From the Guidelines
The recommended treatment for trochanteric bursitis typically begins with conservative measures, including rest, ice application, and activity modification, and may involve injections with either lidocaine alone or in combination with a corticosteroid, as suggested by Robbins et al 1.
Treatment Overview
The treatment approach for trochanteric bursitis aims to reduce inflammation, alleviate pain, and improve the quality of life for patients.
- Conservative measures such as rest, ice, and activity modification are initial steps to reduce inflammation around the hip.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to reduce pain and inflammation, although specific dosages and durations are not detailed in the provided evidence.
- For cases where trochanteric bursitis is suspected to be a source of pain, injections with lidocaine alone or in combination with a corticosteroid are recommended 1.
Diagnostic Considerations
Ultrasound (US) can be used to detect trochanteric bursitis, as well as other conditions such as joint effusions, bursal collections, capsular and bursal thickening, and synovitis 1. However, differentiation between bursitis and gluteus medius tendinosis may be difficult, and the two conditions may coexist, as noted by Douis et al 1.
Additional Considerations
While the provided evidence does not extensively cover all aspects of trochanteric bursitis treatment, such as physical therapy, weight loss, and surgical options, the focus on injections with lidocaine or corticosteroids for pain management is supported by recent guidelines 1. Given the information available, the most direct and effective approach for managing trochanteric bursitis, based on the strongest and most recent evidence, involves the use of injections as part of a comprehensive treatment plan 1.
From the FDA Drug Label
For relief of the signs and symptoms of bursitis The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. The initial total daily dose should not exceed 1250 mg of naproxen. Thereafter, the total daily dose should not exceed 1000 mg of naproxen.
The recommended treatment for trochanteric bursitis is naproxen.
- The recommended starting dose is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required.
- The initial total daily dose should not exceed 1250 mg of naproxen.
- Thereafter, the total daily dose should not exceed 1000 mg of naproxen 2, 2.
From the Research
Treatment Options for Trochanteric Bursitis
The recommended treatment for trochanteric bursitis includes:
- Conservative measures such as rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and stretching exercises focused on the lower back and sacroiliac joints 3
- Corticosteroid injection, which has been shown to be effective in resolving symptoms and allowing patients to return to activity 3, 4, 5
- Physical therapy, which can be used in conjunction with corticosteroid injection or as a standalone treatment 4, 5, 6
- Surgical procedures such as iliotibial band release, subgluteal bursectomy, and trochanteric reduction osteotomy, which may be necessary in rare cases of intractable symptoms 3, 4, 6
Efficacy of Treatment Options
Studies have shown that:
- Conservative measures are effective in treating trochanteric bursitis, with symptom resolution and return to activity ranging from 49% to 100% 4
- Corticosteroid injection is a effective treatment modality, with symptom resolution and return to activity ranging from 49% to 100% 4
- Low-energy shock-wave therapy (SWT) has been shown to be superior to other nonoperative modalities in two comparative studies 4
- Surgical procedures have been shown to be effective in refractory cases, with efficacy varying depending on the clinical outcome measure 4
Patient Outcomes
Studies have reported that: