The first line of treatment for trochanteric bursitis or other causes of greater trochanteric pain syndrome is nonsurgical. If activities can be identified that seem to trigger the symptoms, often these can be modified, resulting in resolution.
Supervised physical therapy can be helpful to outline a home program of treatment and can be especially beneficial for cases that fail to respond to simpler measures of management. If not contraindicated, nonsteroidal anti-inflammatory medications can help modulate symptoms by reducing inflammation. For recalcitrant cases, judicious use of corticosteroids injection may be appropriate. Surgical trochanteric bursectomy is rarely necessary. In fact, if symptoms fail to respond to standard forms of conservative treatment, a deeper investigation may be warranted to look for other causes beyond simply bursitis.
Rehabilitation emphasizes gentle stretching of the Iliotibial Band and strengthening of the Abductor muscles, designed in a fashion to not aggravate the bursitis symptoms. This reduces friction and pressure of the Bursa.
When an injection is needed, it can be performed under Ultrasound guidance to precisely inject the Bursa, and also to look for whether bursal swelling is present. Equally important, the deeper lying Abductor tendons can be inspected for damage. Tendon damage often masquerades as “Bursitis”.
Surgical Bursectomy is infrequently necessary, but can be performed with the aid of an arthroscope. When used outside the joint this is termed an Endoscopic procedure. The bursa can be excised and the other structures contained within this Peritrochanteric Space can be surveyed.
Video illustrating an Endoscopic Trochanteric Bursectomy
Location
2004 Hayes Street
Suite 700
Nashville, TN 37203
Office Hours
Monday-Friday:
8:00 am – 5:00 pm