Hip Bursitis (Trochanteric Bursitis)

Also known as: Trochanteric bursitis, Greater trochanteric bursitis, Hip bursa inflammation, Lateral hip bursitis, Outer hip bursitis, Greater trochanteric pain syndrome (GTPS), Trochanteric pain syndrome

Last updated: December 18, 2024

Hip bursitis (trochanteric bursitis), also called greater trochanteric pain syndrome, is inflammation of the bursa near the greater trochanter of the femur. It causes pain on the outer hip, sometimes linked to irritation or tears of the hip abductor tendons, and is a common cause of lateral hip pain. Pain may spread down the outer thigh and worsen when lying on the affected side. Many cases improve with rest over weeks to months.

Key Facts

  • Hip bursitis, referred to as trochanteric bursitis or greater trochanteric pain syndrome, involves inflammation of the bursa near the greater trochanter of the femur
  • Pain on the outer aspect of the hip over the greater trochanter
  • Diagnosed through history, physical exam, and imaging
  • First-line treatment includes exercise, weight management, and activity modification

What It Is

Hip bursitis, commonly referred to as trochanteric bursitis or greater trochanteric pain syndrome, involves inflammation of the bursa near the greater trochanter of the femur. The condition causes pain on the outer aspect of the hip that may be associated with tendon irritation or tears of the hip abductor muscles. It is one of the most common causes of lateral hip pain.

Affected Anatomy

This condition affects several structures in and around the joint:

  • Trochanteric bursa (between greater trochanter and iliotibial band)
  • Greater trochanter of the femur
  • Gluteus medius and minimus tendons
  • Iliotibial band
  • Tensor fasciae latae muscle
  • Other peritrochanteric bursae

Common Symptoms

Symptoms can vary in intensity and may change over time. Common experiences include:

  • Pain on the outer aspect of the hip over the greater trochanter
  • Pain that may radiate down the lateral thigh
  • Pain when lying on the affected side, often disrupting sleep
  • Pain with walking, climbing stairs, or prolonged standing
  • Tenderness to touch over the lateral hip
  • Pain that may worsen after prolonged sitting, especially crossing legs
  • Stiffness or aching sensation in the hip region
  • Pain with hip abduction against resistance

Causes and Risk Factors

Multiple factors can contribute to the development of this condition:

Causes

  • Overuse or repetitive friction of the iliotibial band over the greater trochanter
  • Gluteal tendinopathy or tears of the hip abductor tendons
  • Direct trauma or injury to the lateral hip
  • Abnormal gait or biomechanics
  • Leg length discrepancy
  • Hip or spine surgery
  • Underlying conditions such as hip osteoarthritis or low back problems

Risk Factors

  • Female sex (more common in women)
  • Age over 40 years
  • Obesity or excess body weight
  • Running or activities involving repetitive hip motion
  • Previous hip surgery or injury
  • Leg length inequality
  • Weak hip abductor muscles
  • Low back pain or lumbar spine pathology

How It's Diagnosed

Diagnosis typically involves a combination of clinical assessment and imaging studies:

  • Medical history focusing on symptom location, triggers, and associated conditions
  • Physical examination with palpation over the greater trochanter
  • Assessment of hip abductor strength and gait
  • Provocative tests for lateral hip pain
  • X-rays to rule out bony abnormalities or arthritis
  • MRI may show tendinopathy, tears, or bursal fluid if diagnosis is uncertain
  • Ultrasound can be used to assess tendons and guide injections
  • Diagnostic injection into the bursa may confirm the diagnosis if symptoms are relieved

Treatment Options

Treatment approaches range from conservative measures to surgical interventions, often starting with the least invasive options:

Self-Care and Activity Modification

  • Rest and activity modification to reduce aggravating activities
  • Ice application to the affected area
  • Gait analysis and correction if abnormalities are identified
  • Shoe orthotics if leg length discrepancy is present
  • Avoiding sleeping on the affected side

Physical Therapy and Exercise

  • Physical therapy focusing on hip abductor strengthening and iliotibial band stretching

Medications

  • NSAIDs for pain and inflammation

Injections and Office-Based Procedures

  • Corticosteroid injections into the bursa may provide relief for some patients

Surgery

  • Surgical intervention (bursectomy, tendon repair) is rarely needed but may be considered for refractory cases

Prognosis and Recovery

The course of this condition varies between individuals:

  • Most cases improve with conservative treatment over weeks to months
  • Symptoms may be recurrent, particularly if underlying factors are not addressed
  • Associated gluteal tendinopathy or tears may have a more prolonged course
  • Addressing biomechanical factors and maintaining hip strength can help prevent recurrence
  • Chronic symptoms may persist in some individuals despite treatment

Related Pages

Frequently Asked Questions

Sources