Inflammation of the greater trochanter - how dangerous is it?

Synonyms in a broader sense

Bursitis, greater trochanter pain syndrome, tendinitis of the hip

introduction

An inflammation at the greater trochanter can lead to the development of the so-called greater trochanter pain syndrome (general information can be found here: Greater trochanter pain) to lead. This syndrome encompasses a wide variety of lateral hip disorders. Inflammatory processes in this region can be caused by tears in the muscles (especially the gluteus medius muscle or the gluteus minimus muscle), impairment of the bursae (bursae trochanterica) on top of the greater trochanter, or the so-called "rapid hip".

Patients with inflammation of the greater trochanter usually notice severe stabbing pains very early in the area of ​​the lateral hip. This pain can vary depending on the extent of the disease both at rest and under stress occur. In addition, the inflammatory processes can become evident overheat and or Swelling to lead. Even the natural one Range of motion of the hip joint is visibly restricted in a patient with inflammation of the greater trochanter. The diagnosis of inflammation of the greater trochanter includes the consideration of the clinical picture, the examination of the hip joint in the Side comparison and various imaging techniques. Depending on the underlying problem, a appropriate treatment be initiated.

causes

Inflammation of the greater trochanter can be caused by various underlying diseases. So-called bursitis is one of the most common causes of inflammation in the greater trochanter. A bursa is a sliding structure that lies between two fixed parts of the joint. Bursae are found in every real joint in humans. The main functions of these structures are to evenly distribute the pressure acting on the joint and to facilitate the sliding of cartilage and bone onto one another. Direct cause of the development of bursitis on the trochanter (med .: Trochanteric bursitis) is usually the penetration of bacterial pathogens. However, these bacterial pathogens do not necessarily have to come from the hip area: bacteria that are located elsewhere in the body can also reach the bursae on the greater trochanter via the bloodstream. In addition, bursitis can also be caused by viral pathogens.

Read more also under: Trochanteric bursitis

Another cause of inflammation at the greater trochanter is tendinitis on the hip (technical term: Trochanteric endinosis). This term refers to a painful disease of the tendons in the area of ​​the large rolling hillock of the thigh bone (trochanter major). In most cases, these two inflammatory diseases of the greater trochanter do not occur independently of each other, but rather in combination.

Please also read: Tendinitis on the hip

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The hip joint is one of the joints that are exposed to the greatest stress.
The treatment of the hip (e.g. hip arthrosis, hip impingement, etc.) therefore requires a lot of experience.
I treat all hip diseases with a focus on conservative methods.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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How dangerous is inflammation of the major trochater?

Inflammation of the greater trochanter is usually caused by inflammation of the tendons and the bursa in this area. This can usually be treated well with anti-inflammatory painkillers, physiotherapy and physical therapy and heals quickly. Surgery is only necessary if the pain is very pronounced.

Symptoms

People who suffer from inflammation in the hip will notice stabbing or pulling pain in the hip area right from the start of the disease. This pain can under certain circumstances radiate to the lower, lateral thigh. In the case of less pronounced inflammatory processes, the symptoms are primarily provoked by movements of the hip joint. The reason for this is the fact that when the hip is moved, the individual joint parts rub against one another and tension is created in the tendon area. The symptoms typical of inflammation of the greater trochanter can be provoked, particularly when bending and stretching the hip joint while walking.

Pronounced inflammation at the greater trochanter can lead to severe pain even when the patient is resting. Significant overheating of the skin surface of the upper, lateral thigh is also one of the typical symptoms of inflammation at the greater trochanter. In addition, any redness in this area can indicate an inflammatory change. In addition, the normal range of motion is clearly restricted when there is inflammation at the greater trochanter. During the physical exam, tapping the trochanter may provoke pain.

Pain with inflammation of the major trochanter

The greater trochanter is a large, palpable protrusion of bone on the outside of the thigh, which serves as a starting point for the tendons of various muscles. Various diseases and conditions can cause hip pain in the greater trochanter area.

Please also read: Greater trochanter pain

One possible cause is tendinitis, so-called "Insertion tendinopathies ". Strictly speaking, these are tendinitis. The greater trochanter serves as an attachment surface for a total of 5 muscles. These include the gluteus medius and minimus muscles, the piriformis muscles, the obturator internus muscle and finally the gemelli muscles. Inflammation in the area of ​​the tendon attachments of these muscles can lead to a sharp pain in the hip, which is mainly projected onto the outside of the thigh. In addition, there may be less redness and swelling in this area. In most cases the tendon of the gluteus medius muscle is affected. Tendon irritation affects the gluteus minimus muscle somewhat less often.

