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Trochanteric Bursitis 

Trochanteric Bursitis – Understanding Lateral Hip Pain 

The most common cause of pain on the outer side of the hip is Trochanteric Bursitis. This condition involves inflammation of the trochanteric bursa, a small fluid-filled sac located at the top, outer side of the femur. Its role is to act as a shock absorber and lubricant, allowing smooth movement of surrounding muscles—particularly the Iliotibial Band (ITB). 

 

Why Does It Occur? 

The ITB is a strong band of tissue running from the pelvis to the tibia. Over time, or due to poor gait mechanics and deconditioning, the ITB can become tight. This tightness causes friction over the trochanteric prominence, leading to bursal inflammation. 

 

Symptoms 

  • Pain and tenderness on the outer hip 
  • Difficulty walking up or down stairs 
  • Inability to sleep on the affected side 
  • Chronic discomfort that can significantly affect daily life 

Trochanteric bursitis is more common in middle-aged women and can become debilitating if untreated. 

 

First-Line Treatment 

Non-operative management is the mainstay and includes: 

  • Weight loss 
  • ITB stretching 
  • Core strengthening 
  • Gait retraining 

These can be supplemented with: 

  • Anti-inflammatory medication 
  • Steroid and local anesthetic injections into the bursa 

With consistent treatment, 80% of patients improve, but full resolution may take 8–12 months. 

 

When Surgery Is Considered 

If symptoms persist despite comprehensive non-operative care, surgical intervention may be necessary: 

  • ITB release and bursectomy to reduce friction and inflammation. 
  • In some cases, the hip abductor tendons (gluteal tendons) may be degenerated or ruptured. These require repair, which involves: 
  • Extended rehabilitation 
  • Use of mobility aids during recovery 

A/Prof Hazratwala performs these procedures regularly with predictable outcomes, including advanced techniques for tendon repair using LARS ligament grafts. 

 

Bottom line: Surgery is reserved for patients who fail conservative treatment or have associated tendon tears. Understanding the commitment to rehabilitation is essential before proceeding. 

Trochanteric Bursitis