The initial treatment of trochanteric bursitis includes rest, anti-inflammatory medications, ice and stretching.
- Rest: This is the most important part of treatment. At least initially, patients need to avoid any activity that may worsen symptoms. Prolonging inflammation in the area will only lengthen the recovery period. However, some types of exercise, such as swimming and walking on flat surfaces, may be OK, so long as they don't make the condition worse.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Certain over-the-counter medications, such as ibuprofen or naproxen, can decrease the inflammation and pain.
- Ice: Applying ice packs to the area can lessen symptoms by bringing down the inflammation. Initially, this can be done every three to four hours, and is especially helpful following exercise and physical therapy. A thin cloth or paper towels should be placed between the ice pack and skin to avoid damaging skin, and the pack should be applied for no longer than 20 minutes at a time.
- Stretching: Many patients with trochanteric bursitis have a tight IT band. A regular routine of stretching the IT band, along with strengthening exercises for the surrounding hip muscles, usually improves symptoms over the course of just a few weeks. Massaging the IT band with a foam roller is also helpful, though it can be painful at first. Even after the pain is resolved, regular stretching is key to staying symptom free. Doctors may prescribe a structured, supervised physical therapy program to address the condition and keep it from recurring.
If the treatments above fail to bring adequate relief, there are other options to consider:
- Injections: Cortisone is a steroidal hormone that can relieve pain by reducing inflammation. It can be injected directly into the bursa in patients who continue to have pain despite adhering to their treatment regimen. It's usually given with lidocaine, an anesthetic that brings immediate pain relief, and ultrasound imaging may be used to guide placement of the injection. In some cases, the doctor may consider other types of injections, such as trigger point or platelet-rich plasma injections, and a therapeutic technique called dry needling.
- Surgery: In rare cases, when noninvasive treatments haven't led to improvement, surgery to remove the inflamed bursa may be an option. This minimally invasive procedure uses an arthroscope (an endoscope for joints) that can be passed through small incisions. Patients generally go home the same day and can usually walk the following day with only mild discomfort.
With proper care, most people begin to feel better quickly, with symptoms resolving in six to 10 weeks. Physical activities should be resumed gradually, so the problem doesn't recur.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
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