Hip Bursitis III

 

Sorry for the delay. Hope your hips were getting better with activity modifications alone. Now for the rest of the story…

1)      Once greater trochanteric bursitis is in full bloom, you might need to add some anti-inflammatories to the equation. If you’re working on this on your own, then over-the-counter (OTC) non-steroidal anti-inflammatories (NSAIDs) are what you can use. Aleve and Advil are useful and as long as you have no medical reasons not to use them, they will help. But you can’t use these alone and expect to get well. You’ve got to address the mechanical issues as well.

If you go to your doctor for treatment, then you can get prescription level doses of NSAIDs and also he/she might recommend short courses of prednisone or even a cortisone injection. These are often very helpful and can even “cure” the condition, but don’t be surprised if it comes back. Unless you’ve addressed the causative or mechanical factors involved, this will often be the case.

2)      Stretching the iliotibial band can help, but sometimes it can cause more pain, so often when the condition is in a dire state (and believe me, sometimes it is), I don’t recommend stretching. Wait until it calms down first. Sure, these are gentle stretches and you can start doing them, but go easy at first.

Wall Stretch: Stand about a foot from the wall with the painful side toward the wall. Cross the bad leg over the outside leg and slowly lean into the wall. Extend your arm up the wall to support yourself, but if you have a rotator cuff tear (I’ll talk to you later) then just lean your shoulder into the wall. IMG_1006-1

Bed Stretch 1: Scoot to the edge of your bed and roll onto your side, with the painful side up.  Try not to fall off. Then slowly swing your top (painful) leg over the side of the bed and let it hang down. Try to keep your knee straight.IMG_1000-1

 Bed Stretch 2: In a face-up position bend your hip and knee.  Then cross the involved leg over the other leg. You can increase this stretch by pulling the knee of the involved leg with the opposite arm.

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Bed Stretch 3: Get on your side (painful side up again). Move your bottom leg forward to get it out of the way of your upper leg. With your upper knee bent, slowly lower your leg to the bed. 

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While doing these stretches , you should feel tension across that hip. If it is too painful, then back off. Either decrease the amount you do it or stop altogether, until you have more control of your pain.

If both of your hips hurt, let me first say, “I’m sorry.” And then let me say to do all the above on both sides, unless you can’t tolerate lying on either hip. Then let me again say, “I’m sorry.” This is a bad problem to have. People who have it are to be pitied in any way that you might pity a person with any illness. They need love and attention…and this blog.

 

 

 

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134 Responses to Hip Bursitis III

  1. margie October 24, 2012 at 4:27 pm #

    Can ice help reduce hip bursitis inflamation, or are the hip parts too deep for ice to relieve inflamation? thank you!

  2. Barbara July 20, 2013 at 10:04 pm #

    Sorry it took so long for me to respond to your question. I haven’t quite figured out how this blog engine sends me reminders for comments.

    In answer to your question: Frankly, I think the hip is too deep to be effected by icing. In general, chronic conditions like arthritis respond better to ice. Acute conditions, like sprains and fractures need ice. For everything else? Sometimes it comes down to what feels best. So there’s no wrong or right temperature to apply on hip bursitis.

    • JoeD March 1, 2017 at 5:40 am #

      Wait, what? The bursitis is right on the outside as shown here: http://www.mayoclinic.org/diseases-conditions/bursitis/multimedia/bursitis-of-the-hip/img-20007193

      That doesn’t appear to be too deep down. And if anti-inflammatories are going to work then why wouldn’t ice work? I mean, that’s the whole point of ice, to bring the inflammation down.

      • Barbara March 2, 2017 at 6:32 am #

        You’re right, the hip bursa on a relatively thin person is pretty superficial, but on anyone with a little extra adipose on the sides of the hip (and that includes most women), the bursa is pretty deep. I often have to use a two inch needle to get there for an injection. And sometimes I have to resort to the use of long spinal needles.
        So depth is one thing, as far as icing is concerned. You have to leave ice on for an awfully long time in order for it to be effective that deep down. It’s different than applying ice to the ankle or knee. But if you’re skinny, the ice might reach.
        The second issue is the ice itself…as an anti-inflammatory. Ice is effective for reducing swelling following an acute injury. I always recommend ice, and never heat, following an acute injury. But in my opinion and experience, it’s not really an effective “anti-inflammatory” for chronic conditions. That’s not to say that it’s not an effective pain reliever, because in many cases it is. But after the swelling and “inflammation” from an acute injury resolve, people pretty much vote 50-50 for ice and heat, as effective pain relievers.
        There’s no harm in either…unless you burn your skin, which can happen with heat and ice. So always keep a cloth barrier between your skin and ice.

  3. Sally Pasillas August 11, 2013 at 2:12 pm #

    Does walking in pool help? My hip pain is so bad at times can’t even walk.

    • Barbara August 12, 2013 at 3:52 am #

      People often ask me if certain forms of exercise help various conditions. I would not say that any particular form of exercise is actually beneficial in that way. Don’t get me wrong. Exercising is a good thing, but it’s just not necessarily therapeutic in terms of “treating” a disorder. Now regarding hip bursitis, if that’s what you have, sometimes pool walking can actually aggravate that condition! Go figure. I actually see patients who get hip bursitis from pool walking. That’s because when you pool walk, there is increased resistance against your forward movement, so in essence you are power walking. The advantage to pool walking is that you’re not completely weight bearing, so it reduces weight bearing loads on your joints. It’s often good for overweight people who are trying to exercise, or people who are recovering from surgery on their lower extremities. And as far as exercising is concerned, I think it’s a good thing to do, simply because it does reduce stresses on the joints. But it might increase the drag of the iliotibial band across that large bone up by the hip (greater trochanter), thereby giving you hip bursitis. So don’t be surprised if it causes or aggravates hip bursitis.

      You might need to see someone about that pain if it is that severe. It might be time for a shot or some anti-inflammatories. And I’m assuming you’ve read my blog and are pretty sure you have bursitis and not arthritis or sciatica. If you actually have arthritis, then swimming in that pool, rather than walking in it might be your best bet.

      Sorry you’re having so much pain. I hope you’re trying to get some help on this.

  4. Debra Greenfield October 25, 2013 at 7:46 pm #

    Hi…I see this is somewhat dated, I hope you are still involved…So..I’m a 62 year old very, very active woman who studies ballet and have done so for 40 years or so…I had to quit for a year (5 years ago) with a torn disc (not herniated, torn) which healed and I resumed ballet and have been dancing again for the last four years. I got sore, but nothing debilitating…About 3 months ago I added cycling with my dog (attached with a safety bar called a Walky Dog)…and I started getting progressive hip pain….I finally had to stop exercising as walking was difficult…My PT thought it was Greater Tronchanteric Pain Syndrome…

    But, I saw a physiatrist who told me it wasn’t and I should work thought the pain. Although the pain is exactly what you describe, I didn’t “jump” when he pushed on it, or have difficulties sleeping at night…He told me I wasn’t textbook, and I should have read the textbook…ah…ortho surgons are quite similar…MRI, and injections (I proved to be horribly allergic to two epidurals with steroids during my disc problem)…

    Is it possible to have a milder form that comes on progressively? I’m feeling better after 3-4 weeks of no ballet or cycling but still not great? How do I know when to resume activities, I’m kind of losing my mind!!!

    thanks so much, Debra

    • Barbara October 27, 2013 at 1:31 am #

      Debra, as you can see from all the comments on this subject in my blog, a lot of people suffer from this condition. If we rule out spinal and hip joint sources of pain, then we can focus on the many sources of lateral hip pain, otherwise known as trochanteric pain syndrome. Traditionally we consider the primary source of lateral hip pain to be greater trochanteric bursitis. And as you noted, I have described that condition in detail on the blog. But your symptoms don’t fall exactly into that little box.
      I have seen many patients with variations on the theme of lateral hip pain and I’m going to suggest a few other sources of pain in that area:
      1) There are other bursas in this region and they are located more posteriorly, or behind the greater trochanter. Often when I inject the greater trochanteric bursa, patients get immediate relief of their pain, simply from the local anesthetic. If injections into this bursa don’t help at all, we have to consider other bursas. That might be your problem.
      2) Degenerative tears of the gluteal tendon. This can often be seen on an MRI and would also be a cause of more posterolateral hip pain because that tendon is behind and slightly below the greater trochanter.
      3) Piriformis syndrome is another cause of posterolateral hip or buttock pain.
      4) Obesity can result in a wide based and abnormal gait, which can result in mechanical lateral hip pain. I’m assuming that because you do ballet, you are not obese, but I thought I’d mention it for completeness sake.
      So you can see that not all lateral hip pain is greater trochanteric bursitis. Perhaps you should ask your orthopod to consider some of these other sources of pain.
      I’d like to give you one simple suggestion which might help you. It has helped many of my patients with buttock and lateral hip pain. It has helped me with it as well, and even if it doesn’t help, you should do it anyway because it’s a good thing to do for your body. Sit Like a Man (S.L.A.M)! That’s my acronym for this program I have initiated in so many of my female patients. You have only to look at babies to see how we might naturally sit. Sitting with our legs together is a learned behavior and not natural. I’m not suggesting that you sit like that when you have a skirt on, but if you do more of it when you’re at home, on the toilet, getting out of bed and wearing pants, you’ll be better off. Your knees and your hips will thank you.

  5. K Williams November 19, 2013 at 7:08 pm #

    Great blog. My hips are thanking you. I am however suffering with some bursitis in a different area: The iliopsoas bursa (according to my doctor). In addition to that, I am having milder pain in the trochanter area and another frontal part of my hip, adjacent to that iliopsoas. My question is this…I did indeed have two cortisone injections in the two most painful areas. After about two-three weeks, the pain returned-lessened, but nevertheless, it’s baaaaaack. How often are multiple doses of cortisone (say, given again, weeks apart) effective at treating the inflammation enough for the actual healing to begin? This is what I THOUGHT was achieved with the first dose, but I guess it was a nasty trick. Maybe I need another bout? Is it possible that I’ve been misdiagnosed? Or is now the time to embrace the possibility of lessened inflammation and commence the strengthening/stretching exercises? I feel stuck and I want my life back! Haha (not really laughing though…). Also, pain often lessens with extremely light cardio activity such as recumbent biking….is that abnormal?
    Thanks in advance for whatever information you may be willing to offer. Love your blog.

    • Barbara February 20, 2014 at 7:25 pm #

      K.,
      Okay now the iliopsoas bursitis is a little harder to diagnose and treat. And there are other conditions in that same area which could mimic that pain. So it’s harder for me to make that call, here, on the internet, where I can’t examine you or get X-rays.
      But here are a couple of thoughts. Cortisone injections don’t really result in healing. They decrease inflammation and thereby reduce pain. And depending on what your problem is, you have to rest, or stretch or cast or just wait for more time to pass in order for things to heal.
      Also, certain areas of the body can be injected multiple times with relatively little potential for negative effects. But other areas can only be injected a few times, and then if there is no improvement, further investigation of the problem is indicated. Sometimes a single injection might not be effective, but a follow up injection will do the trick. There are just too many variables to make a judgement regarding a single injection. Most docs aren’t tricksters with your body.
      Sometimes exercise helps a condition. But other times it can have a detrimental effect. It’s hard to make a blanket statement. In general I would have to say that if it’s not hurting you while you exercise or after you exercise, then it’s probably okay to ride that recumbent bike.
      Sorry, wish I could offer you more help. Sounds like you need a follow up visit with your doc and perhaps a little more information regarding your problem.

  6. jamison December 1, 2013 at 9:34 am #

    This is the most helpful blog I have come across – thank you for your generosity and delightful sense of humor, Dr. Bergin! You’ve been enormously helpful in allowing me not only to pinpoint whether this is bursitis or something else, but also providing concrete steps to reduce the pain. Thank you!

    • Barbara February 20, 2014 at 7:14 pm #

      Jamison,
      Thanks for the feedback! Appreciate it. Tell your friends about http://www.drbarbarabergin.com or give me a shout out on Yelp or something! I love getting my message out to the world!
      Thank YOU!

    • Dr Ben August 17, 2015 at 12:53 pm #

      Had tka of left knee that is 6 weeks post op and doing well with PT. Had laminectomy L4-5 on nov 2013 , reasonably successful. And also 4 year hx MRI diagnosed left painful greater trochanteric bursitis with 1 cortisone injection in 2012 by Ortho and 2 cortisone injections, 3 weeks apart, by pain management into the bursa under fluoro which had seemed to resolve the painful bursitis till the left trochanteric bursitis and low back pains have all flared up as the knee is beginning to get better. I am 65 years old. Great Blog a d websites ! Thank You.

      • Barbara August 18, 2015 at 5:38 am #

        Your situation is not an uncommon one. I tell my patients suffering from hip bursitis, that you can get it from just having an ingrown toenail. All it takes sometimes, is just a short period of limping, and the whole apple cart is upset. I recommend the use of crutches, canes or walking sticks to my patients who are limping a lot. Even if you have an ingrown toenail. If you have a bad limp, you’re going to upset the apple cart, and that can manifest itself in your knee, hip or back. Sometimes even your shoulder!
        Hang in there. Things will continue to improve.
        And thanks for reading my blog! Pass it on! I want to prevent 100,000 injuries or bone and joint maladies before I retire!

      • Dr Ben August 25, 2015 at 6:26 am #

        Follow up email. Added your wonderful stretches to my home exercise program. Is there any danger to further cortisone injections under ultrasound, had two injections in Jan 2015 three weeks apart, by pain management into my left greater painful trochanteric bursitis. Had tka of left knee 7-6-15. How about future cortisone injection to L4-5 on left. Or might tapered prednisone work just as well. In the past, injections into left greater trochanteric bursa worked great. Thank You. Any danger to left hip. Have a tiny AVM at stable 5 mm in head of left hip.

        • Barbara August 25, 2015 at 11:13 am #

          I really don’t think there’s a down side to doing multiple cortisone injections in the greater trochanteric bursa. Rarely do I have patients who come in frequently for those shots, but I have a few on whom I do them every once in a while. Sometimes I’ll do a series of 2-3 of them, especially if the patient gradually gets better after each one. I have a few patients who come in every year or two. So I doubt, for example, that you would have a cortisone shot once a month for the rest of your life. That would be excessive. There is no danger to the hip joint itself.
          When you say you have AVM, if you mean AVN (avascular necrosis), then I would caution you that high, regular doses of steroids (cortisone) are associated with avascular necrosis. You would have to have a lot of regular cortisone injections in order to consider that as a cause of AVN however. Most of the time, we don’t know why some patients get AVN, and can find no associated pre-disposing factors. It’s a frustrating, sad condition.

          • Dr Ben August 25, 2015 at 6:47 pm #

            Thank You ! I started with a personal trainer today in addition to my PT. I guess I want my left tka to get a little better before I get the next injection or two into the painful left trochanter bursa. Any danger with getting an injection later in the paravertebral musculature at L4-5. Pain there also. I will have those cortisone injections spaced with appropriate time in between to keep the cortisone load to my overall
            Health within reasonable level. I am a retired family practice doc who might return to part time medicine if I can get this knee rehabbed and my pain issues improved. Thank You ever so much for your expertise. Finally, I got a traditional tka and am 7 weeks out, and think I should have got a conformis knee or had a OS who could have done the minimally invasive approach, but the wonderful OS I trusted seemed to do a good job but my new Biomet vanguard cruciate knee is somewhat restricting and still hurts, although slowly improving. I am working hard. You are quite inspirational.

