Trochanteric Bursitis

Trochanteric bursitis is an inflammation of the protective fluid-filled sac between your hip bones and surrounding soft tissues.

The bursa sits next to your greater trochanter, cushioning the space between your hip bone and the soft tissues. When inflamed, this natural protective barrier stops working effectively.

Physiotherapy helps reduce inflammation and restore normal hip function through targeted exercises and hands-on treatment.

Symptoms of trochanteric bursitis

• Sharp or burning pain on the outside of your hip
• Increased pain when lying on the affected side or when pressure is applied
• Pain that worsens with prolonged walking, stair climbing and running
• Tenderness and warmth over the outer hip area
• Stiffness in your hip joint, especially in the morning
• Pain that intensifies after sitting with your legs crossed
• Discomfort that increases during repetitive hip movements

Similar conditions

Hip osteoarthritis shares some symptoms but typically causes deeper joint pain and morning stiffness throughout the hip rather than specifically on the outer side.

Iliotibial (IT) band syndrome causes outer hip and thigh pain. It usually appears during activities and improves with rest. The pain is often more prominent along the outer thigh rather than concentrated at the hip.

Related: Hip pain from cycling

Gluteal tendinopathy presents with similar symptoms but typically causes more pain during single-leg standing and specific tendon-loading activities. The pain is usually more focused around the tendon attachment rather than over the broader hip area.

Causes of trochanteric bursitis

Overuse

Running, walking uphill, and long bike rides strain your hip bursa. Even daily activities like climbing multiple flights of stairs or extended walking on uneven surfaces can trigger it.

Biomechanical issues

Poor walking or running mechanics, leg length differences, or muscle imbalances around your hip can place extra stress on the bursa, leading to inflammation over time.

Direct pressure

Regular pressure on your hip from sleeping positions or prolonged sitting on hard surfaces can compress and irritate the bursa.

Exercise changes

Sudden increases in activity levels or changes in exercise routines, especially hill running or excessive stair climbing, can overwhelm your hip’s adaptive capacity.

Impact of being overweight

Extra body weight puts additional stress on your hip bursa. Each step creates more pressure on these cushioning structures. Your bursa works harder to reduce friction between tissues when managing increased load from excess weight.

This extra stress makes the bursa more likely to become inflamed. The pressure also slows healing once inflammation develops. Carrying extra weight changes your walking pattern, which can further irritate the bursa.

Weight loss often helps reduce symptoms and prevent recurrence. Even a slight reduction in weight decreases the load on your hip bursa.

What to do if you suspect trochanteric bursitis

• Modify activities that aggravate your symptoms
• Apply ice to the affected area for 15-20 minutes several times daily
• Avoid sleeping on the affected side
• Consider using a pillow between your legs when sleeping
• Take appropriate anti-inflammatory medication

When to see a physiotherapist

• Book an appointment if your hip pain persists beyond a week of self-care measures
• Don’t wait if climbing stairs becomes difficult or if hip pain disturbs your sleep
• See a physiotherapist immediately if you develop a limp or find yourself adjusting regular movements to protect your hip

Physiotherapy treatment

Initial assessment

Your first visit helps pinpoint what’s causing your hip pain. A thorough check of your hip movement, muscle strength, and walking style reveals the extent of your bursitis. This detailed examination guides your recovery plan.

Pain management phase

Early treatment focuses on reducing inflammation and pain and modifying activities to allow your hip and its inflammation to settle.

Ice or heat application, depending on your symptom pattern, helps manage discomfort. Your physiotherapist might use ultrasound therapy to reduce inflammation in the bursa.

Manual therapy

Hands-on treatment techniques target the affected area and surrounding tissues:

• Soft tissue massage to release muscle tension
• Joint mobilisation to improve hip movement
• Taping techniques to offload the irritated bursa

Progressive strengthening

Simple exercises begin your recovery, focusing on gentle hip movements like side-lying leg raises and standing leg lifts to rebuild strength.

Your exercises advance to resistance band work and controlled weight-bearing movements once your hip tolerates basic strengthening without pain.

Dynamic exercises like lunges, single-leg squats, and balance training strengthen your gluteal muscles and protect your hip from future bursitis.

Recovery timeline

Initial phase (0-2 weeks)

Your hip will feel sharp and painful, limiting daily activities, but a combination of rest, ice therapy, and gentle movement starts your healing process.

Early progress (2-4 weeks)

Your pain levels drop as walking becomes more comfortable, allowing your physiotherapist to introduce specific exercises for rebuilding strength.

Building strength (4-6 weeks)

Movement feels smoother now, with only occasional discomfort. Regular exercise builds your hip stability. Some activities need careful planning, but improvement is clear.

Getting back to normal (6-8 weeks)

You can walk long distances and climb stairs without pain. Your hip feels strong enough for gardening, shopping, and household tasks.

Final recovery (8-12 weeks)

You can return to full activity. Your physiotherapist will help you maintain an effective exercise routine to prevent future flare-ups. However, some activities might require extra recovery time.

The bottom line: Most trochanteric bursitis injuries cause movement-limiting pain for a maximum of two weeks. At the four-week mark, things will start feeling much better, with near-full movement back within six weeks.

Prevention strategies

• Regular hip-strengthening exercises
• Proper warm-up before activities
• Gradual progression of exercise intensity
• Good posture maintenance
• Weight management, if necessary

Summing up

Trochanteric bursitis starts as a mild irritation on the outside of your hip but can quickly develop into persistent pain that affects your daily life. The longer you walk, exercise, or sleep on an irritated hip bursa, the longer your recovery will take.

Starting treatment at the first sign of outer hip pain lets your bursa heal properly. Your irritated hip needs the proper care now, not weeks of compensation patterns that could create new problems. A correct assessment and treatment plan will get you back to feeling like yourself sooner rather than later.