Physical Therapy for Trochanter Bursitis: Can It Help Relieve Hip Pain?

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What is Trochanter Bursitis?

The femur, which is the longest bone of the body, is the thigh bone that connects to the pelvis to form the hip joint. Outside this joint, the femur has a lateral portion which protrudes and serves as the attachment of tendons coming from the hip muscles. Between these attachments are spaces (bursae) that are lubricated and prevent friction during the contraction of the muscles, which help in the sideward movement and inward rotation of the thigh from the hip.

Direct trauma such as a fall and repetitive movements of the hips and thighs can cause inflammation of the bursae in the trochanteric region of the hips. This leads to a condition called trochanteric bursitis. It is a superficial swelling and pain on the side of the hip not involving the joint itself, but causes pain on moving the thigh. Activities, sleeping on the affected side, and touching will elicit pain. The pain may radiate to the lateral movement of the thigh up to the knee.

Pain relief treatment usually consists of resting the affected hip and leg and taking of nonsteroidal anti-inflammatory drugs. Injection with corticosteroids in the affected bursa has been found to be effective in many patients. In addition, physical therapy for trochanter bursitis is advised to improve the function of the hip.

Physical Therapy for Trochanter Bursitis

Initially, physical therapy usually consists of the application of the PRICE principle, which means: Protect, Rest, Ice, Compression and Elevation. These are usually done in the first couple of days of injury or acute pain to decrease swelling and pain. Other means of physiotherapy to reduce pain and inflammation include:

  • Applying low-level electrical currents by Transcutaneous Electrical Nerve Stimulation (TENS) to block the pain
  • Soft tissue massage
  • The therapeutic application of ultrasound to enhance topical drug absorption (such as anti-inflammatory drugs) or phonophoresis
  • As the swelling subsides, gradual exercising should be done to improve the range of motion of the joint and increase the strength of the muscles surrounding it.

Exercises for Trochanteric Bursitis

Stretching exercises applied to the thigh and hip muscles help in strengthening and stabilizing the joint and the leg. Examples of these are:

  • Stretching of the iliotibial band (a hip to thigh muscle) by standing and crossing the foot of the affected side of the hip over the other foot. This is done with the patient standing sideways next to a wall, with the side to be stretched leaning toward the wall. This should be done in a controlled and sustained manner so that stretching of the muscle can be felt as the foot is crossed over the other side.
  • Stretching of the iliotibial band can also be done in the lying position, this time with the foot crossing over to the other knee. The affected thigh is then pulled gently across the midline, and the stretch is felt at the side of the affected hip.
  • The thigh muscles can also be stretched by passive inward pulling of the knee across the other side as far as possible, with this position being held in place for at least 10 to 20 seconds. These stretching exercises can be done in various degrees of hip flexion so that the thick muscle fibers of the different muscles in the thigh can be exercised.

It is important to remember that these exercises should be done without sudden or jerking movements, which can exacerbate pain and inflammation.

References

eMedicine, “Trochanteric Bursitis: Treatment & Medication” accessed 2/3/11

https://emedicine.medscape.com/article/309286-treatment

Cyber PT, “Greater Trochanteric Bursitis” accessed 2/3/11

https://www.cyberpt.com/trochantericbursitis.asp