Treatment for Trochanteric Bursitis of the Hip: Expert Guide

Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025

In this article, you will find out everything you need to know about hip bursitis and the most effective ways to treat it, including an advanced treatment called Prolotherapy.

What is Trochanteric Bursitis?

Trochanteric bursitis, also known as greater trochanteric pain syndrome (GTPS), is a common cause of lateral hip pain. It occurs when the bursa—a small, fluid-filled sac that cushions the outer part of the hip (greater trochanter)—becomes inflamed. This inflammation leads to pain, tenderness, and sometimes swelling on the outside of the hip, making activities like walking, climbing stairs, or lying on the affected side uncomfortable.

Trochanteric bursitis can affect anyone but is most common in middle-aged and older adults, especially women and runners.

Anatomy: Where Is the Trochanteric Bursa?

The greater trochanter is the bony prominence on the outside of your hip. The trochanteric bursa sits between this bone and the overlying tendons and muscles, acting as a cushion to reduce friction during movement. Inflammation of this bursa is what causes the pain and symptoms of trochanteric bursitis.

Symptoms of Trochanteric Bursitis

• Pain on the outside of the hip, especially when lying on the affected side
• Tenderness to touch over the greater trochanter
• Worsening pain with walking, climbing stairs, or standing up from a seated position
• Occasional swelling or warmth over the hip
• Stiffness or reduced range of motion
• Pain that may radiate down the outer thigh
• Difficulty sleeping on the affected side

Symptoms may develop gradually or after an injury or repetitive stress.

Causes & Risk Factors

• Repetitive hip movements: Running, cycling, or standing for long periods
• Direct trauma: Falls or blows to the hip
• Muscle imbalances or weakness: Especially in the gluteal muscles
• Leg length differences
• Arthritis or spinal conditions
• Obesity
• Previous hip surgery
• Age-related degeneration
• Inflammatory conditions: Such as rheumatoid arthritis

Women and middle-aged to older adults are more commonly affected¹.

Diagnosis

Diagnosis of trochanteric bursitis is based on a combination of medical history, physical examination, and sometimes imaging. Your clinician will:

• Ask about your symptoms, activities, and any recent injuries
• Examine your hip for tenderness, swelling, and range of motion
• Perform special tests to distinguish bursitis from other hip conditions
• Order imaging (ultrasound or MRI) if needed to confirm the diagnosis or rule out other causes

Early diagnosis and treatment are key to preventing chronic pain and loss of function.

Impact on Daily Life

Trochanteric bursitis can significantly affect your quality of life. Simple activities like walking, exercising, or even sleeping can become uncomfortable. Some people avoid physical activity due to pain, which can lead to muscle weakness and further joint problems. Addressing the condition early is key to maintaining mobility and independence.

Common challenges faced by patients:

• Difficulty participating in sports or fitness routines
• Problems with work, especially if standing or walking is required
• Disrupted sleep due to pain when lying on the affected side
• Reduced social activities and travel
• Emotional impact, including frustration and anxiety about recovery

Conservative Management

Most cases of trochanteric bursitis improve with conservative (non-surgical) management. This includes:

• Rest: Avoid activities that aggravate pain, especially repetitive hip movements.
• Ice: Apply an ice pack for 10-15 minutes, 2-3 times daily to reduce inflammation.
• Footwear: Wear cushioned shoes and consider orthotics if you have leg length differences.
• Weight management: Maintaining a healthy weight reduces stress on the hip.
• Posture: Maintain good posture and avoid slouching.
• Gradual return to activity: Increase activity levels slowly as pain improves.
• Education: Understanding your condition and how to manage it is crucial for long-term success.

Best Exercises for Trochanteric Bursitis

Exercise is a cornerstone of recovery. The right exercises can reduce pain, restore mobility, and strengthen the hip to prevent recurrence. Always consult a healthcare professional before starting any exercise program.

1. Hip Abductor Strengthening

• Side-Lying Leg Raises: Lie on your unaffected side, lift the top leg up slowly, hold for 2 seconds, and lower. Repeat 10-15 times per side.
• Standing Hip Abduction: Stand upright, hold onto a chair, and move your affected leg out to the side. Hold for 2 seconds, return. Repeat 10-15 times.

2. Gluteal Strengthening

• Bridges: Lie on your back with knees bent, feet flat. Lift hips up, squeeze glutes, hold for 3 seconds, lower. Repeat 10-15 times.
• Clamshells: Lie on your side with knees bent, feet together. Open knees while keeping feet together, hold, and return. Repeat 10-15 times.

