A fairly common orthopedic condition that we see in the physical therapy office is trochanteric bursitis. This is the medical name for pain on the outside of the hip, over the bony part of the femur called the greater trochanter. This is usually not associated with a problem in the hip joint itself, such as osteoarthritis, but is a strain of the soft tissues overlying it.
A bursa is a small fluid-filled sac that acts as a friction and pressure reducer. Occasionally this can become inflamed because of trauma, muscle imbalance or tightness, or overuse. This condition can occur at any age, but seems to be more common in middle age and later, and about 80% of the cases occur in women. Symptoms include pain on the outside of the hip that may radiate down the side of the thigh; pain lying on the involved side; and pain squatting, walking and on stairs.
The first line of treatment is rest, application of a cold pack, and sometimes use of a cane to take pressure off the hip. Physical therapy can speed your recovery in many cases.
Assessment of the contributing factors often reveals gluteal weakness, tightness of the ilio-tibial band (a connective tissue band that runs down the outside of the thigh) and postural or gait abnormalities. Treatment can include moist heat or cold packs, ultrasound, soft tissue massage, and a stretching and strengthening program to balance the muscles of the hip and thigh.
There can also be lifestyle factors that need to be addressed, such as (in runners) always running on banked roads in the same direction; weight loss when appropriate; and correction of any significant leg length discrepancy with a lift.
In some cases the condition can become chronic, but often it will resolve completely with treatment and normal activities can be enjoyed once again.
