Trochanteric Bursitis - Fact or Fiction?

So you have hip pain and have been told that the X-ray is normal and your hips are fine, and you have a condition called trochanteric bursitis.

The clever health professional who has given you this grand description of your pain problem, shows you where and what the trochanteric bursa is (under GTB below)…..

Trochanteric Bursitis

….and then proceeds to inject local anaesthetic and steroid into the area, with no relief of your pain for any significant period of time if at all.

Why did it fail?

The trochanteric bursa does indeed exist but actual bursitis or painful inflammation in this area is vanishingly rare in clinical practice.

What you are actually feeling is referred pain; pain that is felt in an area of the body, that has its origin elsewhere. In people with back pain resultant from intervertebral disc and/or sacro-iliac joint pain, they will often complain of hip pain first and point to the outside area above GTB in the diagram above.

The reason that they feel back pain in the hip area is because nerves that carry the pain signal to the brain from the lumbar discs, sacro-iliac joints and the hips, all pass very closely to each other in the spinal cord; this is called CONVERGENCE.

Indeed the hip pain can predominate and can fool the best of healthcare professionals, the mistake that they make is not asking the patient if they have back pain AND hip pain.

Of course some people can have both back and hip problems together and there will be a need to treat them both.

If you have been around this website and looked at the ways of investigating pain, I think you know what I am going to say is the best investigation to tell what is irritating and converging on what... SPECT CT.

A positive SPECT CT gives a diagnosis and a possible to route to a cure.

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