3. Hip Flexor and IT Band Stretching

• IT Band Stretch: Stand, cross the affected leg behind the other, lean away from the affected side. Hold for 20-30 seconds, repeat 2-3 times.
• Piriformis Stretch: Lie on your back, cross the affected leg over the opposite knee, gently pull the knee toward your chest. Hold for 20-30 seconds.
• Hip Flexor Stretch: Kneel on one knee, other foot in front. Gently push hips forward until you feel a stretch in the front of the hip. Hold for 20-30 seconds.

4. Balance & Core Stability

• Single Leg Stance: Stand on the affected leg, hold for 10-30 seconds. Repeat 3 times.
• Planks: Hold a plank position for 10-30 seconds, focusing on core engagement.

5. Low-Impact Cardio

• Swimming or water aerobics: Reduces joint stress while improving fitness.
• Stationary cycling: Use low resistance and avoid high-intensity sprints.
• Elliptical trainer: Provides a smooth, low-impact workout.
• Walking: On even surfaces, at a comfortable pace.

Tip: Consistency is key. Perform these exercises 3-5 times per week for best results².

Lifestyle Modifications & Prevention

Preventing trochanteric bursitis or reducing the risk of recurrence involves making key lifestyle changes:

• Maintain a healthy weight: Excess weight increases pressure on the hip bursa.
• Choose supportive footwear: Shoes with good cushioning and arch support help reduce impact.
• Warm up before exercise: Gentle stretching and mobility work prepare the hip for activity.
• Cross-train: Alternate high-impact activities (like running) with low-impact options (like swimming or cycling).
• Address muscle imbalances: Work with a physiotherapist to strengthen weak muscles and improve biomechanics.
• Modify your environment: Use cushioned mats if you stand for long periods, and avoid hard surfaces when possible.
• Listen to your body: Don’t push through pain—rest and seek help if symptoms persist.

Workplace ergonomics: If your job involves standing or repetitive movement, consider ergonomic adjustments to reduce hip strain.

Advanced & Alternative Treatments

For persistent or severe cases of trochanteric bursitis, advanced and alternative treatments may be considered:

• Shockwave Therapy: Uses sound waves to stimulate healing in chronic cases. Some studies show benefit for GTPS⁴.
• Platelet-Rich Plasma (PRP) Injections: PRP uses your own blood’s growth factors to promote tissue repair. Early research is promising, especially for tendon-related GTPS⁵.
• Dry Needling: A physiotherapy technique that targets trigger points in the hip muscles to relieve pain and improve function.
• Acupuncture: May help reduce pain and inflammation for some patients.
• Manual Therapy: Hands-on techniques by a physiotherapist to mobilize the hip and reduce soft tissue tension.
• Surgical intervention: Rarely required, but may be considered for severe, refractory cases or when there is a structural abnormality.

Note: Always discuss advanced treatments with a specialist to determine the best approach for your individual case.

Medical Treatments for Trochanteric Bursitis

If conservative management does not relieve symptoms, additional treatments may include:

• Non-steroidal anti-inflammatory drugs (NSAIDs): For pain and swelling, as advised by your doctor.
• Physical therapy: Tailored rehabilitation to restore movement and strength.
• Corticosteroid injections: For short-term relief in severe cases.
• Shockwave therapy: May help chronic or resistant cases.
• Prolotherapy: See below for details.
• Surgery: Rarely needed, only for persistent or severe cases.

Case Studies

Case Study 1: Prolotherapy for Chronic Trochanteric Bursitis

Background: A 55-year-old runner with a year-long history of hip pain diagnosed as trochanteric bursitis.
Treatment: After three prolotherapy sessions at ProHealth Clinic, pain reduced by 90% and the patient returned to running within 8 weeks.
Outcome: At 6-month follow-up, the patient remained pain-free and had resumed all activities.

Case Study 2: Exercise and Prolotherapy Combination

Background: A 42-year-old office worker with persistent hip pain failed to improve with physiotherapy alone.
Treatment: After adding prolotherapy, pain scores dropped from 8/10 to 1/10, and function was fully restored within 3 months.
Outcome: The patient returned to regular gym workouts and reported no recurrence at 1-year follow-up.

Case Study 3: Rapid Relief in a Manual Worker

Background: A 60-year-old builder developed acute trochanteric bursitis after a fall.
Treatment: Early intervention with prolotherapy and physiotherapy.
Outcome: Returned to work within 4 weeks, with full pain resolution and no further episodes.

Case Study 4: Long-Term Success with Lifestyle Change

Background: A 68-year-old retiree with recurrent hip pain and obesity.
Treatment: Combined weight loss, exercise, and prolotherapy.
Outcome: Lost 10kg, pain resolved, and improved mobility and quality of life at 1-year follow-up.

Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.