Trochanteric Bursitis
Trochanteric bursitis is inflammation of the bursa - a small fluid-filled sac - on the outer hip, causing pain that often worsens with walking, climbing stairs, or lying on the affected side. It’s a common and treatable condition, and most people improve with physiotherapy, activity adjustments, and simple anti-inflammatory measures.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
What is Trochanteric Bursitis?
The greater trochanter is the bony prominence on the outer side of the hip where several tendons attach, including the gluteus medius and minimus. Overlying this area are fluid-filled sacs called bursae, which act as cushions to reduce friction between bones, tendons, and muscles during movement.
Trochanteric bursitis occurs when one of these bursae - most commonly the trochanteric bursa - becomes inflamed. This inflammation leads to pain around the outer hip and thigh and often overlaps with gluteal tendinopathy, as these conditions frequently coexist.
Understanding Trochanteric Bursitis
Trochanteric bursitis usually develops gradually, and the pain and discomfort can affect daily activities. Symptoms often include:
- Pain on the outer side of the hip, which may start sharp and become more of a dull ache over time.
- Pain that worsens with pressure, such as lying on the affected side.
- Pain during walking, climbing stairs, or rising from a seated position.
- Tenderness when pressing over the greater trochanter.
- Radiating discomfort down the outer thigh toward the knee, but usually not below it.
- Stiffness or reduced hip mobility, especially after periods of rest.
Because these symptoms can resemble other hip or lower back conditions, a careful assessment by a healthcare professional is important to ensure the correct diagnosis.
Causes and Risk Factors
Trochanteric bursitis usually develops when the bursa over the outer hip becomes irritated or inflamed. Several factors can contribute to this condition, often working together:
| Overuse or repetitive strain | Activities like running, long-distance walking, or climbing stairs can overload the bursa. |
| Biomechanical issues | Weak hip muscles, abnormal gait, leg length differences, or spine problems can increase stress on the hip. |
| Coexisting hip conditions | Gluteal tendinopathy, hip arthritis, or previous hip surgery can alter mechanics and trigger inflammation. |
| Trauma | Falls or direct blows to the hip can irritate the bursa. |
| Age | Soft tissues become less resilient with age, making irritation more likely. |
Diagnosing Trochanteric Bursitis
Diagnosing trochanteric bursitis usually starts with a detailed discussion of your symptoms and a physical examination. Your clinician will check for tenderness over the outer hip, observe your gait, and test hip strength and range of motion to identify movements that trigger pain.
Imaging may be used to support the diagnosis or rule out other conditions:
| Ultrasound | Hip ultrasound is a quick, non-invasive test that can show inflammation of the bursa and detect associated gluteal tendon problems. |
| MRI | MRI is occasionally recommended if symptoms are persistent, severe, or if there is a need to exclude other hip or spine-related issues. |
This combination of history, examination, and targeted imaging helps ensure an accurate diagnosis and guides the most appropriate treatment plan.
Treatment Options
Management of trochanteric bursitis usually starts with conservative approaches, with procedural options reserved for persistent or severe cases.
Conservative Treatments
| Activity modification | Avoiding activities that aggravate the hip, such as prolonged standing, stair climbing, or lying on the affected side. |
| Pain relief | Over-the-counter medications such as paracetamol or NSAIDs can reduce pain and inflammation. Ice packs or heat therapy may provide additional symptom relief. |
| Physiotherapy | Targeted exercises to strengthen the gluteal muscles, improve hip stability, and correct gait or biomechanical issues. Stretching and mobility exercises can also help reduce tension around the hip. |
| Supportive measures | Using cushioned seating, avoiding pressure on the hip during sleep, and wearing appropriate footwear to reduce stress on the hip. |
Procedural Options
| Steroid injection | Deliver anti-inflammatory medication directly into the bursa to reduce pain and swelling, often providing several months of relief. |
| PRP injections | In selected cases, additional treatments such as platelet-rich plasma (PRP) injections may be considered, particularly if conventional injections or physiotherapy are insufficient. |
| Surgery | Rarely required, but bursectomy or tendon repair may be considered if symptoms persist despite all conservative and minimally invasive measures. |
A stepwise approach, starting with conservative management and progressing to procedural options as needed, usually provides the best outcomes for long-term symptom relief.
How can Lanthorn help?
Hip Ultrasound - £300
A hip ultrasound provides a clear view of the trochanteric bursa and surrounding tendons. It can confirm inflammation, identify associated gluteal tendinopathy, and help guide decisions about the most appropriate treatment.
Hip MRI Scan - From £350
MRI offers a more detailed assessment when symptoms are persistent or complex. It can evaluate deeper structures, clarify the extent of tendon involvement, and rule out other causes of lateral hip pain.
Ultrasound-guided Steroid Injection - £450
For cases where pain is limiting daily function or not improving with conservative care, a precisely targeted steroid injection can help reduce inflammation and provide meaningful relief.
