If you’re experiencing pain on the outside of your hip that’s making it hard to sleep on that side or climb stairs, you might have trochanteric bursitis. While it can be frustrating and painful, physiotherapy offers excellent treatment options that can get you back on your feet and moving comfortably again.
What is Trochanteric Bursitis?
Trochanteric bursitis happens when the small, fluid-filled sac (bursa) that cushions the bony part on the outside of your hip becomes inflamed and irritated. This bursa sits between the greater trochanter (the bony prominence on the side of the hip) and the overlying tendons and muscles, acting as a cushion to reduce friction between these structures during hip movement.
It’s the most common type of hip bursitis and is more frequent in females, people who are overweight, and those aged 40 to 60 years. The pain typically develops gradually over weeks or months, often without a specific injury, and can become quite severe if left untreated.
How a Physiotherapist Treats Trochanteric Bursitis
A physiotherapist treats trochanteric bursitis through a comprehensive approach that reduces inflammation and addresses the underlying causes of your condition. Physical therapists treat people experiencing trochanteric bursitis with a combination of stretching, strengthening, and movement retraining activities to decrease irritation in the hip, resolve pain, and help restore normal function.
What a Physiotherapist Does
Diagnosis: Your physiotherapist will conduct a thorough clinical assessment to diagnose bursitis and identify underlying issues like poor posture, muscle weakness, or movement patterns that may be contributing to your pain.
Soft Tissue Techniques: They may use massage, dry needling, or trigger point therapy to help relieve pain and release tension in tight muscles. These hands-on techniques help reduce muscle tightness and improve blood flow to the affected area.
Graded Exercise Program: This is the cornerstone of physiotherapy treatment. A qualified physical therapist can create a personalised treatment plan that includes exercises for trochanteric bursitis, manual therapy, and posture and movement mechanics education. Your program will be carefully designed to restore proper muscle balance and control around the hip, pelvis, and lower back.
- Strengthening: The focus is on strengthening the gluteal muscles, hip abductors, and other stabilising muscles. Weakness or dysfunction of the gluteus medius can lead to increased stress on the greater trochanteric bursa, potentially contributing to the development of bursitis. Your physio will often use eccentric exercises that lengthen the muscle while strengthening it, which can be particularly effective.
- Balance and Proprioception: In later stages of your rehabilitation, exercises will focus on improving your balance and body awareness. This helps correct underlying movement issues that may have contributed to your bursitis in the first place.
- Education: Your physiotherapist will teach you about proper movement patterns, posture, and activity modifications to help manage your condition and prevent future episodes.
Key Treatment Principles
Offloading and Reducing Compression: Initially, reducing pressure on the bursa is important to calm inflammation, followed by a gradual increase in activity. This might mean temporarily modifying activities that aggravate your symptoms.
Addressing the Root Cause: Treatment doesn’t just focus on the painful area. A very significant factor influencing the development of trochanteric bursitis in the majority of people is factors such as posture, habit, and physical conditioning, which can be treated by physical therapy and activity modification.
Controlled Progression: A graduated strength program will be crucial, with specific attention to the gluteals. Your exercises will gradually progress to ensure your muscles and tendons can handle the increased load without causing further irritation.
What to Expect from Your Recovery
Physiotherapy often yields positive outcomes within weeks, though chronic cases may take longer. Maintaining rehabilitation exercises even after pain subsides is crucial for preventing recurrence. Over 90% of people with greater trochanteric pain syndrome recover fully with conservative treatment such as rest, pain relief, physiotherapy, and corticosteroid injection.
The key to successful treatment is patience and consistency. The condition tends to be chronic in nature (spanning many months or years) and has a high recurrence rate, particularly in women. Muscle conditioning and education are critical for this condition – the recurrence of bursitis pain is common in people who have not obtained satisfactory muscle function with their physical therapy efforts.
Other Treatment Considerations
Relative Rest: Your physiotherapist may recommend a period of modified activity, but the goal is always to return you to your normal activities gradually and safely.
Additional Support: If symptoms persist, your doctor may be able to assist with issues such as anti-inflammatory medications. In some cases, if physiotherapy alone isn’t providing sufficient relief, your physiotherapist may work with your GP to discuss options like cortisone injections or platelet-rich plasma (PRP) treatments.
Long-term Management: The best prevention strategy includes excellent hip muscle control, guided by your physiotherapist or doctor. Continuing with your exercise program even after your pain resolves is essential for preventing future episodes.
When to Seek Help
Don’t let hip pain limit your daily activities. If you’re experiencing pain on the outside of your hip, especially if it’s affecting your sleep or making it difficult to walk or climb stairs, it’s time to see a physiotherapist. The sooner you start treatment, the faster your recovery will likely be.
At BodyViva, our experienced physiotherapists understand how frustrating trochanteric bursitis can be. We’ve seen countless patients overcome this condition and get back to doing what they love. With the right assessment, treatment plan, and your commitment to the rehabilitation process, you can expect significant improvements in your pain and function.
Ready to take the first step towards pain-free movement? Book an assessment with one of our experienced physiotherapists today. We’ll work with you to develop a personalised treatment plan that gets you back to living life without hip pain.