          • Dr Ben August 25, 2015 at 6:59 pm #

            and, finally, can I stop beating myself up with the traditional tka I ended up with. With continued hard work on my home exercises and PT and the trainer, could I get a really good ROM and pain relief someday ? My flexion is 134 degrees at 7 weeks out and extension is zero degrees. The trainer is working also on my painful low back, THANK YOU !!!!

          • Dr Ben August 26, 2015 at 4:09 pm #

            While awaiting your response to my email from yesterday, I also need to mention I strained my left shoulder about two months ago by not warming up properly before use of my shoulders on a machine. Hurts posteriorly mostly but also slight discomfort anteriorly. No loss of ROM, but painful thru ROM’s. Your website is WONDERFUL and a real SERVICE !!!!!!!!

        • Dr. Ben September 7, 2015 at 4:25 am #

          Hope All is well in your Life. Do You have any comments on my multiple Aug 25 emails ?

          Also, is there any further reading You might recommend on trochanteric bursitis ?

          Thank You

          • Barbara September 7, 2015 at 5:41 am #

            Sorry Ben. I’ve been out of town with only an iPad. It’s too hard to figure out how to approve comments on the iPad. But to be honest, I really don’t have anything else to say, that hasn’t already been said in previous comments. I’ve written so much on greater trochanteric bursitis. I’m all tapped out! Please read some of what I’ve already written. There are tons of sources for information regarding greater trochanteric bursitis on the internet, but it’s all pretty standard fare. I think my Sit Like A Man and activity modification ideas are somewhat unique. Really pay attention to WHEN it hurts, and try to identify activities which result in pain. Then make every effort to change or eliminate that activity. You’re a guy, so you already sit like a man.
            As I’ve said before, GTB is usually self-limited. For those who continue to suffer from it year in and year out, please continue to seek other potential sources of your pain. In other words, see an orthopedic surgeon, physiatrist or rheumatologist.

  7. Alison February 23, 2014 at 11:03 am #

    I totally agree! This is the best insight into hip bursitis I have come across. I love your SLAM suggestion. Thank you so much!

  8. Victoria May 10, 2014 at 10:49 am #

    I agree with all of the above – this is so helpful and fun to read – the only good thing I’ve encountered re: the blasted hip thing. I’ve had hip pain for about three years on and off (I’m 48). Like you mentioned, it took a while for me to notice that it wasn’t going away. So is it my car – sliding in and out from under the steering wheel? – my bed (saggy pillowtop that’s only three years old?) or my desk job (will try to SLAM more!)?

    My doctor says it’s a bulging disc pressing on sciatic nerve, and prescribed massage and PT. PT says it’s trochanteric bursitis combined with piriformis syndrome (and does VERY painful treatments for such, which help only until I sleep in said bed and ride in said car again). He says hip is fine. I’ve been in PT for a month. Advil on and off. I don’t like Aleve but maybe that will be the answer.

    I’m at a loss for what to do. This minor, nagging pain is becoming really disruptive. It’s helpful to read that I’m not alone, but that doesn’t alleviate the pain!

    • Barbara May 13, 2014 at 4:06 pm #

      Victoria,
      I’m glad my blog has been helpful. Wish you were well. In reading your note, I’m going to assume that you really do have bursitis, because it’s so easy to get that diagnosis right. If it hurts to push on your great trochanter (the bump on the side of your hip), then it’s bursitis! The therapists probably have more hands-on experience with you and they have pushed on that bursa, eliciting a painful response. Now, that’s not to say you DON’T have sciatica. Unfortunately, having one condition doesn’t preclude you from having something else. So I have bunches of patients with both sciatica and hip bursitis, AND hip arthritis. So frustrating!

      I’m assuming you’ve read my blog and some of these responses to other people’s questions. Then I’m assuming that you’re doing your stretches, sitting like a man, breaking down your movements and slowing down when you stand up from a chair and get out of your car. You’ve taken anti-inflammatories. Now if you haven’t done all the above, then you need to start doing it. And if you have done it all, then it might be time for a shot from your favorite orthopedic surgeon.

      And give it time! I’ve never seen an 88 year-old who tells me she’s had hip bursitis since she was 45. It truly is self-limited and eventually will get better. It’s also a benign, painful condition. That means it’s not ruining anything: your hip, your nerves or your muscles. Now hip arthritis and sciatica are a different story. Make sure you don’t have these conditions because they aren’t self-limited in most situations and should be treated appropriately.

      • Victoria May 26, 2014 at 6:32 am #

        Thank you so much for your reply! My PT insists he can cure me, and doesn’t allow me to expect rapid results. I have decided to see an orthopedic just because I’ve not gone for scans to confirm that all is well. I have done all of the recommended treatments, and the symptoms fade and then return. I can elicit the pain by putting right foot on left knee and pushing right knee away from my body. Most aggravating are car rides, sitting at work for long periods, and, alas, sleeping (this seems to be the single worst irritant, sadly, so perhaps the mattress should go). The worst spots alternate between the side where the bursa is and the buttock, where I guess the piriformis or sciatic nerve is acting up. I feel as if I am thinking about it too much lately, and it is, truly, a “pain in the butt!’ Your blog is great. I keep coming back to see the suggestions!

        • Barbara May 26, 2014 at 7:18 am #

          Just a couple of other comments in response to your comment!

          1) I literally had to ditch my car. I was driving in a very small car to save gas during the week. On the weekends I’m a truck-driving cowgirl. I started noticing that my hip was worse during the week, and finally I realized it was the car. Two things: the shape of the seat can actually push against your hips and force your hips into a rotated position, and second, if it’s a low riding car, your hips have to work extra hard to get in and out. I switched to driving my truck full-time and my hip pain got about 60% better! My gas bill went up. If you don’t have the option of getting a different car, please notice if either of those two things affect you. Then put a pad on the seat to lift you out of the pocket so nothing is touching your hips and so that you can kind of spread your legs. When you get in and out of the car, don’t do it on one leg. Swing your legs around, plant both feet on the ground, then use your arms to help push yourself out of the seat.
          Three inch mattress topper for the bed. Put a pillow between your legs.
          If some of this pain is coming from sciatic nerve irritation, then buy the book “Treat Your Own Back,” by Robin McKenzie, http://www.amazon.com/Treat-Your-Own-Back-802-9/dp/0987650408/ref=sr_1_1_ha?s=books&ie=UTF8&qid=1401113153&sr=1-1&keywords=treat+your+own+back, read it and follow the recommendations. I don’t need to diagnose you to recommend this book, because everyone should get a copy and follow it.

          Last but not least…and this is a general rule of thumb. If you’ve read my blogs, then you’ve already seen it. But it’s one of my mantras, and you can always go back to it when you are wondering if what you’re doing is right…or wrong
          If something hurts, don’t try to work through it. That rarely ever works, especially in adults. Identify what hurts, stop doing it or figure out a way to do it which diminishes or alleviates the pain.
          My second or third mantra…SIT LIKE A MAN. 99% of patients with hip pain due to causes other than arthritis are women. Our body mechanics are the culprits and when we sit lady-like it exaggerates the bad mechanics. Even in your car, I want you to sit with your legs slightly spread, knees rotated out.
          Okay, I better sign off and go ride!

          • Victoria May 27, 2014 at 3:21 am #

            Thank you again! In fact, my car is one of my prime suspects and what first caught my attention on your blog! I drive a Jetta and noticed that I Had to put my right leg in and twist my body to get behind the wheel, reverse to get out. This for four years. Lately I have been pushing the seat all the way back before getting out and spinning both legs to the side first. We do have an old Explorer that I can drive but with an hour commute each way, my gas bill will be through the roof! I will also look into the book you mention; and will see the orthopedist in a couple of weeks.

            Funny that you say not to work through it, because the PT told me the exact opposite. I think he was referring to the piriformis pain, but he seems to think strengthening the area will take care of everything. Hopefully he is right, and before I hit 88!

            Best wishes to you!

  9. Carrie May 22, 2014 at 9:06 pm #

    Hi- what a great article. I have right hallux rigidus and have had a chilectomy and cadaver tendon inserted to pad the joint. Needless to say, no pain relief from either and I’ve got a wicked bunion now and walk very different than normal. I’ve learned to manage my foot, per se, but now have bilateral hip bursitis with the left being inflamed for 2 months acutely. My PCP is also sports med and has conservatively treated me, but I’m 33! Eek! I get out of a car and wobble and hobble till I can get the joint going.

    Any suggestions on next steps? Will this be something I live with forever or is there a successful treatment for bursitis in younger patients? Also, any suggestions on the great toe? It’s a true bummer. Thanks!!!

    • Barbara May 24, 2014 at 4:15 pm #

      I’m glad you got something out of my blog on hip bursitis. Wish your situation was that simple. I think I said in the blog, and if I didn’t, I’ll say it here. Hip bursitis is a benign, painful condition, the key word being “benign.” This means that it won’t destroy your joint, or a nerve or a muscle. And it’s also usually self-limited. It usually resolves. It might take a year or even two, but I never see any 80-year-olds telling me they’ve had hip bursitis for the past 30 years.
      But your situation is different, because I do have many 80-year-olds who have suffered their entire adult life with arthritis in their big toe. Hallux rigidus is not a benign, painful condition. It is quite destructive and can have a serious effect on the quality of your life. And yes, it’s probably your limping from the stiff, painful big toe which results in your hip bursitis. Gals can get hip bursitis from just walking around with an ingrown toenail for a day or two.
      So let’s talk briefly about your toe. I’ve pretty much experienced every ache and pain I describe on my blog, and this is no exception. I have had pain and stiffness in my first metatarsophalangeal joint for about 20 years. I had “bunions” when I was in high school, and even though I had them corrected, just 18 years of living with an incongruent joint is enough to predispose anyone to arthritis in that joint. So what do I do? I wear stiff soled shoes as much as a possibly can. I wear Dansko clogs to work. I wear thick soled boots when I ride horses. I rest that joint as much as possible. Needless to say, I don’t know the condition of your joint. It must be bad because you’ve had some salvage-type surgeries for it. Your only choice now, might be to have that joint fused. So a fusion completely stiffens that joint so you can no longer move it. That alleviates the pain, but it is not an end to the problems, especially at your age. Once you stiffen that joint, you often end up with problems uphill from there, in the midfoot, the knee, the hip. It’s hard to get a proper shoe fit. There are many issues, trust me. So let’s not have a fusion unless you’ve exhausted all other options.
      Rest that foot. Don’t run or even walk for exercise. Ride a bike. Swim. That you should not participate in sports goes without saying, but I’ll say it anyway. And find as many stiff soled shoes as you can and wear them as often as you can. Consider getting carbon fiber insoles for lace up shoes, like tennis shoes. It will stiffen them up. Can’t use them on slip on shoes. Don’t wear backless shoes…ever. Right…no flip flops.
      I like wearing the stiff soled shoes on both feet because it evens out my gait. When you limp, for whatever reason, you’re more likely to suffer from hip bursitis. As far as that simple, benign condition (hip bursitis) is concerned? My instructions to you would be no different than for anyone. Read the blog and the responses to others on this line. You’ve got to continue to tackle the foot problem a little more.

  10. Carrie May 24, 2014 at 5:01 pm #

    Thanks so much for your reply. I appreciate you taking the time to address my issues. I’m glad to hear someone else not recommend a fusion as this is my last resort and hope to not have to expire it for many years. I’m also glad to hear the bursitis won’t be lifelong- at this point with my toe issues, that’s hard to believe. I need to do a better job with stiff shoes and appreciate the reminder. Too bad I’m spending $150 on ugly clogs instead of cute heels. 😉

  11. Donna June 9, 2014 at 7:54 am #

    I have had bursitis of the hips for 3 years. I was diagnosed 3 years ago. I have had physical therapy and have had injections. The physical therapy helped me for a short time and the injections seems to help me the first few injections that I got but the last one seemed to wear off about a month after I got it. My doctor told me since the injections don’t seem to be helping me that the next step would be to have a procedure done where the doctor takes your blood out and spins the proteins in it and puts it back in your body. I used to walk 3 miles a day and I am a very fast walker just on a daily basis. I never walk slow. I used to wear flip flops all the time I am flat footed. I started getting heel spurs and they went away when I stopped wearing the flip flops. My pain is in my right back side of my butt and on both sides of my hips and down both of my thighs. I can’t sleep at night I flip flop from my left to my right side all night it seems like. If I do too much walking I am in extreme pain including lower back pain. When I get up from a chair or get out of a car I am so stiff and I limp when I walk until I have walked a few steps. You said that when you push on the hips it should be tender to have bursitis of the hips. My hips aren’t tender to push on them but the sides of my thighs are very tender. I have become overweight since I developed this problem. I am only 5 ft. 2 inches tall and weigh 213. Three years ago my weight was 146. Do you think I have been misdiagnosed? This medical problem is causing me to be depressed and consuming my life right now. I would appreciate any suggestions.

  12. Barbara June 9, 2014 at 6:59 pm #

    Donna,
    Your history is a little complicated, and while on the surface it sounds like you might have a component of hip bursitis, if there’s no tenderness directly over the lateral aspect of your hips (over the area of the greater trochanter), then it’s unlikely you have greater trochanteric bursitis, which is the traditional form of bursitis. It’s the area to which we refer when we speak of hip bursitis. Now there are some other bursae around the back side of the greater trochanter. So determining if you have bursitis involving one of these more obscure bursae would be paramount, because if you inject the greater trochanteric bursa and it doesn’t get better, that would be a consideration. Nonetheless, you did have some relief at one point, and even the most recent injection helped transiently, so that in and of itself speaks to the probability that you at least have some component of greater trochanteric bursitis.
    Occasionally, I have patients tell me they are not tender laterally, but when I go poking around over there…they are tender. Many are surprised because they say that is definitely the pain they are experiencing, but they just hadn’t realized that it was that spot.
    But honestly it does sound like you might have a more complicated problem going on. At the minimum you have some iliotibial band pain (the pain radiating down the side of your thighs). But worse, you might be experiencing problems arising from your back, and I would certainly consider looking into that before considering other treatments.
    Regarding the PRP treatment, I probably wouldn’t consider that if the cortisone injection doesn’t help. But it might work if you truly got some temporary relief from the last injection. If I’m not sounding committed to my recommendations, it’s simply because your problem sounds complicated. Frankly I think it’s time for a second opinion. Look into the possibility that it might be related to your back. I have a couple of partners who do arthroscopic hip bursectomies. If any patient referred to them for that surgery even hints of radiating pain down their leg, they will first want them worked up for back related pain. It goes without saying that it would be frustrating to do (or have) an operation, only to have the patient wake up with the same pain and later find out they had a herniated disc. It is not uncommon for patients to suffer from two or even three of the common causes of “hip” pain: bursitis, arthritis and sciatica. Time to get it checked out.

