Trochanteric Bursitis
NHS Tayside RefGuide
Warning
Who to refer
Emergency referral should be arranged for people with:
- Hip pain associated with systemic symptoms.
- Signs and symptoms of infection. (refer medicine/ infectious diseases)
- Known primary malignancy and suspicion of a pathological fracture.
- Sudden inability to bear weight.
- History of a fall.
Referral to secondary care hip service should also be arranged if:
- The symptoms could be related to previous hip surgery or fractured femur.
Who not to refer
Symptoms less than 3 months duration without trial of conservative treatment.
How to refer
- SCI Gateway/Orthopaedics/Hip
- If the patient is under MSK Physiotherapy. investigations and onward referral, if appropriate, will be organised by physiotherapist.
Information to include
- Duration of symptoms, any cause of onset.
- Pain spread and severity (constant/intermittent/night pain)
- Treatment to date
- Walking aids
- Functional limitation
- XR findings
- BMI.
General information
Trochanteric bursitis:
- Self-limiting condition
- However, some appear to continue to have ongoing difficulties despite management. Attests to stubborn nature of condition
- Caused by inflammation or physical trauma in muscles, tendons, fascia, or bursae
- More common in women than in men, especially in women aged 40–60 years.
- Frequently seen together with other conditions such as low back pain, osteoarthritis of the knee, rheumatoid arthritis, and fibromyalgia.
- Over 90% of people with greater trochanteric pain syndrome recover fully with conservative treatment such as rest, pain relief, physiotherapy, or
- corticosteroid injection.
Symptoms and signs
- Pain lateral aspect hip on walking
- Inability or difficulty lying in comfort on the affected side.
- Tenderness on palpation of greater trochanter
- Chronic nature most common
- Rarely presents with swelling/warmth or erythema
- ?Tight ilio-tibial Band (Obers manoeuvre).
Initial management
- Analgesia & NSAIDs as appropriate
- Advise weight loss if appropriate
- Advise ice packs
- Advise to avoid activity that may worsen the pain such as repetitive hip movements or lying on the affected hip.
- Refer to MSK Physiotherapy
- Steroid injection can be given by suitably trained healthcare professional (including MSK Physiotherapists).
Primary Care diagnostics
XR.
Useful resources
NICE CKS. Greater trochanteric pain syndrome. Last revised September 2023.