip works normally without the bursa. Your Resurgens specialist will explain whether a procedure makes sense for your situation.

Schedule an Appointment for Hip Pain

If outer hip pain is interfering with your sleep or your daily activities, a hip specialist can find the cause and help you get relief. Book an appointment online today with a Resurgens hip specialist or call us at (404) 847-9999.

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