    • K Williams June 10, 2014 at 10:27 am #

      Hey there Donna. I too had a very similar issue as you. It took a long time to figure out the origin of the pain. It turned out my back was involved (I believe there were other components too but my back was a large part of the problem, I think!). I had prolotherapy treatment on my hip and lower back (similar to PRP) and it resolved almost 100% of my pain. It was a miracle cure for me. I hope you figure it out. I just know that I was skeptical of the prolotherapy route and it turned out to be my saving grace. God Bless! I SO feel your pain. 🙁

  13. drbarbarabergin June 11, 2014 at 3:05 pm #

    In many areas insurance companies don’t pay for prolotherapy. So if your insurance doesn’t pay for it, then it can get expensive. So I don’t prescribe it, but I think it’s harmless and if it helps, then that would be great.

  14. Sarah June 25, 2014 at 1:48 am #

    Hi there

    This is so helpful – and easy to read which is always good 😀

    I am fed up with being injured to be honest! I have been running (well walking very fast with my feet leaving the ground..) for about a year now and can do around 6 miles on a good day (smug). However, I am also 50 🙁 – recently. In the past three months I have had a very painful IT problem on my left leg, which stopped me running for a few weeks, and now I have this stupid hip pain on the opposite side It is exactly as you describe, painful when I touch it, can’t sleep on it,. can’t cross my legs. So, I have stopped running but started doing some slow stuff on my cross trainer. I also cycle 4 miles a day to work and back.

    Is this going to help?? I really don’t think I need to see my GP – I saw him for the IT and he gave me exercises and recommended pain killers, which was fine.

    Basically, will it go away?? I miss running so much

    • Barbara June 25, 2014 at 10:40 am #

      Sarah,
      Just today one of my patients told me her primary care physician told her that aches and pains were like birthday presents. You had to have a birthday in order to get a present! I love this quote and I’m going to use it instead of my old stand by: Pain and suffering are life’s way of telling you you’re still alive.
      Don’t worry, along with that statement, I still try to help my patients get better. But adult repetitive strain disorders are here to stay. You have one of them. Greater trochanteric hip bursitis or its uglier sibling: gluteal tendon tears or tendinosis. As I’ve said in previous responses to queries regarding this condition, it is self-limited. It will eventually get better in most cases. But it could take years!
      Sit like a man. Don’t stand with your hip cocked to one side (as if you were carrying something heavy on your hip). Get in and out of chairs like a man (legs apart to the 11 and 1 o’clock position). Don’t cross your legs. Get a memory foam mattress topper. Do your iliotibial band stretches. And last but not least, stop exercising so much. I think you’re just doing to much and our poorly evolved bodies are just not equipped to take it. Certainly do nothing which actually causes pain while you’re doing it. I don’t know you and I don’t know your body, but for the most part, most of us gals aren’t put together for long distance running. When you start to hurt while running, that’s usually a pretty good sign that this is the case. Make sure your shoes are the right shoes for you. Make sure the running surface is a good surface for running. If these are all a go…and you’re still having pain, then stop running. It will probably get better, but it could take months.
      I know this isn’t what you want to hear. And I don’t just tell patients these things to upset them, or just because I feel like it. I base this on thirty years of studying and practicing medicine!

      Get better!

  15. Sarah June 26, 2014 at 5:50 am #

    Thank you! Grr, old age 😀

    Sarah

  16. Reana July 5, 2014 at 8:14 pm #

    Thank you for your blog. I’ve had hip bursitis/IT band syndrome and hip snapping for almost 5 months. I’ve had 1 cortisone shot, PT and anti inflammatory pills. Nothing is helping. I’m a healthy 27 y/o female. It has been a frustrating process to say the least! My doctors don’t have much to say on the issue so I appreciate your website.

    • Barbara July 13, 2014 at 10:29 am #

      Reana,
      This is a very frustrating condition, and even though I have a lot of ideas regarding its’ treatment, sadly I also have many patients with whom I have not had total success. Be sure to read my blog entry as well as my responses to the comments many sufferers of this condition have sent to me. I add a few ideas and recommendations in there too. Next, remember to persevere. This condition can take a year to resolve…maybe even more! But also remember that it IS self limited. Lastly, don’t assume your condition is greater trochanteric bursitis, particularly if you are not responding at all to traditional treatment. You should get at least a little relief, even if temporary! If that is not the case, then consider an alternate diagnosis; sciatica, piriformis syndrome, gluteal tendon tears, and inflammation of other, less common bursae.

      • Reana July 21, 2014 at 1:08 pm #

        I really appreciate your website and response..and I appreciate you! 1 additional cortisone shot later and nothing is helping. Over 5 months with the “bursitis”. Many female co-workers of mine has had hip bursitis and one highly recommends massage therapy (nuero musular/trigger point massage therapy) over and around the affected area and all the way around the hip (front and back) & IT band. I had my first session last week and WOW this is the best it has felt in 5 months. Big pain relief and the muscles don’t feel tight anymore. It was recommended to eat 1/2 cup of pineapple every day as it is a natural anti-inflammatory. I have another few appointments with the massage therapist and I’m hoping it will continue to improve the pain. I haven’t had an MRI yet (just X-ray by orthopedist) but I’m thinking I might get one if it continues over the next few months. Thanks again.

  17. Violet July 19, 2014 at 3:30 am #

    Hi!

    Three years ago I slept on the wet floor at work.My leg and hip was really bruised even the first aider was shocked how bad it looked! I could not sleep on that side at all for several weeks. I went to see a doctor and I have been told that is bursitis! I fill the pain goes down to my knee as well! I was only 26 when it happend! I was working in a restaurant when I had the accident and I cant do the job anymore, as my leg really hurts after all day my feet! My employer dismissed me from work but they admitted liability
    I am really upset that that I cant have my life back as I live now in pain because of silly fall.

  18. violet July 21, 2014 at 10:37 am #

    Hello again!

    I posted my concerns before about my injury but It disappeared..Can ask some advise please…

    • Barbara July 21, 2014 at 12:52 pm #

      Violet,
      I’ve been out of town and very busy. I don’t keep up with the blog on a daily basis. I’m going to submit your question to the blog, but here’s my reply. You have a complicated, and unfortunate situation. If you haven’t found any help in my blog about greater trochanteric bursitis and in my answers to other questions, then there might not be much else I can do for you. You really need to find a doc who will spend some time with you on this problem. Usually this condition will resolve eventually, although I have had a few patients suffer with this for a few years. You’re getting on the long side of reasonable! When you introduce the workers compensation issue, then it’s a whole ‘nutha issue. You may need more work up. There might be something else going on, but I can’t tell you the answer to that from afar. Sorry.

  19. Violet July 22, 2014 at 1:01 am #

    Thank you for reply!

    The pain is really especially when the weather is van and raining! Here in England the weather always wet! The winter for me is nightmare. When I go to spain to a nice hot place I feel just a tiny pain. I cant understand why.

  20. Elizabeth September 26, 2014 at 5:38 am #

    Hi, I was wondering if I can get back on my treadmill or will this cause more pain? I really miss working out..can you recommend a exercise machine that will not make my pain worse?
    Thanks!

    • Barbara September 26, 2014 at 10:50 am #

      Off the cuff, I would say that if all you have wrong with you is greater trochanteric bursitis (GTB), it’s okay to get back on the treadmill. However, sometimes treadmills are responsible for the onset of GTB. Note that treadmill walking, while better than no walking at all, is not natural walking. I’ve heard that if you just go up to the first inclination, it is more like human walking. Nonetheless, it’s not the same. So my recommendation would be that you walk slowly and don’t put the inclination any higher than the first increment. Walk with a natural gait. Do not turn up the speed. Power walking definitely aggravates GTB. So no power walking. So if you can live with those restrictions, I think you’ll do okay. It goes without saying…but I’ll say it anyway…if it hurts…don’t do it.

  21. Reana September 26, 2014 at 11:47 am #

    Elizabeth & Dr. B,
    I’ve had bursitis pain for 8 months now and for me walking on level flat surfaces is great. Keep in mind I also have IT band syndrome and hip snapping as well along with the bursitis- a few things going on. Walking regularly (not fast walking) actually has really helped with the pain. I feel like when I’m up on my feet (WEARING TENNIS SHOES WITH SUPPORT – important) my hip feels a lot better than when I sit or lay down all day. The trick is the right shoes. Walking around with shoes with zero support is BAD news for my hip. Normal pace walking seems to be the best thing in my case. My physical therapist said LONG/BIG strides (steps), but I’m not sure why. Dr. B – any insight on that?

    For me, being in very cold weather helps my hip. Maybe because it’s as if the hip is being iced? Heat also feels like temporarily. They both work for me temporarily. Dr. B – is it best to use hot or cold at a certain time of day?

    I feel like everyone is different and like Dr. Bergin said – if something hurts, stop, and try something else. I’ve tried swimming but this aggravated the hip because I kicked my legs too hard and tweaked the hip a bit. I’m sure slow and steady swimming might work, but I’m just not into swimming. I can also play 9 easy holes of golf (on FLAT courses) but do not carry your bag (use a pull cart). I only play when my hip is having a good week. I’m also trying a yoga class next month. I searched for yoga videos on You Tube and found some that had some really amazing stretches for opening up the hips. These stretches worked so much better than the ones provided by my physical therapist and online. I notice a big difference when I do these leg/hip stretches and walk everyday. I also tried hip massages. They are painful but they REALLY helped alleviate the pain for 5 days at a time. But I couldn’t keep it up financially. For me it’s great if I am going to be on a trip and I want the hip to feel somewhat normal for a short period of time.

    I would try things and see what works best for you. I appreciate anyone sharing their favorite exercises that don’t aggravate the hip because I could use more ideas. This is the most challenging thing for me because I am young (28) and was in several several adult sports leagues and very active playing sports with friends and my husband on the weekends. I’m not a runner/jogger, but I do miss the sports and hiking. It has been a difficult adjustment. Thanks everyone.

    • Barbara September 30, 2014 at 3:33 pm #

      Reana,
      Thanks for your comments and recommendations. This kind of dialog is always beneficial. This is such a frustrating condition. I know that just hearing what works for someone else helps.
      blb

  22. Viorica Bretan September 28, 2014 at 1:33 am #

    Dear Barbara
    2
    I have been seen by specialist in Musculoskeletal Ultrasound as I fell on my hip. My hip was really bruised and I had lot of pain. I went to see a doctor.

    The diagnose as follows: Calcification area in the gluteus medius, very probably post-traumatic, approximately 2.5 cm associated with discrete bursitis of the gluteus medius.

    It is good or bad news? I cant understand what she tried to tell me..Could you explain me please.
    I really appreciate it.

    hank you

    • Barbara September 30, 2014 at 3:30 pm #

      I should always start with a disclaimer: I haven’t seen your X-rays or your ultrasound, so I can’t be certain about your diagnosis, but if you fell on your hip and they are diagnosing post-traumatic calcification of your hip, then it is likely you have something like myositis ossificans (MO). This is a condition which causes soft tissue calcifications after sustaining some bleeding into your soft tissues. There are some situations/conditions which predispose people to developing MO, rather than just suffering a bruise. Nevertheless, it’s usually a self-limited condition and eventually it should stabilize and stop hurting. Surgery is usually not an option. It does not have to be removed. In a way, a simple case of soft tissue calcification might be better than hip bursitis. You’ll probably heal and eventually the condition will stabilize or resolve, whereas hip bursitis, as you can see from all these emails, can just drag on and on.

  23. Viorica Bretan October 2, 2014 at 1:26 am #

    thank you for your response!

    I have the results of the xray as well. The diagnose is Coxarthrosis. I am only 29 years old I should not get it. The doctor told me that a trauma can cause Coxartrosis and is age related. Is that true? Thank you

  24. Cindy October 20, 2014 at 4:40 pm #

    Dr. Bergin,
    I have had this issue for about 5 years. I am 47 years old. I have seen 3 rheumatologists, an orthopedic and 2 general practitioners. 2 of the three rheumatologists have said I have hip bursitis in both hips. They have given me cortisone shots that have helped very little. They relieve the pain for a small time and then its back. The orthopedic simply told me to lose weight. I did. I lost 50 pds with no change in the hip pain. Everything I have read says it will eventually go away. This has been 5 very painful years. The lack of sleep, having to limit my physical participation in family outings, and trying to treat myself from the time I get in from work until bed time is beginning to really wear thin. The job I do requires walking and standing quiet a bit. Standing seems to hurt the worse. I do remind myself to sit whenever I can. I do the stretches you have advised, use Ibuprofen, heat and ice. The only other thing my Dr. has offered me are pain pills. I do not want use them on a regular basis. I have used them at night when it becomes unbearable but I can not use them during the day. I saw a video of myself walking a couple days ago, and I appear to be limping and rolling my hips. Sometimes the pain is so bad it radiates to my knee. I limp badly on those days and sometimes do not know if I can make it to a chair to sit down. I am thinking of going to a chiropractor. What is your opinion?

    • Barbara October 21, 2014 at 10:23 am #

      Cindy,
      So when I see people who’s “hip bursitis” has lasted for more than a year or two, I start thinking of other sources of pain: the back, other more uncommonly painful bursae around the hip, and gluteal tendon tears, to name some. You should see someone who is willing to delve into this a little more. Do you live near Austin, Texas? Ha!
      Also, don’t forget to SLAM (sit like a man), and don’t stand around in that position women so often assume: hip cocked out to the side to take pressure off the other leg, like when we hold a baby on our hip.
      Other than that, I have nothing more to tell you via a blog. Find another doc to dig into this more. Sometimes PM&R docs will do this, because they can stick some needles into those other bursae.
      Take care,
      blb

      • Cindy October 23, 2014 at 3:56 am #

        Thanks,
        I have been thinking about changing. Unfortunately, I live in a rural area and already drive 2 hrs to see the Dr. I have. I did have x-rays and a MRI done when this first started and they didn’t show anything with my back. One rheumatologist (the first one I saw) told me he thought it was the ligaments and tendons-not bursitis. He actually gave me shots in my thighs that helped me for more that 6 months. Then he retired. (Boo) I think he may have been on to something. Thanks for understanding the frustration and pain-not too many seem to know how painful this can be.

  25. Barbara October 23, 2014 at 9:39 am #

    It does sound like your doc was on the right track. Sorry he had to retire. I would love to live out in the country, but it does put you far away from those who could help you. Hang in there.

  26. Caroline November 17, 2014 at 12:34 pm #

    Hello,

    Thanks for an informative blog! I’m 56, just had my 2nd cortisone injection for troch bursitis in 6 months, also undergoing acupuncture. For someone who’s accustomed to being VERY active, all of this “resting up” is almost a death sentence! Starting yet another round of PT tomorrow, will swear off all cardio for 4 weeks, but will continue my core and upper body strength training regimens.

    As you said in an earlier post, you cannot assume that swimming, which is considered a more “gentle” exercise, will be tolerable for someone with bursitis! I’ve tried almost every form of cardio there is, even rowing, and they ALL involve the hip, directly or indirectly. The other frustrating thing has been that the activity does not necessarily hurt while I’m doing it; i’m guessing that the endorphins that are generated are working to buffer the pain, while I’m exercising. It’s only the next day that I realize I’ve overdone it.