Read more about this at: Tendinitis on the hip

Degenerative processes or small injuries in the area of ​​the tendons can also cause sharp pain.
Another cause of pain in the greater trochanter area is bursitis (Bursitis). There are 3 bursa in the area of ​​the greater trochanter, which are a kind of "cushion" between the muscles and the bone surface. They distribute pressure and friction evenly across the surrounding tendons, muscles, and bones, allowing smooth movements. Inflammation of the bursa is usually painful and can result from improper or excessive stress on the hip or from injuries.

Another cause of pain in the area of ​​the greater trochanter is the so-called "snapping hip" (Coxa saltans). A strand of fibers called the iliotibial band runs along the greater trochanter. Parts of this fiber strand can slide over the greater trochanter at too small a distance, so that there is a quasi-sticking during movements. In addition to occasional pain, there is a clearly audible and palpable snap on the hip. Pain is especially common when there is further irritation or inflammation in the area.

diagnosis

The diagnosis of suspected inflammation of the greater trochanter is divided into several sections. Even the description of the complaints during a doctor-patient conversation (anamnese) can provide an initial indication of the underlying disease. Further diagnosis of inflammation of the greater trochanter is carried out using imaging methods (e.g. roentgen and Magnetic resonance imaging).

therapy

Inflammation of the greater trochanter caused by damage to the tendons can usually be treated with pain reliever and anti-inflammatory drugs (such as ibuprofen).

In addition, physiotherapy and physical measures can help alleviate the symptoms in the long term. However, if the tendinitis is particularly pronounced, surgical treatment must often be initiated. If an impairment of the bursa is responsible for the inflammation at the greater trochanter, the exact cause must be determined before initiating suitable therapy. In the case of an underlying bacterial infection, antibiotic treatment can be started after the responsible pathogen has been determined.

Most of the affected patients respond very well to this therapeutic measure and are symptom-free after a relatively short time. Bursitis caused by excessive stress, on the other hand, often has to be immobilized over a longer period of time. Only when the joint is no longer stressed can the inflammatory processes subside and healing begin. In rare cases, however, both antibiotic treatment and immobilization of the hip joint remain unsuccessful. Surgical treatment of the inflammation at the greater trochanter must then be considered in the affected patient.

Exercises for the home

Hip pain is not uncommon. Next degenerative processes are above all Incorrect and overloading as well as small injuries that cause and promote inflammatory processes in the area of ​​the greater trochanter. While in In acute phases of inflammation, the hip is protected as well as an anti-inflammatory and pain-relieving medication, e.g. with ibuprofen and diclofenac, can be in the foreground gentle stretching exercises heal after the acute pain has subsided, promote. This is especially important for runners, as they are particularly often affected by tendinitis and bursitis in this area. Here it is particularly important to ensure that the hip muscles are stretched well. This minimizes the risk of incorrect or overloading.

Below are some exercises that are suitable for stretching the hips and can easily be performed in everyday life. However, these are not a substitute for a professional doctor or physical therapist. In the case of acute inflammation and severe pain, the exercises should only be carried out according to professional guidanceto avoid damage caused by incorrect movement.

Sample exercises for hip stretching:

• Elongation of the Glutes: The starting position for this exercise is the supine position. Now pull the bent right leg towards your chest. Hold your right knee with your right hand. The left hand covers the right calf. Now pull your leg to your left shoulder until you feel a stretch. However, do not stretch if you are in severe pain! Make sure that the knee remains unloaded. Hold this position for at least 30 seconds. Then switch sides.
• Variations in stretching the Hip flexors: For the first exercise, stand in a firm stance. Now pull one heel towards your buttocks. Make sure that the heel does not touch the buttocks. Grab your heel with your hand on the same side and hold the position. When you are stable, push your pelvis forwards until you feel the urge to stretch. The stomach is tightly tense. Hold this position for 30 seconds and then switch sides. For the second exercise, stand in a wide stride position. Make sure you have a straight back and a firm trunk. Then support yourself with both hands on your front leg. Avoid a hollow back! Now push the pelvis forwards again until you feel a stretch. They remain in this position for 30 seconds. Now change sides.

Read more on this topic: stretching

prophylaxis

The development of an inflammation at the greater trochanter can often be prevented by observing simple rules of conduct. One of the most important prevention factors is avoiding prolonged, steady movements that place excessive strain on the joints. In addition, incorrect posture of the body axis should be urgently avoided during sport. Especially the regular one stretch and warming the tendons of the hip muscles effectively helps prevent inflammation of the greater trochanter.

forecast

The prognosis of inflammation at the greater trochanter is generally very good. Although the course of this inflammatory disease and with it the painful intervals very tedious can be, the inflammatory processes can usually be treated with comparatively simple means.However, in order to optimize the healing process and prevent renewed inflammation, it is absolutely necessary exact cause to get to the bottom of the origin of this disease. Only treatment that is precisely tailored to the underlying problem can prevent inflammatory processes in the long term and thus ensure a good prognosis.