ASK THE EXPERT - AUGUST 5, 2011

Question:

Dear Dr. Milne,
My left hip has been hurting for the last 5 months as I have been training for a half marathon. My doctor has diagnosed me with “greater trochanteric bursitis”. What causes this and what are the treatments? Kelly S., 36, Frontenac

Answer

Greater trochanteric bursitis is an inflammatory condition that affects many active people each year. This condition affects women more than men and often occurs in the 30-50 year old age range. A new running routine (your half marathon) or exercise program (boot camp) are common precipitating events.

The primary symptom of greater trochanteric bursitis is pain. The point of maximal tenderness is usually the bony prominence on the most lateral aspect of the hip (this is the point that contacts the floor when you lay on your side). The pain is caused by inflammation of the fluid filled bursa that exist between this bony prominence and the iliotibial band (tendon) that slides over this prominence as we walk or run.

Treatment is focused on decreasing the inflammation and pain. This may include activity modification (decreas- ing mileage or cross-training), use of anti-inflammatory medications, icing, physical therapy and stretching, or a cortisone injection. There is an association between greater trochanteric bursitis and per planus (flat feet) as well as leg length discrepancies.

The good news is that greater trochanteric bursitis, while painful, is often self limiting and usually resolves with time. It is important however to differentiate this from other more serious disorders about the hip. These may include stress fractures, labral tears, arthritis and systemic illness.

A careful history and physical examination along with X-ray, ultrasound, or MRI examination may help differenti- ate the cause of your hip pain.

Consult your orthopedic surgeon or sports medicine physician to confirm your diagnosis.