    An added complication: I’m a kidney donor, therefore am advised by my doctor not to take NSAIDS so as to protect my remaining kidney. My only options are cortisone, rest, acupuncture and PT. I like what you said about examining a particular way you might be sitting or standing, and I’ll certainly be looking into the extra cushions i’m loading onto my LazyBoy chair, and if they’re really necessary. I also know that having a desk job does not help.

    So, so frustrating! Why can’t all the couch potatoes suffer from this, and let those of us who want to be active be pain free!!?

    • Caroline November 17, 2014 at 12:54 pm #

      Something I forgot to mention. For the past 3 years, I’ve suffered from a skin condition called morphea, which is localized scleraderma. It’s rare, and not enough is known about it to be able to offer successful treatment. It causes extra collagen to form on parts of the body (especially on my hips), and the orthopedist suggested to me that since this is an inflammatory condition, it could be one reason why the bursitis eventually returns. I’ve modified my diet and have eliminated gluten and dairy, and have noticed that the lesions no longer ache, so I think that’s a good thing. But, since this is more of an aesthetic issue than anything else and most of the lesions are on my torso, it’s not a big deal for me. That is, UNLESS it has something to do with recurrent bursistis; I made a concious decision not to try any of the experimental treatments for morphea (methotrexate, cellcept, malaria meds), instead trying to deal with it by changing my diet. I did have 2 rounds of UVA and UVB light therapy, which did nothing for the appearance of the lesions, yet stopped their aching (which my dietary changes are doing, anyway).

      Whew, sorry for a such a long, rambling post… i guess it’s obvious that i’m frustrated!

      • Barbara November 17, 2014 at 4:34 pm #

        Caroline,
        In my professional experience, I see women of all sizes and shapes, active and sedentary jobs and lifestyles, and all measures of healthiness, suffer from great trochanteric bursitis. As I have said before, it is simply one of the scourges of a long, womanly life. So in all honesty, I cannot blame morphea, your job or your activity level for this.
        Let me give you a personal account. I have not suffered from bursitis for about 15 years, and suddenly a recent change in a routine has resulted in the recurrence of this disease. About two months ago I came down with a particularly bad case of diverticulitis, for which I had to take a long course of antibiotics. While I was still experiencing abdominal pain, I took to leaning on a counter top at work, simply because standing up straight was painful. Within days of this, I began experiencing bursitic pain in my right hip, which is the hip which kind of juts out when leaning on my clinic counter top in this fashion. I quickly realized the association, and stopped standing like that. I also noted the pain was worse when I walked fast and “purposefully,” (in other words, if I rushed down a hallway, or walked fast for exercise). I noted that if I slowed down and stood up straight, the pain diminished, and now, about a month after the onset of hip pain, it has nearly completely resolved. I can say firstly, that it is truly a blessing to be an orthopedic surgeon, and able to recognize and start trying to treat a musculoskeletal pain the moment it starts. That is of course, no consolation to you. However, I can then say there clearly was a mechanical cause to my pain, which resolved by addressing the mechanical issues. I am still walking for exercise, but refuse to walk quickly. Remember, one burns essentially the same number of calories when walking as compared to running. I refuse to walk fast. If I’m walking with someone who wishes to power walk, I just let them go on ahead. When I walk slowly, I can stand up straight, extend my back and adjust my gait so that it is painless. Not so when power walking. And I haven’t taken a single pill.
        Now once bursitis has set in, it will take much longer for it to go away, but you must persevere. Attributing it to jobs (unless it is a job which alters the mechanics of your gait), or other conditions (other than those which would alter the mechanics of your gait…and I’m talking down to even a little ingrown toenail), is to ignore the root cause of the condition and simply delays recovery.
        A few quick suggestions. Slow down. Stand up straight. Get in and out of chairs like a man. Don’t jump up from a seated position, rotating on your hip to turn directions. Make that turn slowly. If you’re overweight to the point that the size of your thighs alters your gait, then lose weight…by eating less, not necessarily by exercising more. And last but not least, have patience with your body’s ability to heal.

        • Caroline February 3, 2015 at 11:28 am #

          I thought I would post an update for your information, and for the benefit of others here.

          Inflammation in my hip and piriformis muscle (in the butt) was confirmed by MRI. You were right about resting. I laid off all cardio for 4 weeks, and started back VERY conservatively, i.e., swimming, biking, ellipting, but beginning only 10 minutes at a time, and icing the hip afterwards. I can now do my usual 40 minute workout, but my hip tells me when I’ve overdone it!

          I also saw an osteopath, who gave me a little exercise to do whereby I hold one of those rectangular, soft-ish yoga blocks between my thighs, squeeze gently while pulling up and in with my abs. At the same time, I push the balls of my feet into the floor, and splay my toes apart. I hold these for about 30 seconds, and do a few times a day, both at home and at work. This is to encourage me to concentrate less weight on the outer edges of my feet, which is where I strike hardest when walking. I don’t know why, but this has really helped!

          I also do my series of hip and piriformis stretches once or twice a day. These things have made a world of difference! Side note: acupuncture did not help me at all.

          I wish all of you who are suffering have as positive results as I’ve had!

  27. leslie December 3, 2014 at 11:22 pm #

    Ihave rt side trochanteric bursitis again after failing conservative tx had bursectomy 5 yrs ago, well its back worse than ever. nsaids don’t help
    cpmpounded with ulcerative colitis they actually sent me to er for gi issues. had injection today, why does it keep coming back. at this pt amputation seems like a blessing can’t sleep more than 2 hrs with multiple meds. pain is off the charts.
    thank you for being here
    leslie

    • Barbara December 5, 2014 at 10:12 am #

      Leslie,
      That is a really disappointing history. I don’t actually perform that operation, but one of my partners does, and usually patients do pretty well. One thing he always wants, before performing the surgery, is to make sure there are no other sources of the pain. He wants to be sure there is no spinal cause for the pain, like a herniated disc. He wants to make sure that the hip joint itself is not a source of the pain: the labrum or arthritis. And finally, that there is no other peritrochanteric source of pain, like a degenerative tear of the gluteal tendon. Greater trochanteric bursitis is often associated with other conditions in the same area, tendonitis or tendonosis being one. Women are more commonly afflicted with GTB as well as degenerative tears of the gluteal tendon. Unfortunately there is not much which can be done about that, but it can result in a frustrating persistence in the pain following a surgery which should help pure GTB. Otherwise, you’re back to square one. Read my blog and read some of the responses to other questions regarding this very frustrating, and painful condition. I’m sorry you are suffering again.

  28. Fiona January 18, 2015 at 10:23 am #

    I am reading your blog in the middle of the night as I am again awake due to the pain of trochanteric bursitis. I am finding all your comments very helpful…and hopeful, when you say it will eventually get better!
    I have had this bout of bursitis for over 6 months now and I am definitely aware that climbing up and down stairs aggravates my hip, BUT I live in a 3 storey house, which we built, so will not be moving any time soon. Can you suggest the best way to do stairs? I have tried stepping up and down one at a time, going up and down on my bottom, and am now considering getting crutches. I do limit how many times I use the stairs but can’t avoid them. Any help would be appreciated!

    • Barbara January 19, 2015 at 6:00 pm #

      Fiona,
      I keep saying I’m going to do another blog on stairs. The first one was just about stair safety. But I need to do another one with just a little more information. One of these days…
      Firstly, let me say to all, just in case anyone else is reading these comments…I would like for all my readers to avoid 2 story homes where there is no downstairs bedroom. Okay, I said it. Now we can move on with what to do when that’s not an option. You say you are limiting the amount of stair climbing you do, but are you doing everything you can do to avoid them? Keep a toothbrush, hair brush, deodorant, or any other item which might cause you to have to make a trip upstairs, in the downstairs parlor bathroom. I would even go so far as to keep a set of your evening comfy clothes downstairs. Keep your jogging outfit and shoes downstairs. You get the picture. Truly, avoid stairs. I know many will say that stairs are good for you and increases the amount of exercise you do. But frankly, in many of us the risk outweighs the benefits. So just avoid them.
      So now that you’re down to the bare necessities in terms of climbing stairs, when you have to, climb them like a man. Stand at the top of a busy staircase and watch men and women coming up the stairs. Men will have their hips rotated outward so that their knees are pointed to 10:00 and 1:00. Women will be turning their hips and knees inward. It’s more lady-like, and it’s how we have trained our legs to move in this situation. So just like with sitting…sit like a man (SLAM) and take stairs like a man (no catchy acronym for that one).
      And use the banister, not just as a balancing and safety measure, but use it to help push or pull yourself up the stairs. Every little bit helps.
      Hope this helps you.
      In order to illustrate the direct association of GTB with the mechanics of your lower extremities, let me tell you of a recent experience of mine. Over the past several months I have had a couple of scrapes with diverticulitis. It took me a while to get over it, and I found myself leaning on a counter at the working area of my clinic. So when I was reviewing notes, etc. in my computer I was bent over a little in order to lessen the pain in my abdomen. I didn’t think anything of it at the time. Sometime afterward, I began experiencing hip bursitis again! Imagine my anguish! This condition sucks (for lack of a better word to describe it). But within a day of its onset, I began to focus on what I might be doing to promote its reemergence, recalling that it took me nearly a year to get over it the first go round. I quickly recognized that I noticed it while I was leaning on that counter top! I immediately ceased this behavior, and tolerated the abdominal pain, because I’d much rather have a sigmoid colectomy than suffer from greater trochanteric bursitis! Within a couple of weeks, the bursitis was gone! Well, one of the advantages of being an orthopod is that I can recognize and diagnose, and then quickly treat my own musculoskeletal conditions. Wish it were so for everyone.
      But the bottom line for you is, change every pain causing behavior you can, in order to diminish the pain. If it hurts at night, get a 3 inch mattress topper. Put a pillow between your legs. If certain activities are painful, stop doing them to the best of your ability.
      Best to you on this one. Hope this helps.

  29. leslie January 20, 2015 at 11:18 am #

    unfortunatelymy bursitis is on year six. have had two injections in two months with some relief -area reduced for a short period then back o ful blown. PT recommended that I start geting up and out of chairs like an eighty year old man, usin my arms and not using my legs at all. I am still pretty much confined to bed. no walking no sittin and no better. I think the pt was wrong as I have not been using my legs and have actually lost 20 lbs of muscle mass. This cannot be good for a 50 yr old woman. There has to be a better solution

  30. Barbara Bergin January 20, 2015 at 7:45 pm #

    Leslie,
    I really can’t remember a case like yours. I’m not so sure it’s just bursitis. It’s rare to see someone become bed ridden and to lose muscle mass from that condition. Hopefully your docs are looking into other potential sources of your pain. If not, please try to find someone who will investigate a little further.

  31. Fiona Cole January 26, 2015 at 9:10 pm #

    Thank you so much for all your advice and encouragement….I now sit, walk and climb stairs much more “like a man” and I can feel it NOT hurting!
    I have had GTB now for nearly a year and it has been very life-limiting; cortisone injections and even a month long course of steroids have not helped at all, so I was despairing of ever walking normally, without pain, again.
    BUT I do have some good news. In desperation I clicked on an ad for something that said it would help inflammatory conditions like bursitis, and I even ordered the product. Now, I am NOT employed by this firm, neither do I know anyone connected with them, but I have to say that a ten day course of his natural product, which employs the body’s own osmotic processes has helped me more than anything my doctor prescribed. I hesitate to use the word “miraculous”, but I now feel %70 better than I did before using this product. I will stop there….I know I can’t name it here, but do feel it is a wonderful new addition to the treatment of bursitis armoury. I am about to start my second ten day course, and have very expectation that I will experience even more improvement.
    I won’t name the product here, but perhaps I can email you the website? It has been developed by a doctor, here in Australia, in response to his own experience with bursitis and the website has a very good video which explains the science.
    Enough….if this is not appropriate here, I very much apologise, but hope you will look into this.

    • Barbara January 27, 2015 at 4:21 am #

      Fiona,
      You can go ahead and mention the product name on this site. I tried to email you but it came back “undeliverable.” When you send the comment, I’ll check it out, and if I feel it’s something I want to share with my followers, I’ll approve it. I do appreciate your respectful concern over passing on product endorsements.

    • Jessica May 4, 2015 at 4:38 pm #

      Fiona,

      Could you please tell me the name of the product you are using? I have had bursits in both hips for 3 years. I have tried so many things with only limited success. The best I have found is Hyland’s Muscle Therepy gel with Arnica. It is wonderful but I have to use it several times per day every day.

      Thank you!
      Jessica

      • Barbara May 7, 2015 at 2:11 pm #

        Jessica,
        I hope Fiona is paying attention! Otherwise we won’t be able to figure out the name of that product.

        • donnafreem June 18, 2015 at 9:10 am #

          Please let me know WHAT the name of the product from Australia that the woman mentioned but would not name the product name….and if you could please also post whether you feel it’s an effective product, that would be great also. Love your website, Barbara.

          • Barbara June 18, 2015 at 8:20 pm #

            Sorry I can’t get that information for you. I’d have to look through all the commentary on hip bursitis. It’s been my most popular blog series and literally tons of folks have responded with comments and questions. If you really want it, just go to all the comments at the end of each “hip bursitis” blog and look for the one which mentions the product. I recall that I did not and could not endorse the product or speak to its efficacy, mainly because I wasn’t sure it could work. There is certainly no evidence of efficacy, other than an anecdotal endorsement. Probably wouldn’t hurt you to try it.
            Thanks for checking out my blog. Hope it helps you. If it does…pass it on to your friends and family, please!

