What is Trochanteritis: Symptoms and how to treat it?

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The trochanter is a bony protrusion located at the top and side of the femur, where the tendons of the hip muscles are inserted, and gives its name to the painful condition known as trochanteritis or trochanteric bursitis.

A patient with trochanteritis presents with radiating pain along the side of the leg, down to the knee and sometimes to the ankle. Trochanteritis may be bilateral or may affect only one side of the hip.

This pathology affects the activities of daily living. For this reason, in this article we will focus on the causes, symptoms and treatment of trochanteritis.  

What is trochanteritis?

Trochanteritis is the inflammation of the site where the muscles insert into the femur. This set of painful symptoms is accompanied by a lateral irradiation that extends to the knee and sometimes even to the foot.

Around the greater trochanter there are four bursae, which are sacs filled with synovial fluid and which act as a cushion to prevent friction between the tendon insertions and the bony prominences. Therefore, any inflammatory process of this bursa is called trochanteric bursitis or trochanteritis.

The painful syndrome of the greater trochanter, as trochanteritis is also called, is a pathology that affects between 10% and 20% of the population. It most commonly occurs in patients between 40 and 60 years of age, especially in women and obese people. 

What causes trochanteritis?

As pharmacist Javier Zaragoza Villanueva, founder of Farmazara.es, tells us, trochanteritis is more common in older adults. People who are out of shape or overweight have a higher risk of suffering from trochanteric bursitis.

On the other hand, it is a frequent process in sports practice, especially in athletes who, as a consequence of their activity, suffer excessive friction of the region, such as marathon runners. 

The most common causes of trochanteritis are:

  • Overuse of the hip when exercising or standing for long periods of time.
  • Injury to the hip, such as from a fall.
  • Obesity
  • Having one leg longer than the other
  • Arthritis in the hip, knee, or foot.
  • Foot problems such as bunions, plantar fasciitis or Achilles heel.
  • Spinal diseases such as scoliosis and arthritis of the spine.
  • Tearing in the gluteal muscles.
  • Weakness in the abductor muscles of the hip.
  • Previous hip surgeries and the use of prostheses.
  • Pathological conditions such as rheumatoid arthritis, gout and psoriasis.
  • Presence of calcium deposits in the tendons that attach to the greater trochanter.

What are the symptoms of trochanteritis?

The most common symptoms of trochanteritis include:

  • Pain in the hip joint that may also be felt outside the thigh.
  • Difficulty walking.
  • Joint stiffness
  • Swelling and warmth of the hip joint.
  • Increased pain when getting out of a chair or bed, climbing stairs, or prolonged sitting. 

How is trochanteritis diagnosed?

The diagnosis of trochanteritis is determined by interview and examination. The patient’s history of pain, especially if it has appeared after overexertion, is relevant for the health specialist to make a correct deduction of the pathology that afflicts the patient.

First of all, a traumatologist performs a detailed physical examination of the hip joint. With the patient lying sideways on the hip, the greater trochanter is palpated to look for the point that generates the most pain.

Subsequently, with the patient still lying down, the patient is asked to separate the hip. The reproduction of pain when performing these maneuvers is an indication of trochanteritis.

The physician may request imaging tests, such as radiographs, bone scintigraphy and magnetic resonance imaging, in order to rule out the possibility of an injury or other medical condition with the same clinical picture.

Plain radiography is required in patients with recurrent episodes of trochanteritis or in patients with orthopedic implants.

On the other hand, ultrasound is an imaging test used to detect the presence of excess fluid in the synovial sac of the trochanter.

How to treat trochanteritis?

Physiotherapist Jorge Cavero maintains that according to recent studies “a high percentage of pain located in the hip region was resolved by performing a treatment directed only to the lumbar spine”.

The main objective of treatment for trochanteritis is to reduce pain and inflammation, in order to be able to condition the musculature and then carry out rehabilitation and physiotherapy programs.

Among the measures applied to treat trochanteritis are the following:

  • Changes in physical activity. Temporary suspension or modification of activities that cause pain at the hip level is started. 
  • Cryotherapy. It consists of the application of ice for 10 to 15 minutes several times a day to reduce pain and inflammation.
  • Use of anti-inflammatory drugs. The use of oral anti-inflammatory drugs is recommended during the first week to attenuate the inflammatory process.
  • Infiltration of corticoids. When the previous treatments have no effect, infiltration with corticosteroids can be considered, which provide rapid relief.
  • Use of physiotherapy. It is very important to initiate a program of stretching and strengthening of this muscle, as well as strengthening the general musculature of the hip to progressively balance the articular balance and reduce friction in the area. 

Additional measures to treat trochanteritis 

When trochanteritis is in a recovery phase, strength exercises indicated by physiotherapists will be combined with other motor control and proprioception exercises.
In recent years, techniques such as shock waves have been used in the case of trochanteritis with good results.
Other good measures to promote recovery in patients suffering from trochanteritis include the following:

  • To have rest.
  • If you are overweight, it is necessary to adopt diets aimed at losing weight, so as not to overload the joint.
  • A last resort when the problem becomes chronic is surgery by arthroscopy.

The trochanteric bursitis can improve when a good treatment is applied based on exercises, stretching and massages, which the patient himself can do at home.

German Fuertes Otero
German Fuertes Oterohttps://www.google.com/search?kgmid=/g/11p5t5jsss
CEO at PharmaSalud.net. M.D. from Stanford Medicine: Stanford, California, US, M.Sc. from University of Cambridge: Cambridge, Cambridgeshire, UK and University of Oxford: Oxford, Oxfordshire, UK. PhD at Harvard University Harvard Catalyst: Cambridge, MA, US.

Aunque pueda contener afirmaciones, datos o apuntes procedentes de instituciones o profesionales sanitarios y la información contenida en PharmaSalud esté redactada por profesionales en medicina, recomendamos al lector que cualquier duda relacionada con la salud sea consultada con un profesional del ámbito sanitario.

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