Hip bursitis (trochanteric)

Hip bursitis (trochanteric bursitis) is an inflammation of the bursa located between the greater trochanter and the gluteal tendons. This bursa acts as a cushion and gliding layer between bone and tendon.

When irritated, it causes pain at the side of the hip. Today the condition is often called 'greater trochanteric pain syndrome' (GTPS), because the pain rarely comes from the bursa alone. In most cases there is also a problem with the surrounding gluteal tendons (see also gluteal tendinopathy).

It is important to identify the underlying cause. Treating only the inflammation without addressing the cause often leads to recurring complaints.

Possible causes and risk factors:

• Overload of the gluteal muscles, e.g. sudden increase in walking or running
• Weakness of the gluteal muscles, reducing hip stabilisation
• A leg length difference
• Female sex and age 40 to 60
• Coexisting hip osteoarthritis or low back pain
• A fall on the side of the hip

Typical symptoms include: pain at the side of the hip (often sharp or stabbing), pain when lying on the affected side (disturbed sleep), pain when climbing stairs, walking long distances or standing up from a low chair, radiating pain to the outer thigh (sometimes above the knee), and tenderness over the greater trochanter. Symptoms can resemble hip osteoarthritis or radiating pain from the lower back. A targeted clinical examination and imaging (ultrasound or MRI) help to differentiate.

Treatment initially focuses on reducing inflammation and addressing the underlying cause: load and lifestyle adjustment, targeted exercise therapy (strengthening the gluteal muscles and correcting movement patterns), an injection for persistent inflammation, and attention to sleep posture (pillow between the knees, avoiding lying on the affected side). Surgery is rarely required.