  32. Nalan January 29, 2015 at 1:21 pm #

    Hi
    I have started having hip pain mid December 14. I went to my GP and was referred for an x ray. The x ray showed that I had problems with my hip bones. The GP said ‘your bones are damaged.’ I was referred to hospital orthopedic department.
    I am a reception class teacher. I am very active all day long. I was given 1 week sick note before Christmas holidays – I did not use the sick note it was 4 days before the holidays. I went to work.
    Over the holiday I felt generally unwell. Lay in bed for a week. The pain got worse. After Christmas holidays. I went back to school for inset day. The second day I was in so much pain I left school at lunch time. Called the doctor they said – we have referred you to hospital. There is nothing else we can do. you have to wait.
    I called again I was in so much agony the GP said what do you want me to do for you. I asked him to check for trapped nerve. He sent me for another x ray from my back. Which showed everything normal.
    In the mean time I went to local urgent care centre twice. I was given 2 cruches. It had become very painful to walk.
    We spoke to another GP who we knew as a friend and he suggested we go to Turkey (I originate from Turkey) to get my condition diagnosed. He helped us book an appointment. We went to Turkey for 3 days. I saw an orthopedist he looked at the x ray and said hip bones were not that bad to cause so much pain. He asked where the pain was. He then explained it was nothing to do with hip bones. It was trochenteric bursitis. He gave me a shot. I went into the hospital limping and came out walking. I suffered the pain for over a month.
    I am off work with my 3rd sick note at the moment. I don”t like staying at home. But even within the house if I move quiet a bit I feel the pain coming back (not as strong as it was before the shot). I try to rest as much as possible. I have 2 small children I attend to all their needs.
    I have a hospital appointment in 2 weeks time. I am just hoping the pain will not come back. I am using anti inflammation tablets ans an anti inflammation creme followed by an ice pack held in the area 20 mins each time.
    But I find it annoying when I asked gp to check other option he said unless you hip problem is sorted we will not look at any other options.
    Now when I go to see the doctor at the hospital I will get told off for going to Turkey for treatment.
    Sorry to have written so long but There must be a quicker way to diagnose conditions faster so people suffer less./ shorter periods of time.
    My questin is I am reffered for hop bones. Would they look at my bursitis??
    Thanks
    Nalan

    • Barbara February 3, 2015 at 3:50 pm #

      Nalan,
      Your comment is very extensive and your condition sounds complicated. It’s a little above and beyond my ability to address through my blog. But a couple of thoughts come to mind.
      I agree with the doc who said that usually hip bursitis is not severe enough to land patients in the hospital. It does make one wonder if there isn’t some other underlying condition. Keep searching.
      Most doctors who see hip pain, or any pain for that matter, are capable of addressing and diagnosing hip bursitis. But frankly, it’s a very specific diagnosis, with a specific sign (tenderness over the lateral aspect of the hip) and a specific symptom (pain over the lateral side of the hip). I have never had to use an MRI to diagnose hip bursitis, although occasionally it shows up on an MRI. I usually use MRI scans to rule out other sources of pain, such as labral or gluteal tears. So hip bursitis should never take a long time to diagnose. I DOES however, take a long time to treat and get well. If you really feel you have bursitis, you must look to my blog and to the other comments on the blog to see what you can do. Otherwise, seek a doctor who can really break down and isolate the different symptoms you have in your hip, and thereby figure out the source or sources of your pain. I have had patients with two or three different causes of hip pain: back, bursitis, hip joint.
      I don’t know what to tell you about going to Turkey. My guess is that if you’re coming from a country in which you have a socialized system of medicine, you might not feel as though you’re able to get the kind of attention you want. Docs in those countries just won’t get paid for spending a lot of time with you on a complicated problem, whereas if you go somewhere where the doctors are getting paid for the time they spend with you, they might be more interested in seeking out the source for your pain. Turkey might be just that kind of place, but I certainly can’t say for sure. I have had a few patients come here from Turkey with medical records, and the docs seem very thorough.
      Good luck.

  33. Pat February 21, 2015 at 2:42 pm #

    I have had GTB for going on 4 years. At first I didn’t treat it at all and the doctor didn’t seem particularly concerned. It presented as tingling in both hips–more in the left than the right. Last June I moved from a 2 story house to a senior housing apartment. Better, right? However in the process o the move, I experienced more hip pain and it extended down into my thighs. The doctor did prescribe prednisone which got rid of the pain quickly, but it came back eventually. Due to the good advice on your blog, I have started taking Aleve regularly, not just some of the time. One of the best remedies I have tried is Thai massage, which is available here in the Midwest. It lasts for several weeks and then the pain starts again. I am also taking a yoga class for 55+ (I’m 81). It is extremely encouraging to learn it is a self-limiting condition. I am now going to SLAM all the time, and no more stairs. Thanks Barbara, for your wonderful blog and the answers you give. It has given me new hope.

    Can you say some more about mattresses in general? My husband and I are in the market for a new one, not just a mattress topper.

    • Barbara February 22, 2015 at 8:42 am #

      Pat,
      I’m so glad you got some benefits from reading my blog.
      Regarding mattresses, you should buy the best quality you can afford. Advising you on mattresses is a little like advising you on the type of jeans you should wear. It’s very personal. But I can give you some advice, based on personal and professional experience. My personal preference is a firm mattress with a nice, fat pillow top or memory foam top. This is what many of my patients like as well. I have some patients who like a full memory foam mattress, like the Tempurpedic brand. Others cannot tolerate them. I also have many patients who like the “Sleep Number” mattress. I have not used either one, so I can’t comment personally on these. When choosing mattresses, please be prepared to spend some quality time looking for one. Don’t just plop down on the showroom samples and go “that feels pretty good…when can you deliver it?”
      I want to make a couple of additional statements in response to your comment. Firstly, I’m a little concerned regarding the symptom of “tingling.” GTB usually doesn’t cause tingling. Now your definition of tingling and mine might be different. But to me, tingling might be close to numbness, which might indicate something coming from the back, instead of directly from the greater trochanter. So just make sure we’re not talking about sciatica rather than GTB.
      Secondly, I’m not sure I want you taking Aleve every day for the rest of your life. Aleve and Advil are both non-steroidal anti-inflammatories (NSAIDs), with all the potential risks and complications of taking the full prescription form of any of the NSAIDs, even though they’re over-the-counter. To name a few potential issues, they can be associated with stomach ulcers, liver and kidney disease. They should also not be taken by anyone on blood thinners. And people with allergies to aspirin or prescription NSAIDs should never take OTC NSAIDs. So be careful taking any OTC medication. Even though the companies producing them give low dosage recommendations and warnings, they’re not without the potential for complications associated with their use. Also make sure you’re not taking similar prescription medications. Many folks your age are taking blood thinners and prescription anti-inflammatories (Celebrex, meloxicam), as well as other medications which are metabolized in the liver and kidneys.
      Thanks for reading my blog. Sorry I’ve not been as active on it as previously. I’ve got other irons in the fire right now, but plan to get back to it in a couple of months. I’ll also be getting back to work on my novels! Right brain is resting right now.

  34. Fiona Cole February 22, 2015 at 10:42 pm #

    I would also like to reiterate my thanks for your encouragement and great advice….have passed SLAM onto numbers of friends, including a couple who are GPs.
    Since we last talked, I feel I have “turned a corner” and can see slow improvement instead of just feeling stuck with the pain and discomfort. As this condition took months to develop, I am allowing myself to recover slowly and not be too hard on myself!

    • Barbara February 23, 2015 at 6:57 am #

      Thanks Fiona! Really appreciate your appreciation (ha…that’s like that stupid commercial on TV…the one I always fast-forward through). Seriously though, I’m so glad you get the SLAM and the slow recovery concept. If I were the queen of the world, I would make all women SLAM. It’s interesting because SLAM is also mentally beneficial. We gals are all about making ourselves look small. Just look at women sitting in a mixed group of people. They’re all looking diminutive; sitting with their arms crossed in front, crossing their legs. Look at the men; legs spread, arms spread out over another chair…looking bigger than they are. When my 6’7″ son comes to visit, he essentially takes up a whole couch between his spread arms and legs, where his 6’2″ girlfriend takes up only a tiny corner of the couch. It’s not just a position in space and a comfortable spreading of the body. It’s an attitude as well. The world is mine. We gals need to take up more space…mentally and physically.

      Regarding the time it takes to heal, I often like to tell a story about a dog who once appeared at our door, walking on three legs. He seemed perfectly comfortable to be walking like that, and we kind of adopted him, feeding him outside and occasionally giving him a little loving. He didn’t really live with us, but hung out at our place for 6 months. Then one day he started walking on all four legs, as if nothing had ever been wrong. He ate with us for a couple of days, and then left and never came back. He just allowed his body to heal, taking advantage of the respite we offered, and then was on his way…home or wherever. We humans rarely want to give our body the same grace. We don’t even want to give an ankle sprain a chance to heal properly. People are always wanting a pill or even an operation to get something to heal faster. And when I tell them it will take 6 or 8 weeks to heal, then they often want an MRI to be sure that’s all that’s wrong with them. That little dog taught me a lot about healing and rest.

  35. Doodawgs2 February 27, 2015 at 3:57 pm #

    Great blog, Dr. B! I have been suffering from GTB for years, initially both hips but now just the right. Sometimes it feels fine; other times it’s excruciating. Following your recommendations has helped considerably. Just a comment to the other gals out there – my cause seems to be carrying a heavy purse & a loaded tote, and since I always take the furthest parking spot and always take the steps instead of the elevator, all that extra weight on my left side results in over compensation on the right. Since I’ve ditched the excess “luggage”, changed the mattress, and employ SLAM whenever possible, it’s made a huge difference!

    • Barbara February 27, 2015 at 4:16 pm #

      k,
      I love to read what you’re saying. I’ve been lazy on the blog, but I do thank you for reading it. In a couple of months I plan to start back to blogging a little more consistently, and in one of those blogs I plan to address the issue of heavy lifting, and particularly “heavy toting.” This is definitely a problem for women. Sorry to say this, but we just aren’t put together to do this…and yet we do! Make more trips and carry less weight. Carry less awkward weight…like amplifiers! Thanks for reminding me of this important factoid. Glad you’re getting better.
      I hope you don’t mind my asking a question. How did you find my blog? I get tons of responses to my greater trochanteric bursitis blog, more so than any of the others. I wonder how that bursitis blog got out into the internet better or more than the others.

  36. Doodawgs2 March 1, 2015 at 8:32 am #

    Well, I just stumbled upon your blog while searching for any new info on this topic; mainly because I’m mattress shopping, but also because I just had a sleep study and failed miserably – no pun intended! I was thrilled that the sleep lab was using a sleep number and anxious to evaluate it. Bad news was because I had great difficulty getting my pillow between my knees, I tossed and turned all night and had such significant hip pain that I doubt I slept a wink. At any rate, I found this blog to be thought provoking and extremely informative; I never realized how many other women suffer from GTB, but also that so few doctors actually offer long term coping solutions. In my case, I had surgery and cortisone injections, but I’ve never had a day or night completely free of pain. It’s impacted the way I live my life in a big way, and I have learned through investigation how to make the best accommodations for me to live the best quality of life I can. Have managed to make smart enough choices that my left hip is relatively pain free; just dealing with the right. Yoga has helped also. Thanks, Dr. B. Keep up the great work!

  37. Nichole April 5, 2015 at 3:46 pm #

    Hi Dr. Bergin – Thank you so much for writing this and providing all of your responses above!!! I am a 29 year old female. Recently (about a month ago), my right hip started hurting. I have always had hip “challenges”. Stiff hips when I get up from sitting for a while. Sometimes, my leg/hip just simply won’t straighten when I get up, but not like the pain I have started having recently. My mom is 65 with two hip replacements because the ball is larger than the socket. I am very active. I run almost everyday. I am 5 foot, 105 lbs. The pain is an isolated spot (tender to the touch in the area though) and it is right where the bone sticks out, but almost the back portion of that bone. In addition to running, I also take a workout class – last Monday I did both in the same day and pushed myself pretty hard during the run – running club and we ran uphill the whole time. After that, the pain in my hip became more severe. On a scale of 1-10, used to be a 3-4…now I’d say 7. It hurts to put pressure on that leg – stepping up stairs, impact when running etc. I’m still working out because I was concerned about what the time off would do. I’m in new shoes…hip pain is closely timed with when I bought the new shoes. I am switching back to my old shoes. I fought the urge to give them up because they’re expensive and are specifically running shoes – I was being stubborn. I’m switching back to the old shoes. I don’t go to the doctor a lot – though I have health insurance, I just prefer not to if I can avoid it. What if I stay on ibuprofen for a few weeks? I”m concerned about going to a family physician because I feel like because it’s a hip issue – I’m worried that they will diagnose it improperly and I’ll spend a lot of money with few answers & limited treatment. I don’t want them to default to doing an MRI. I really want to rule as much out on my own as I can. The pain feels like it’s an inflammation – my side is achey…but I can identify where the pain is and it literally feels like a burning in the joint.

    What will a doc do? What are initial tests that they do – can they really tell what the true issue is? How much harm am I doing by waiting to go to the doc? How much ibuprofen can I / should I be taking? When I take ibuprofen (really have only been taking it once a day, 600 mg). How much harm am I doing if I keep running? If I can stand the run even through the pain – would bursitis go away eventually or do I need to completely take some time off from running?

    Thanks!

    • Barbara April 5, 2015 at 6:36 pm #

      Nicole,
      It’s probably time to go see a doctor…an M.D….any M.D. You don’t need to start out with an orthopedic surgeon, although many people do. Orthopedics is probably almost a primary care specialty. I know that sounds a little contradictory, but just about everyone ends up with orthopedic problems sooner or later, and probably half the people I see come to see me directly, and half have already seen their primary care docs. The advantage to seeing a primary care physician is that you then have one doc who is either handling or guiding your medical care. They know what’s going on with you, what medications you are taking, what treatments you’ve undergone. When you start trying to see specialists on your own, you can end up with the wrong choice: a gastroenterologist, when you need a general surgeon, for example. I often hear people say that they get frustrated because nobody knows all of their problems. That’s because they don’t have a primary care doctor. It’s really hard for a specialist to know all of your history, and each time you see a specialist without the knowledge of your primary care doc, you have to tell your story all over again, and something gets lost in translation.

      On the flip side, when you have a broken ankle, most people are probably going to bypass their primary care physician and go straight to their local orthopod. And we try as much as possible to send copies of our notes to your primary care M.D.

      When I see patients for hip pain, that can involve anything from the bursa, the tendon, the hip joint, to the back. On occasion it’s coming from the abdomen or the uterus! In those cases I’ll be wishing they had seen their primary care doc first!

      So you make that choice, but go ahead and make it. You’ve had this for a while and your symptoms don’t easily direct me to call it one condition over another. But one thing that concerns me is the possibility of a stress fracture in a skinny gal who runs and exercises a lot. Look, don’t fool around with this. Just make an appointment to see someone. I really can’t give you a lot of advice on this over the internet.

      One thing I would do for now, and this is a recommendation I give in general. If it hurts, and it keeps hurting with certain activities, you probably should stop them. Quit running for now. Whether it’s greater trochanteric bursitis or a stress fracture, your body will thank you.

      Then start looking for a phone number!

    • Barbara May 4, 2015 at 8:22 am #

      Nicole,
      I think I already answered your comment. If not, can you please let me know. I’ll try to address some aspects of your comment, but your history is very complicated and I certainly cannot give you direct medical advice on it. You should be seeing a specialist.

  38. Judy April 21, 2015 at 3:24 pm #

    I was surfing the web looking for info about hip bursitis and found your blog. It had the most useful info of any of the sites I looked at! I have only had hip pain for 2 weeks and have self-diagnosed the problem! My hip bursitis is only in my left hip. It is not so bad during the day unless I sit for too long. I doesn’t hurt at all when I walk. The worst is at night when I try to go to sleep. I discovered a couple of the stretches you recommended on my own as they alleviated the pain and let me get to sleep. I also use a pillow between my legs for the same reason. We were in a warmer climate all winter and we walked 3-5 + miles a day. I was pain-free. Then we rode home and I sat or was the driver for MANY miles. I have used a cushion in the car and EVERYWHERE I go for many years. I had a ruptured disc and back surgery in 1997 and I really protect my back. When we got home I returned to the fitness center and began walking on the elliptical. I can walk on it pain-free for 3 miles. But now I am wondering if it is aggravating
    my hip. I used to walk on the treadmill for 3 miles but found the elliptical was easier on my knees. Must I stop using the elliptical? I dread that! It is my favorite time of day and I love it!

