Trochanteric Bursitis (Bursitis of the Hip)

Also Known As Bursitis of the Hip or Hip Bursitis. In North America, it is estimated that over 60% of the causes of hip pain are caused by Trochanteric Bursitis.

What is a Bursa?

A bursa is a closed, fluid-filled sac whose functions is to cushion and provide a gliding surface to reduce friction between tissues of the body. The major bursae are located adjacent to tendons near large joints, such as in the shoulders, elbows, hips, and knees. When the bursa becomes inflamed, the condition is known as bursitis.

Bursae are lined with special cell tissue known as synovial cells, and are responsible for secreting fluids rich in proteins and collagen. This fluid acts like a lubricant between surfaces high in friction, such as an elbow or shoulder joint, thus allowing tendons and muscles to slide over bone effortlessly. Once this fluid becomes infected, a condition occurs known as bursitis. There are about 160 bursae in the human body and some people have more than others.

The trochanteric bursa rests between the bony area on the outside of the hip (the greater trochanter) and the tendon (illotibial band) that passes over this bone. When this bursa becomes inflamed (for any reason noted below), every time the tendon moves over this bone, pain (mild to severe) will result. Pain may radiate down the outside (lateral) of the thigh. As this tendon is moved during each step, many sufferers of hip bursitis find it extremely painful to walk. In some cases, patients require the use of a wheelchair.

Causes of Trochanteric Bursitis

There are a multitude of ways to contract bursitis, but fundamentally, the cause is from one of the following.

Trauma (Acute or Chronic)

Trauma causes inflammation of the trochanteric bursa, resulting in a widening of the blood vessels in the bursa. This widening allows proteins and various fluids into the bursae that are not supposed to be there, resulting in a reactive swelling from the bursae. Until these foreign materials leave the bursa or are broken down by the bursae defense system, the swelling and pain will remain.

Acute Trauma means a direct blow to the hip either from contusions from falls or sports contact injuries. This can happen when a patient falls onto their upper thigh, causing blood to leak into the bursa and cause swelling and pain.

Chronic Trauma will occur if there is mild trauma to the hip that occurs repetitively. This is more common in athletes (running sports) and hikers, whose excessive and frequent movement of the tendon over this bursa can incite hip bursitis.

Post Surgical

Patients who have had total hip replacement surgery or hip fracture surgery often complain of pain over the outside of the hip. Often, this pain is due to irritation of the bursa, is is a common cause of hip bursitis. Trochanteric bursitis is also known to occur as a complication of arthroscopic surgery of the hip, though it is uncommon. (Trochanteric Bursitis due to Arthroscopic Surgery of the Hip is estimated at an occurrence rate of 1.4% of all cases.)

Crystal Deposits (Caused from Gout and/or Rheumatoid Arthritis)

Some people with diseases such as rheumatoid arthritis, gout or scleroderma may contract bursitis from crystalline deposits in the joints. Although not much is known about how this process happens, it is common knowledge that Uric acid is a normal byproduct of daily metabolism. If your are diagnosed with gout then you are unable to break down this uric acid properly, leading to crystalization of this excess acid which deposits in joints—a painful symptom that can often lead to bursitis.

There are a number of things that can indirectly cause bursitis such as repetitive use or overuse from work or sporting activities, acute injuries and aging. Over the years your muscles will start to lose their mass and strength, your tissues will lose their elasticity and degenerate, making you more susceptible to injury. Weakened muscles and/or tendons or injuries to your hip can instigate bursitis. You are at increased risk of suffering from this condition if your work and/or lifestyle require frequent and or prolonged walking or running.