This condition presents with a range of the following symptoms:
- Pain that travels down the outside of the thigh and occasionally to the knee.
- Pain when sleeping on the side – especially the affected hip.
- Pain on rising from a deep chair or after prolonged sitting (e.g. in a car).
- Pain when climbing stairs. Pain sitting with legs crossed.
- Increased pain with prolonged walking, standing or cycling.
The pain originates primarily from the inflammation of the bursa (a small fluid-filled sac) which lies over the prominent bone of the hip (femur). There are four bursae associated with the hip, so pain can be felt in different areas.
It can start traumatically (from a fall or pressure to the area) or can also be a gradual onset. This may be due to repetitive trauma or frictioning of a tight soft tissue structure while running, walking or cycling.
A thorough assessment is important to eliminate other conditions
- Referral from lumbar spine
- Or of the hip joint
- Weakness of hip musculature
An ultrasound scan may be required to confirm diagnosis and on some occasions, an injection of corticosteroid and total anaesthetic into the joint will help to relieve the inflammation.
Treatment is initially for pain relief ice, rest and perhaps taping to offload the area. As pain settled it is vital to restore joint range, muscle length and strength and also proprioceptive (balance) skills. A return to activity should be carefully monitored 6 to 8 weeks is the most common time for this. Recovery maybe more prolonged if a chronic gluteal tendinopathy is diagnosed.
To help prevent this condition an exercise programme to maintain strength and endurance of the lumbar/hip/pelvic area is highly recommended.