  39. Marci May 6, 2015 at 6:24 am #

    Thank you for your articles on bursitis, they are the best I have read on the web! They are really useful on the mechanics of the pain, and that is a real help. I have a question that may have more to do with the biochemistry of it – I got my hip pain after taking up running (age 44). But I was running for 6 months and I was feeling great, no pain anywhere. I originally took it up to deal with the irritability and tiredness I was getting from perimenapausal fluctuating hormones. Running was the only thing guaranteed to cheer me up. The pain started on the left hip, and in my groin. But then when it got bad and hurt in both hips, it became generalised; so my shoulder hurt (I sleep on my side) and my wrists. When the pain ebbs I still have the sore hips. After two months of not being able to run, I went on HRT, which helped with the overall pain but didn’t resolve the hips. So I’m assuming there is some generalised inflammation going on which I need to solve, but beyond that, how do I heal my hips so that I can run again? Any thoughts would be gratefully received! Best wishes, Marci

    • Barbara May 7, 2015 at 2:10 pm #

      Marci,
      I’m glad you’re getting some helpful information from my blog. Unfortunately, I really can’t give you specific recommendations regarding your return to running. Groin pain can be a complicated symptom. It can be due to actual hip joint problems (arthritis, labral tears, osteonecrosis), hip flexor tendon issues, or even stress fractures, just to name a few. That’s speaking in generalities, since I really can’t advise you specifically, other than to say I wouldn’t continue to manage groin pain without a consultation from your doctor. If it’s just lateral hip pain, you should be able to gain all the information I know on it from my blog and the responses to comments from my followers. But groin pain can be more serious. And even lateral hip pain, if it doesn’t get better on its own, should be evaluated by a physician.

  40. Brenda June 12, 2015 at 8:15 am #

    I have had left hip bursitis for 4 years now. It started after a two-day drive across the country–I guess because of sitting for an extended period. It has never gone away. My GP and arthritis doc have both given me steroid injections and the pain always comes back within a short time.

    Now I have developed lots of pain in my right knee. So I went to an orthopedist a few days ago. He felt he could locate the bursa better and gave me another shot. Yes. It really helped. And my knee has started to feel better, so it must have been a limp strain of some sort.

    I will follow your ideas for stretching and for sitting like a man. I am in such heaven now that the bursitis pain has faded some. I fear it will come back. It has been 3 days since the shot. How long should I wait before I start stretching?

    • Barbara June 13, 2015 at 3:52 pm #

      Brenda,
      It’s probably alright to start gentle stretching anytime. I can’t find a recent reply to another patient with similar concerns: that her pain would come back after the shot wore off. Well, this certainly can, and often does happen. Shots in the hip bursa rarely “cure” anyone. Patients often return for more shots, especially if they got relief from the injection, even if only short lived! They just want that relief. I would say shots actually cure folks about 10% of the time. They don’t even work about 10% of the time. They hurt and don’t work about 5% of the time. The rest of the time they help to varying degrees, albeit transiently. But if they give you some pain relief that means that there is a significant inflammatory component to your disease. Relish your pain free state, but persevere with the conservative course of treatment. Continue to sit like a man, get in and out of chairs like a man. Stretch. Modify activities which you previously identified as being painful. Square up your movements. For example, when turning directions, don’t spin on your leg. Walk the turn. When you get out of your car, turn in your seat. Plant both of your feet, and THEN get up (like a man). Don’t twist on your outstretched leg. These are just a few suggestions. I sometimes have success with repeat injections, even if the pain comes back in a month. I’ll redo the injection to see if it gets it second go-round.
      Good luck! We need a little bit of that too.

  41. Joyce July 15, 2015 at 8:54 am #

    I am a 61 year old female with (right) hip bursitis, although for years I was certain it was arthritis and doomed for a hip replacement. My first bout with hip bursitis was sometime after giving birth to my second child who weighed in at 9lbs 6oz (I was 33 yrs old). The pain disappeared, but for the next 3 decades I would have ‘an attack’ of it maybe once every few years that would last only a few weeks. I tried early on, to not pivot on my right leg as that would always trigger an attack. A few months ago while gardening, I knew immediately I moved the wrong way. Only this time, it’s lasting longer and I’ve noticed the hip bone on the left side hurting also, probably due to favoring my right hip, throwing off my gait (?). I came across this site, and I cannot tell you how much I’ve learned regarding the healing process. I have a few questions though. (1) What does it mean that it is self limited? When hip bursitis heals to where you have no pain, can it ever be healed completely? Or is it likely I’ll always have a weakness in that area, where even the slightest wrong turn could trigger an attack? (2) can taking supplements for inflammation help, such as fish or flax oil; anything natural you would suggest?; (3) the first exercise you show (wall stretch). It says bad leg toward wall, cross bad leg over outside, lean into wall. I’m seeing the opposite leg crossed in the picture demo. I’m doing all these exercises (except this one), even sitting like a man, and I just ordered the bed topper from Amazon. Thank you so so much for this blog. I love how you write with humor and emphasize slowing down!

  42. Joyce July 27, 2015 at 12:01 pm #

    My first ‘attack’ of hip bursitis was 28 years ago, shortly after the birth of my daughter who weighed in at 9lbs, 6oz. (I was 32 years old). I’ve had many recurring attacks off and on since, but they only lasted 2-3 weeks at most. A few months ago I was gardening (planting 20 hostas with a big shovel) and it happened again, only this time the pain was more intense and is lasting much longer. This is when I found your blog! I cannot tell you how helpful this information has been to me! I now sit like a man, do your recommended exercises, got the mattress topper, have slowed down in general and been kinder to my right hip as it is healing. I also remember when my 96 year old mom broke her ankle last year, the PT taught her as she would do steps, to go ‘up with the good, down with the bad’ – I’ve been doing that also which seems to help with my (unavoidable) staircase. I’m FINALLY realizing if I slow down in general and take more notice of what might trigger an attack, perhaps (maybe) I can avoid another bout of this dreadful hip bursitis. Thank you so much for this blog and your wonderful advice!

    • Barbara August 2, 2015 at 9:48 am #

      Joyce,
      I love your use of the word “attack.” Having experienced it myself, I can honestly say that hip bursitis falls into the category of disorders which cause “attacks.” I most often refer to it as a “plague,” simply because there are so many of us suffering with it. I also love the fact that you are embracing my Sit Like a Man program…and slowing down. I don’t know if I’ve stressed that enough in my blog. I’m making a note to do that in my list of future blog ideas. The concept of slowing down in many regards, is so important. People don’t like to hear it. Another concept/recommendation is to Stand Like a Man. Think of the way that women stand compared to men. Women are always thrusting that hip out: to hold babies, to hold notebooks, to look sexy. It becomes habit. I’m certain that results in degenerative changes in the tendons around the hip. I often tell my patients to stand like Mr. Clean. Remember how he stands, arms akimbo or folded in front of his chest, legs slightly apart and straight. That’s how men stand. Not with their hips jutted out at the side.
      I’m glad you’re getting better, and thanks for your kind words regarding my blog recommendations.

  43. Kathi October 9, 2015 at 9:24 am #

    I’m pretty sure I have bursitis in the left hip because the symptoms sound exactly right. It started suddenly on a vacation in Italy, I’m going to assume because of all the stairs we climbed and all the walking we did, all on stone surfaces. But that was in June, so it’s been 4 months. Sometimes it is much worse and sometimes it seems ‘almost’ gone. Yesterday I went on a 2 mile walk and it flared up again.

    I’m very frustrated because I have sort of lowish bone density and I am supposed to be exercising. I am 52 years old with a small frame, post menopausal for 3 years. I don’t want to lose bone mass because of this.

    Usually walking isn’t an issue so much. Getting in and out of a car, getting up out of a low sofa, those are problems. I am trying to follow your advice and can say that ‘sitting like a man’ and using a pillow between my legs when sleeping (as long as it stays there) are very helpful. I take a yoga class once a week which does focus on stretching but I’m not sure it’s helping, or hurting, the situation.

    The thing is, it just doesn’t seem possible to avoid aggravating this. I need to drive the car to work, I am on my feet a lot at work (teacher), and at some point each day I get up and down from chairs. Also I often forget to SLAM unless it already hurts (I guess it’s very ingrained to cross my legs, and I often unfortunately sit with my legs actually curled up under me. Bad, bad, bad) It’s starting to feel like it’ll just never get completely better, and it is interfering with a lot of what I would consider normal activity. I guess I need to stop messing around and become much more mindful of my movements at all times? Can I still walk at at least?

    • Barbara October 9, 2015 at 11:13 am #

      Kathi,
      Though the symptoms you are experiencing are common, and I have answered many comments similarly, you bring up a bunch of good points in these four paragraphs, and so I will address them again so that you and others might benefit.
      It’s not uncommon for women to have the sudden onset of various repetitive strain disorders, particularly those involving lower extremities, following extensive travel. We allow ourselves to get a little de-conditioned, and then take off on a trip and do a lot of walking, often on uneven surfaces. Given no contraindications to walking, we should all walk. It’s just the right thing to do. It’s really the best exercise for us to do, and frankly it’s the most natural exercise to do. It’s what we all would be doing all the time if we lived in a world with no vehicles. So walk. And if you haven’t been walking, and you’re planning a trip in which you will be walking, then start a walking program…way ahead of time! Don’t wait until a month beforehand, and then start walking 3 miles every day. You’ll get hip bursitis or a stress fracture in your foot! If you haven’t been walking, then start by walking around the block!

      Thanks for the travel reminder. I’m going to do a blog on this in my RESPECT series. RESPECT THE TRAVELING BODY, or something like that. Wait for it…it’s coming.
      This bone density issue…ugh. Yes, you should walk, but if walking is hurting you, then you can’t walk. And that’s all there is to it. Doing a little bit of painful walking here and there is not going to mean the difference between breaking your hip and not breaking it. You need to be taking your calcium and vitamin D3. And you must make sure you shouldn’t be on any other kind of treatment for your osteopenia/osteoporosis. And keep getting your bone density studies when recommended by your doctor.

      Back to the walking thing. There is no need to speed walk, or even walk fast. Let’s just walk at a leisurely pace. Again, I go back to the caveman. If you were a caveman, (a hunter-gatherer), you would be walking long distances every day, both to find water and food, and a mate. That’s what was important to the natural human being: staying alive and making babies. So imagine yourself a cavewoman. You would walk slowly, so as not to miss something to eat on the ground or in a tree, or a hot, hairy man with a nice club, hiding in the bushes. Point is, I want you to walk at a natural, easy pace.

      If it hurts to do yoga, other than the pain of stretching something which hasn’t been stretched in a decade, then you shouldn’t do it. If it’s hurting your hip, then you should stop for now.
      When you get in and out of the car, swing your legs around first, and then stand up with those legs slightly apart…like a man.

      For that matter, sit like a man, stand like a man, get in and out of a car like a man. Get paid like a man…if you do the same work as a man (just had to put that little politically charged comment in). Really, do everything like a man…except just a few things…cuz we can’t or cuz it makes a big mess if we do.

      Yes, yes, yes to being mindful! If you were a diabetic, would you be mindful of your blood sugar levels and your sugar ingestion? So be that way with your hip, if you want it to get better. And have peace with being mindful of your hip: what makes it better, what makes it worse? Is it painful right now? If not, what are you doing right? If so, what are you doing wrong?

      And last but not least…thanks for the SLAM shout out! I really think this works. I really think it’s the right thing to do, and I really want all women to SLAM whenever possible!

  44. Kathi October 9, 2015 at 2:24 pm #

    Wow, thanks for the quick and very thorough reply! BTW I am in fact pre diabetic and do monitor my blood sugar with a meter (dratted genetics. I am 5 foot 5 and 135 pounds, but very strong family history) very carefully. I am generally a pretty control-freaky sort.

    One problem I see is that the hip pain often kicks in AFTER the offending activity, when it’s too late so to speak. Only after the walk yesterday, for example, did it definitely get worse. Sometimes it does hurt ‘in the moment’ especially when getting in and out of a car, etc. I will follow your techniques for that as the twisting motion of just using one leg is an issue.

    I know the SLAM works because even if I have pain, if I sit like that it goes away as long as I am sitting that way.

    I tend to go on 2.5 mile walks about 3 times a week, and I complete them in 40 minutes, so yes, I’m sort of speed walking there. As far as my bones go, I don’t suppose it makes a difference how fast I go, but I was trying to get some cardiovascular in there. I can easily slow that down for now. Also I think maybe taking smaller steps would help as I tend to take long steps and I think that strains my hip.

    Even the 2.5 mile walks did not prepare me for Italy, where we were (assuming our step recording program on the phone is accurate) topping 7 miles a day. The steps in churches, Colosseum, etc. were also uneven and some quite tall, requiring you to sort of hoist yourself up using the hip, which is what I consider the main culprit.

    The yoga seems to be a neutral activity for the most part.

    Interesting about using calcium and vitamin D exclusively for osteopenia. Yes, I agree, as the meds are said to make the bone more brittle rather than stronger. I’ve only had one scan so far. I feel that anyone with small bones will show osteopenia on the Dexa scan because it does not take bone size into account. It measures the amount of bone (which would be less in small boned people) rather than the quality of bone. However, a second scan will still show relatively whether there has been loss.

    • Barbara October 12, 2015 at 4:17 pm #

      Again, even though I can’t examine you or look at your X-rays, you bring up some good points which I can use to help others as well as yourself.

      I like to categorize pain related to an activity. I think one of my professors in medical school shared this with me, and I have continued to share it with my patients. There is the pain that grabs you while you’re doing something: you put your finger on a hot stove, you have pain under your left knee cap each time you go up stairs, the lateral side of your hip hurts every time you walk fast. That pain should tell you to stop. You shouldn’t try to work through it. Then there’s the pain that hurts a little after you do something: you sing really loud and your throat hurts afterward, you walked three miles with no pain, but every time you get in the car to go home, your hip starts hurting. Try to make some modifications to the program to see if you can make that pain go away. Lastly, there’s the pain which you feel the next day: you danced for several hours and the next day you’re sore. If it goes away, maybe it’s just a sign that you need to condition yourself a little better. But if you recognize that every time you do a particular activity,it hurts the next day, then once a gain, you need to make some modification to the program to see if it gets better.

      Again…so happy SLAM works for you!

      I know of no study which indicates that people who do regular higher intensity exercise live longer. I think if you look at the people who currently are living into their 90s, not very many of them spent much time doing regular “cardio.” Just walk at a nice pace, one that allows your body to move in a natural way. Here’s what I see a lot in my office: people in their 40s+ who are beating themselves up…and getting injured in the process. Slow down. Walking is good for you.

      Stairs are hard on us. Uneven stairs are worse. Avoid them. The benefits don’t outweigh the risks in many folks. If you’re not conditioned to stair climbing, and you go on vacation and climb stairs, be prepared for discomfort.

      That’s it. I hope this helps you, and anyone else watching.

