What is trochanteric bursitis or trochanteritis?
The trochanter is a specific part of the body belonging to the femur, where many tendon and fascial structures are inserted.
The term trochanteritis is a broad term which, due to its suffix -itis, refers to an inflammatory process established in the region of the trochanter. The reality is that very often there is no evidence of inflammation in many diagnoses of trochanteritis that come for consultation. Therefore, this term is a big messy box that encompasses a large number of pathologies that affect the same region, among which the following stand out:
Types of Trochanteritis
This is the inflammation of the synovial bursa in this region.
Lateral femoral cutaneous syndrome
This is pain along a nerve that runs down the side of the leg to the ankle parallel to the sciatic nerve and with the peculiarity that it is a purely sensory nerve, with no motor function.
Myofascial syndrome of the gluteus medius muscle
A strong contracture of this muscle (compensatory to imbalances in the lumbo-sacral area) can generate intense pain in the trochanter area.
Fascia lata syndrome
This is a pain along this muscle that runs from the area above the trochanter to below the knee.
It is a jump that a tendon makes when moving the hip, from the front to the back of the trochanter, a jump that can be felt from the surface of the skin.
There are some others, but these are the most frequent.
They are very disabling problems as they affect activities of daily living as basic as lying on the side on the hip or walking
Causes of trochanteric bursitis
Possible causes of inflammation and irritation of the trochanteric bursa include:
- Microtrauma from repetitive motion.
- Hip dysmetry
- Muscle imbalances
- Direct trauma to the trochanter
- Rheumatoid arthritis
- Spinal injuries
- Bone spurs or calcium deposits that can occur in tendons and the bursa
Symptoms of trochanteritis
- Throbbing pain on palpation and when resting on that hip
- Pain at night
- Pain when going up and down stairs
- Pain after a period of sitting
- In severe cases, inability to walk
Diagnosis of truncal bursitis
A good anamnesis and the corresponding orthopaedic tests are essential. Imaging tests such as ultrasound or magnetic resonance imaging are also of great help, as they allow us to confirm the signs found during the clinical examination.
Treatment of a trochanter injury
The different physiotherapy techniques are aimed at combating inflammation and restoring correct muscle balance. It is very important to know the cause of the injury in order to avoid future recurrences. We will benefit from:
- Shock waves
- Intratisular percutaneous electrolysis
- Dry needling
- Massage therapy
- Functional rehabilitation: very important once the inflammation has been controlled in order to avoid subsequent recurrences.
TROCHANTERITIS. FREQUENTLY ASKED QUESTIONS
What does the body’s regenerative capacity depend on?
The healing of an injury or physical pathology is the responsibility of our body, in which there are automatic mechanisms that are activated when we lose our normal physical or organic balance. These mechanisms are complex and depend largely on metabolism (biochemical, hormonal and neuronal processes). If these mechanisms work at 100%, we will be protected from a large number of impacts that our body may suffer at different levels (physical, emotional, biochemical and energetic) but if these mechanisms are reduced in their function, the capacity for recovery and regeneration of our cells will be compromised, and may block the healing processes of an illness or injury temporarily or permanently. This is very important to bear in mind when treating any injury or pathology, otherwise the patient may undergo multiple physical treatments on an injury without obtaining results.
What is treatment planning like?
The planning of this type of therapy is always personalised, giving priority in the early stages of treatment to reducing pain and inflammation and improving the mechanical and metabolic factors that have caused the injury. If we have to focus on the latter (because there is evidence of a deficit of function in the patient’s tissue regeneration mechanisms) then we will first establish a consistent 3-6 week home treatment regimen for the patient:
Improved dietary hygiene
Natural supplementation: Detoxifying-anti-inflammatory-regenerating.
Should I suspend my professional or sporting activity?
It will depend on each case, if the professional or sporting gesture has not intervened in the appearance of the injury, there will be no reason to suspend it, but if not, the efforts will have to be graduated.
How much time should pass between sessions?
It depends on each case, but normally with the use of state-of-the-art therapies such as those applied at Corporis, the improvement is felt from the first session. Between 3 and 7 sessions may be necessary for complete recovery.
How many sessions do I need to start noticing improvement?
It depends on each case, but normally with the use of state-of-the-art therapies such as those applied at Corporis the improvement is felt from the first session. Between 1 and 4 months is the time that this type of recovery takes, with the most frequent being 2 months for a complete return to normal sporting activities.
Can emotional stress cause this injury?
Yes, sometimes there are no physical or metabolic factors important enough to justify the appearance of this injury, but there are psychological factors. To help the body stop generating this irritation/inflammation of nerve fibres causing pain, it is very important that the patient becomes aware of the relationship between stress-injury and tries to establish strategies to reduce the impact of stress on the body. For this purpose, tools such as Coaching and Clinical Psychology are of great help.
This post is also available in: Spanish
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