  45. Firefly October 17, 2015 at 2:02 pm #

    Hi Dr. Thank you for this site. I have gone to numerous doctors and pts but nothing seems to work. I mean it gets better and then worse. What helped was squats and strengthening my hip area when it’s not aggravated. Recently, I aggravated it (with stairs and walking I think) and now my tronchaetric bursitis is inflamed. I’ve had this for about 4 years on and off now and I”m sooo frustrated. I can’t walk, cycle, run or do what I love. Not even elliptical machine. I used to swim but now I have developed a impeached shoulder on my left shoulder so I’m resting. There are no good orthopaedics here. I’m in Yangon, Burma.

    I really need a doctor I can talk to and would really appreciate your advice. I had a bad bike accident and a fall and I believe that’s the cause of my bursitis. I feel depressed and don’t know what to do anymore. I can’t do much, not even walk.

    How do I heal this and does it ever heal or do I just give up and accept that this is going to be my life? I’m trying to heal it, but it never does. I’ve done everything for it, I feel and even looked into surgery, but docs tell me it’s not a good option.

    Please advise. I need some sound advice and steps I can follow to heal this. I’ve been bedridden for a few days after the inflammation and limping. I’m getting better, I think. I was doing ultrasound for it. Does that really help? Have taken cortisone shot a month ago. One doctor told me I should get it every month as needed. Feel like I need it again. Is it okay to take a shot every month? I hear once I take it, I shouldn’t do ultrasound for 2 weeks. Ultrasound works well for me, but do I have to keep doing it forever??

    So frustrated. I envy those who can walk. I miss that so much.

    • Barbara October 20, 2015 at 11:07 am #

      Firefly,

      This is a very complicated history and I’m not sure I can help you, but I’ll give it a try. You have to understand that because I can’t examine or do any studies on you, I can’t really give you medical advice, other than to reiterate what I’ve said on my blog and told others for this condition.

      It sounds like your hip bursitis might be a secondary problem, due to something else. But it can be a moot point, simply because the pain of the bursitis can outweigh the pain you are suffering from some other condition. But it’s rare to suffer from straight-up hip bursitis for 4 years. Please look into other sources for your pain. But again, assuming that you have bursitis, it’s no wonder you’re frustrated.

      In general, swimming isn’t too hard on hip bursitis. Don’t use your arms. Get a kick board and just kick, even if gently. The majority of calories burned with swimming are generated in the big muscles of the thighs and buttocks. But look, in my opinion, there really isn’t any exercise which frankly “benefits” the hip. Most exercise aggravates it, so take it easy! Give yourself permission to take it easy. If you are trying to lose weight, then just eat fewer calories for a little while.
      If you’re naturally depressed, then I can’t help you much with that. But if you’re just sad because your body isn’t functioning well, and in fact functioning quite poorly, then just remember that “what doesn’t kill you makes you stronger.” I hope you don’t think I’m being calloused and unfeeling, but it’s really the truth. If you live long enough…you will suffer…and some of us have to suffer to a point in which we think we just can’t suffer anymore. And then we survive to suffer another day. But we might survive to experience great human joy. So please have some confidence in your body’s ability to get you through this, and remember that hip bursitis is a benign painful condition. It won’t kill you, even if it feels like it might.

      I have a few patients on whom I give a few regular, fairly frequent injections. It’s okay. Unless you’re a brittle diabetic, there is really no downside to taking them in the hip bursa. I’ve had success with 2-3 repeated injections.

      Remember to get a 2-3 inch memory foam mattress topper. Especially if you’re going to spend a little time in bed.

      But try not to spend time in bed. Again, the fact that you’ve become bed ridden, speaks against greater trochanteric bursitis. Please try to do a little walking, and stand like Mr. Clean (look him up on the internet if you don’t know him in Burma). Don’t stand with your hip cocked out to the side.

      And remember to Sit Like A Man.

      Please try to find someone to make sure there is not some other strange, more obscure disease process going on in your hip. Again, four years of symptoms and pain bad enough to send you to bed, are not typical of greater trochanteric bursitis.

  46. Kiana November 17, 2015 at 7:42 pm #

    hi I have had hip bursitis for 3 years now.I run across your blog because I’ve been trying to figure out how come the hip bursitis keeps coming back. my hips sometimes feel like they are burning like they got caught on fire. it is so bad at times that is hard for me to walk and lay on my side. my back and my bottom also hurts. down my thigh is so tender that it hurts to touch. I have been getting cortisone injections and both hit since November 2013.the first time I had received the cortisone injection at last 4-5 months the second injection off the last 5 months the third only last 1 month now it seems that the injections do not work at all. My primary care doctor gave me some steroid pills which worked the first time she gave them to me. I receive more steroid pills 2 weeks ago and they did not work. the rheumatologist told me that my fibromyalgia set off the hip bursitis. as I’ve been reading I haven’t seen anybody state that they had fibromyalgia I’m wondering could this really be case. I am miserable.

    • Barbara November 24, 2015 at 5:39 am #

      Kiana,
      Fibromyalgia introduces a whole ‘nother level of complexity. And once you’ve been diagnosed with fibromyalgia, all pains can, and often are attributed to it. But a person with fibromyalgia can also have hip bursitis, just like they can also have a broken leg. I don’t know if we understand fibromyalgia enough to say that the fibro triggers pain, or some random pain can trigger fibro. So I still always try to address each specific pain just like I would address your broken bone, and not always attribute it to your fibromyalgia. So read what I have to say about treating hip bursitis, and do what you can for it. I’m truly sorry the shots and medications are less and less effective as time goes by. I have patients who experience the same thing.
      Remember to Sit Like A Man.
      Remember to contemplate the times when you are having no pain, and try to do more of that, and less of the things which cause you pain. I know that sounds…like, duh…but it works, for me as well as my patients.

      For example, as I began answering my blog comments this morning, I was pain free for about 10 minutes. I remember being in the middle of my previous response, when I began to experience the tiniest amount of trapezial (myofascial) pain. It’s not bad right now, but I know from experience that in about 10 minutes it will begin to kind of take over my thoughts a little. So rather than persevere with the typing and therefore the pain, in about 5 minutes, I’ll get up and go get a cup of coffee. While I’m waiting for it to brew, I’ll do a few stretches which I know will diminish the pain. I might go back to my typing, or go do something else! This most often works for me. Maybe it would for you too. I know what hurts, as I’ve dealt with it long enough, so I also know when it hurts. I take the preemptive strike to remedy it. I know what doesn’t hurt, and I do more of that when I need to.

      Have a Happy Thanksgiving, wherever you are!

  47. Cecily January 29, 2016 at 9:11 am #

    This is a terrific website. Thank you. I have had GTB in one or the other hip for many years – first time 30 years ago. I have gotten better for times in between only to have it flare up again. Now my right hip has been very painful for over 3 years. I am 81. I received cortisone shots a couple of days ago in both hips. They have not helped yet, but the doctor says to give it a couple of weeks. I have been a tennis player (no longer) for many years and this may be what caused my problem. I do want to exercise, but the doctor says not to walk and recommended a stationary recumbent bike. I’ve read that biking can be harmful to the hips. Do you think the recumbent bike would be the right way to go? I will try to remember to do the SLAM. Thanks again.

    • Barbara February 16, 2016 at 6:24 pm #

      Cecily,
      Thanks for reading my blog. If I were going to own one piece of exercise equipment, I think it should be a recumbent bike. It’s low impact and not likely to cause a bunch of repetitive strain disorders. You can use it when you’re injured. And it’s not shaped in a way which is conducive to hanging clothes on it. When you’re riding the recumbent bike, try to relax your hips by not turning your feet inward. Allow the hips and legs to angle slightly outward, in the 11:00 (left) and 1:00 (right) positions…just like sitting like a man.
      Keep SLAMMING! I just put out a huge blog entry regarding S.L.A.M., because I’m getting ready to release the concept to the public. Thanks for your support!

  48. Sara February 16, 2016 at 1:45 pm #

    Hi Barbara, I have joint hyper mobility syndrome – or as I know it I am very, very double jointed in all my joints (including my jaw). I have been on a weight loss mission and have lost three stone (43 lbs) and took up fast walking, then running – more like trotting in time to music! – on my treadmill. I really really loved it and for the first time ever was ‘into’ exercise…. however – and there is always a ‘however’ – I have now been diagnosed with bursitis in my left hip and I can feel the right hip going the same way. I have stopped all the exercise for the time being but I am terrified of losing the momentum on my weight loss or even putting it on as I have a sedentary job and don’t burn more than about 1300 calories a day without exercise so as I find a 1000 calorie diet unsustainable for a long time (I love food!) I need to exercise. My question is ‘what can I do?’ There is no swimming pool near me only a gym but I need to do something to keep up my aerobic fitness and get me those leg muscles and weight loss.. Please, have you any advice? I have done so well but now feel that if I can’t move I will put it all on again. Can I walk fast on the treadmill without doing further damage even though it makes my hips hurt afterwards (but not while I am doing it – strangely) as long as I don’t run/trot? Thank you for this blog by the way, it is HUGELY helpful!!
    Best wishes from England!
    Sara

    • Barbara February 16, 2016 at 6:18 pm #

      Sara,
      Attempts at weight loss are often accompanied by injury because people often up their exercise intensity, and often they are de-conditioned. If they are very large, the size of their thighs affects the biomechanics of their lower extremities because they have to walk, ride or swim with the legs apart. This is a formula for problems. I know I’ll get criticism for this, but it’s the truth. The vast majority of weight loss is related to eating. You have to reduce caloric input. Women in particular have a hard time exercising to the degree it would require to even effect the slightest degree of loss. I don’t promote severe caloric restriction. It’s almost impossible to stay on a program like that. I also don’t promote rapid weight loss. Think about it. If you reduce your daily caloric intake by 500 calories, you will lose a pound a week. At the end of a year you will have lost 50 pounds! This time will pass, whether you lose weight or not. Now if you go on a sustainable program, it might be easier to stick to in the long run. Consider the Whole30 diet. It works for some folks.

      If you have large thighs, excessive treadmill walking will result in pain…somewhere. I do not promote speed walking. I see too many patients who injure their lower extremities speed walking. It causes hip bursitis, sacroiliac pain, pes anserinus bursitis and stress fractures. Walk at a leisurely pace, at least while you’re trying to lose weight.

      If you’re certain you have hip bursitis, then read my blog. Read some of the comments, and read my most recent blog entry (Sit Like A Man).

  49. Danise March 10, 2016 at 8:11 am #

    Barbara, your information is great and so simple for me to follow. I have learned so much. I am 72 and have had trochanter bursitis for a year. Had 2 cortisone shots at different times and 2nd did not work. I have been working with a PT for the last 6 weeks and going up stairs is better. She now has me use an elliptical machine to warm up which I think is irritating the bursa. What are your thoughts on the elliptical and stationary bicycle for trochanter bursitis. My MRI shows no arthritis in the hip, just a large bursa inflammation. Thank you for your help.

    Danise from New Jersey

    • Barbara March 10, 2016 at 8:38 am #

      Danise,
      I’m so glad you find my approach to healing easy to follow. That’s the idea.
      Patients often ask if a certain exercise is good for certain conditions. For example, “Is walking a good exercise for my knees?” And actually, in my opinion aerobic type exercises are not “exercises” to be used to treat various conditions. They are exercises we do for enjoyment, for conditioning, for burning calories, etc. But they are not necessarily a treatment modality, and in fact, they can do harm. If you have arthritis in your hips, walking and running can exacerbate the pain. If you have rotator cuff tendonitis, swimming can hurt you.
      Many therapy programs include a little warm up on a treadmill, elliptical trainer or a stationary bike. My preference in general is a stationary bike because it’s just a little easier on the body overall. Treadmills and elliptical trainers can irritate conditions like greater trochanteric bursitis.
      And you know what my philosophy is if you’ve read other blogs and comments. If it hurts…don’t do it! Find another way.
      If I was going to use or even buy one piece of home exercise equipment, it would be a recumbent stationary bike.
      Hope you’ve read my Sit Like A Man blog. I have just released the concept publicly and in fact will be on the local news tonight. If you don’t live in the area, you can watch it on the Austin Fox 7 website tonight or tomorrow http://www.fox7austin.com/. I’m not sure exactly when they will run the story.

  50. Linda April 24, 2016 at 6:42 am #

    Barbara,
    I have just finished reading through this blog. Thank you so much for all of the information! I am a 59 yr. old woman and have been a runner for 36 years. Not a marathoner, but just regular running with moderate distance. About 10 yrs ago I had a bout of gtb, saw an ortho dr. I got a cortisone injection which took care of the problem. I did seem to have frequent bouts of “achy” hips with all the classic symptoms of gtb but mild. I used yoga stretching, foam rolling and cross training and the symptoms always subsided. About a year ago, the same achy feeling started and progressed to an acute pain in one hip that led me back to the dr. Got a shot, all is fine, worked back up to running slowly, but within 4 mos. or so started getting the achy feeling again in the right hip. I dealt with it on my own but kept running until one morning I woke up with the acute severe pain only in the opposite (left) hip. Same treatment got a shot, took care of the pain in that hip and started seeing a pt to see if we could help the mild pain in the right hip that was slowly getting worse. Had a course of deep tissue massage and dry needling but the right hip kept worsening to the point that I could no longer run without pain. Started seeing a sports medical chiropractor who has helped me with graston, stretching, balance and strengthening exercises for the hips and glutes. No running, no aerobic activity of any kind. It has improved but still there. I have continued walking, sometimes fast walking, sometimes a short slow run to assess- this makes it worse afterwards. So now I am starting to experience the achy feeling back in the left hip again. arghh. I so miss running, Very much. Dr. wants me to think about getting another shot in the right hip to see if that can get me back to running faster. He thinks that since we have done a lot of the groundwork with stretching and strengthening, the shot will do 2 things. Allow me to get back to running and if it doesn’t work will show us there is something else going on. I am hesitant mainly because of the expense (xrays and shot) and also because now the other hip is showing signs of gtb and just got that shot in december. Have been working on the course of treatment for 2 mos. and haven’t run for 3 mos. I know I’m being impatient but I have never been this long without running in 36 yrs. and that includes pregnancy and childbirth.I am going to start including slam and the stretches in your blog. The other thing I realized is that 2 yrs. ago I switched from driving a mini-van to a prius. After reading through your blog, maybe that is a factor in this? It is hard to not do anything aerobic, I feel like I am losing all fitness, which I realize is not the end of the world. The other factor here is my husband and I are going on a road trip in 2 mos which will involve long drives, hiking and tent sleeping. Again, I so appreciate your blog, this is the most informative one I have seen in researching bursitis. What are your thoughts?

    • Barbara April 24, 2016 at 1:24 pm #

      Linda,
      That’s a lot of information and I can’t specifically address your symptoms. Suffice it to say that you must continue to follow the guidance of your physicians.
      That being said, I’m not a big fan of running, and I don’t think anyone can prove that if you run or even if you do aerobic conditioning you will live longer. If you’ve read any of my blog you will know that I feel that we should stick with exercise which more closely agrees with what we were put together to do. Humans are hunter-gatherers. We walk. We lift up light things to eat. So walk, don’t run, especially since you associate your pain with the running. It’s really not good for you. Walk and lift light weights. When you talk to people who are 90 years old, not a one of them had a regular exercise program or a special diet. Stop the running and don’t agonize over it. Be kind to your body and figure out what agrees with it: probably walking and light weight lifting. We are wearing ourselves out, and I know we’re going to pay for it when the generations of people doing aggressive and high impact forms of exercise reaches their 70s. Now you may think, “So what! Who cares when I’m 70?” But trust me, if you live to be 90, in agony…you will care.
      Consider a car with a larger seat, and one which is higher off the ground. Sit Like A Man when you’re driving…and frankly at all times.
      With the help of your physician, make sure there is nothing else going on with your hip.
      Best-

  51. lysanne April 26, 2016 at 7:50 pm #

    Hi Dr Bergin, thanks for all this information. I was told by the physo-therapist that I have hip bursitus. After walking (even short distance 5-10 min) my hip hurts a great deal. I have very flat feat with bunions. I have been wearing prescribed insoles for years. The other day I went to buy some milk without them (3 min walk) and I immediatly felt pain in my hip, I regreted it for a week! Even when I’m wearing them, it helps but I can’t stand or walk for more than 30 mins without having to take a seat because my right hip and my feet hurt. Do you think it is possible my bursitis was caused by my flat feet?

    • Barbara April 26, 2016 at 9:35 pm #

      Well, I often say that even an ingrown toenail can result in hip bursitis in women. If our gait changes, it can affect the iliotibial band and the gluteal tendons, which are what cause lateral hip pain. So in answer to your question, “[was] bursitis caused by my flat feet?” It’s possible. You can also just get it from walking: walking too fast, walking on uneven surfaces, walking in bad shoes. So slow down your walking, pay attention to the surface, and for now, just don’t walk for exercise. Really! Take a break. It won’t kill you! Do you live in England? “Physio-therapist.” That’s not what we say on this side of the pond. Also…walking to get milk. In the U.S.A.,in the majority of cities, no one walks anywhere to get anything. And down here in Texas, it’s way to hot to take a walk with a bottle of milk, unless it’s in the middle of winter! But slow down your walking. No power walking. Take your time and I think you’ll notice a difference.

      • lysanne May 1, 2016 at 8:22 am #

        Thanks for the reply! I’m definitely trying to walk less and I will try to slow down. I live in Montreal Canada so yeah, milk could stay outside all day and not go bad 🙂 I don’t even own a car , most people in my neighborhood don’t. So walking is a big deal, I’ve noticed that biking has helped, the pressure isn’t the same on my hip. Since the snow has melted here, I have been using my bike almost like a wheel chair to get around. Your answer does confirm for me that I just have to keep slowing down and walk less. Thanks again 🙂

        • Barbara May 1, 2016 at 1:10 pm #

          Glad you can appreciate what I’m saying. Many don’t…and continue to suffer!

          • Barbara May 17, 2016 at 11:15 am #

            MJ,
            This is really beyond anything I’m prepared to try to help you with over the Internet. The fact that a therapist has seen you and feels as though it is likely to be bursitis, is a good indication that it probably is, or is at least related to hip bursitis. You might have an adhesion over in that area. You’re right. It’s probably not coming from the joint, but there’s no way to be absolutely certain. Hip arthroscopy is not a minor operation in the sense that a knee arthroscopy is. So I of course defer to your orthopedic surgeon. I don’t know of any direct relationship between having hip arthroscopy and the development of hip bursitis, but it wouldn’t be beyond the realm of possibility. You had a big surgery, you walked with a limp a long time before and even after surgery. There was a lot of pulling on your hip during the operation and then the portals used to get into the hip can result in the development of adhesions. So there are many reasons you might have pain, other than that which you experienced as a result of your labral tear. Have some patience with the process, persevere with the recommended post op course, but most importantly, talk to your surgeon about it.

  52. Becky April 28, 2016 at 9:24 am #

    Dear Dr Bergin
    What a wonderful blog!
    I am a woman of a certain age and it seems every time I exercise I tweak something. I am 52, carrying just a little extra weight but BMI is 24 and it is so unfair..
    I am a GP in the UK, so yes we do walk to get the milk, and yes my bursitis really hurts when I go too far .it was triggered by trying to jog to get fit and I am amazed how common it is..
    But thank you for slam. I have a rolling chair at work and by the end of a day at work one leg is squeezed defensively and tightly over the other and it h.urts like mad when I get up.. I have tried umpteen different heights for the chair and wondered if that helped / made it worse but realise I now have to sit like a man but any tips about chair height?
    I have started swimming because so much of me hurts…So of course now have lateral epicondylitis,I think the moral is anyone approaching menopause beware…warm up,strengthen those. muscles and take it slow

    • Barbara April 28, 2016 at 1:46 pm #

      You’re so right. The majority of the things I see I call “adult repetitive strain disorders.” And they are just the result of slow but steady deterioration. And we live a live of repetitive strain, and it’s a long life. Remember…in a natural world, humans only live about 25 years. So every day rather than hate on your body, you must love and appreciate it for getting you this far. If we die young, more often than not, we don’t suffer.
      I have thresholds. There is a threshold for how long I can sit and type, sit and watch TV, walk, stand, etc. And I try to stay under the radar. If I go over…I suffer. So I do one thing for a while, and then switch to something else. Even in my office: I sit a little, stand a little, walk a little, etc. When I walk or lift light weights, I don’t do it for long.

  53. MJ May 16, 2016 at 10:01 pm #

    Hi Dr. Bergin,
    2 months ago I (47 year old male) had a hip arthroscopy and torn labrum repaired. I started physical therapy the day after surgery and ever since I’ve had pain in this area and it seems to be getting worse. I always thought that the pain was strange because it’s not in the same spot where the arthroscopy was done and labrum was repaired. The surgically repaired area feels great but 1 of the 3 incision spots is very close to where I’m now having the pain. I initially thought it was muscular because whenever my Physical Therapist would stretch me, I would really feel it on certain stretches. Last week, I was doing walking exercises where I was crossing 1 leg over the opposing knee and sitting back. I really struggled while crossing the surgically repaired hip side but tried to push through the pain. In addition to the hip pain, I then started getting a sharp pain in my lower back and I had to stop. My Physical Therapist decided to try massaging the area and she discovered it wasn’t muscular and she believes it’s Greater Trochanteric Bursitis.
    Have you ever heard of anyone getting this after surgery? Finally, it seems the more I do in physical therapy the worse it gets. After reading a lot about this type of bursitis, shouldn’t I stop physical therapy to let the area calm down? I feel like it’s getting worse and it’s very frustrating going backwards in physical therapy.
    Thank you so much in advance!

    • MJ May 25, 2016 at 10:29 pm #

      I didn’t realize you answered my question until today I scrolled up a few posts. I have an appointment with my surgeon in 2 days and hope to find out more. Thank you for taking the time and trying your best to answer!

      • Barbara May 26, 2016 at 5:45 pm #

        MJ,
        Hope you’re able to get the help you need!

  54. Meg December 5, 2016 at 1:22 pm #

    Hi,
    4 days ago I went to see my GP as I had severe aches and pains in my upper right thigh to the point where I felt like crying in the morning and at night when the pain was at its worst. Also had just started to feel pains in my upper left thigh too. My GP said I had bursitis and gave me the option of having a steroid injection or painkillers and I opted for the injection which I got in my upper right thigh. GP also said that my details would be passed on for physio. After having the injection, there have hardly been any jolts of pain in my right leg! Hooray! However stiffness and aches in both legs are still present and make it hard to walk/go upstairs/get up from a chair/do exercise in the morning, at night and after periods of not moving around. However no upper body pain or stiffness at all. I’m so tired and feel like crying as the ache is constantly there. Heat packs ease it slightly but it comes back as soon as i remove it. Is this a side effect of bursitis? Will it go away? How can I ease the pain from this stiffness! Sleeping is so difficult as both legs feel sore. I’m not exercising at the moment as I’m so exhausted and am on my feet all day; I work as a chef. I feel so old and feel like I should be using a walking stick or crutches, but I’m only 23!
    Love your blog, it has made me laugh! Recommendations and advice very welcome!!

    • Barbara December 10, 2016 at 9:20 am #

      Meg,
      Sorry you’re having so much pain. You’re very young to be suffering like this. Unfortunately, I really cannot help you with your situation. It is very complicated and I can’t see you or even make any generalizations, based on what you have told me. Please continue to seek help from your physicians. Perhaps a Physiatrist (also called a physical medicine and rehabilitation specialist) would be helpful.
      I hope you will continue to read my blog, because even though I can’t help with some very specific and complicated conditions, there are many conditions out there which are suffered consistently by many people, and I hope to help in that regard.
      Merry Christmas and I send my best…

  55. Rhonda January 9, 2017 at 9:38 am #

    Hey Barbara…

    I am very new to this issue. Woke up last sat. 12/31/16 with lots of pain left hip and down the thigh to the knee. Took Tylenol until Monday when I couldn’t take the pain any more. Went to Emergency Clinic. They said bursitis and gave me 6 days of steroids. Took my last yesterday. Not really sure what next step is. Came across your statements/articles. Have not came across your blog yet. I am currently at home recuperating from right shoulder manipulation and as a result of this surgery I also have DVT (2) in my right Arm. For my DVT I am on Xarelto and cannot take nsaids. I’ve been thru the ringer. Hard to sleep at night on either side. I am 54 and I loved being able to get up and move and get things done and go up & down the stairs. Hard to believe that you can suffer physically by doing too much. Some insights please…

    • Barbara January 9, 2017 at 9:48 am #

      Hey…I know someone with your same name. If it’s you…maybe you could come see me in the office! If not…then, let me start by saying I really can’t give you specific medical advice. You’ve got some extenuating circumstances for sure, but bottom line is if you really just have bursitis, then you should be reading my blog, particularly the entry on Sit Like A Man http://drbarbarabergin.com/sit-like-a-man-s-l-a-m/ and then the one on hip bursitis http://drbarbarabergin.com/the-scourge-of-hip-bursitis/

      Both of these will give you a head start on this nasty condition. There’s always a possibility that you might not just have bursitis, so if you don’t improve, please seek professional help from a specialist…like me…if you’re here in Austin.

  56. Nileema March 3, 2017 at 6:49 am #

    Hi Barbara,

    I have been very active last year, was walking almost 6 to 7 miles a day. And in december i slipped, in about 15 days, end of december was diagonzed with trochanteric bursitis of left hip, have taken anti-inflammatory, methylprednisolone and have done physical therapy. I have been stretching twice a day and strengthening too. I take anti-inflammatory still. But as soon as i stop taking anti-inflammatory, the heaviness in my hip comes back and i keep feeling there is something wrong with the hip. Its been almost two months now. I went to orthopedist and was put on steroids 6 day dose. There is no pain anymore, but trying to understand if the heaviness is always going to be there? Physical therapy has helped a lot.

    • Barbara March 7, 2017 at 10:40 am #

      Nileema,
      This sensation of “heaviness” you describe, is really hard for a doctor to pin down in terms of understanding its origin. You know, like burning can be a nerve pain. Soreness can be a bruised or strained feeling, etc. But “heaviness” is hard to understand, and not really directly associated with bursitis, which tends to be very specific in its presentation with directed soreness or tenderness over the lateral side of the hip. Heaviness can be due to muscle weakness, perhaps. But it’s hard to say. I have never experienced a feeling of heaviness associated with my bursitis. And when the pain of the bursitis resolved, there were no other symptoms.
      I sometimes hear older patients describe a heavy feeling in their legs or just the inability to raise their legs or pick their feet up off the ground. This can be due to overall disability and the gradual weakening of the body as we age.
      Sorry not to be able to help more than this, but if you are still experiencing other symptoms besides direct lateral hip pain, perhaps you should have a visit with your doc again. It sounds like you’ve been prescribed all the right stuff thus far.

      • Nileema March 27, 2017 at 8:37 am #

        Hi Barbara… looks like my muscles were sore all the time due to stretching and strengthening. The hips are much better and i have been following all the modifications mentioned on your blog. It has helped me a lot.

        I have one question though, i am little worried to sleep on my left side due to bursitis. How long one should avoid sleeping on the side where bursitis occurred?

        • Barbara April 9, 2017 at 3:07 pm #

          Nileema,
          It’s all about the pain. If you actually do have hip bursitis, you won’t damage hip bursitis by sleeping on your side. It just hurts to do it. You’ll have to avoid it until the pain goes away. Try a 3 inch memory foam mattress topper. That’s what helped me.

  57. Sharon March 8, 2017 at 8:12 pm #

    Thank you so much for the information about hip burstitis. I have some information now that will somehow hopefully help me. I’m 55 now but was dx with hip burstitis when I was 17. It started only hurting when I had my period and especially after giving birth. I started taking Rx Motrin which and rest . As the years went by flares increased but still Motrin and put my feet up for a day or 2 would work. I was dx w/breast cancer at 32. 6 months of chemo, tamoxifen for 5 years, arimidex for 5 years. 6 yrs after that dx my hip was hurting. It got excruciating . They saw a hairline fracture in the neck of my femur and a non biopsied lesion in the bone. I had 30 radiation treatments. Good news is I’m alive and it was obviously not cancer because I’m writing this. Bad news is what this did to my upper leg and hip. I have struggled with this ever since 2000. I have had bursa injections, si joint injections, epidurals, nerve root injections.The groin pain I thought was going to kill me. That stopped hurting but my hip and upper leg, and buttock hurt constantly. I’ve never had a Dr dx why there is this awful constant pain. I have had a number of tests over the years. Xrays always showed my hip joint was perfectly fine so there is nothing wrong with me.I stopped trying to get help because it was always the same answer. Nothing seems wrong. The last time I tried a pain management the PA told me that it shouldn’t hurt like I said it did. Same thing, different Dr. Any kind of light pressure on the side of my leg for a few minutes just makes everything start aching. I kept working as a cleaner until a few months ago. Now, I have a stabbing pain in the back by my si joint when I bend over, if I walk too much I get a bad pain it feels like my hip freezes and I can’t move. I have been told without being told that they don’t believe my hip hurts that bad and I was looking for narcotics and I didn’t even ask for them. I just want somebody to help me. I will also point out that they don’t even examine my hip thoroughly. I read on my xray from 3 years ago that I have enthesopathic spurring in my greater trochanteric and also oteoporosis . I’m having a new xray for SSDI this month and I am going to see a physiatrist.I can’t work anymore. I can’t walk a half a block. I have a callous so thick on my left elbow because after years of have to sit on my other buttcheek because I cannot sit on the bad hip side. I also have to sleep in the recliner. This has been a constant deep aching pain for 17 years and have found not 1 Dr to talk about this bursitis. I have been made to feel like I’m crazy because injections did not help. I started to cry just reading things on this blog. I’m not crazy. I have even asked if the radiation did this, do I need PT anything and I was told no. I’m not a Dr but I would think that it would do some damage.After reading on this blog I have decided I’m tired of being this way. I will find someone to help me. I don’t know where but I will find someone, somewhere. My current Dr will not give me anti inflammatory drugs because of Factor V and coumadin. I felt so alone till reading your blog. I’m going from helpless to hopeful. Thank you so much. God bless you.

    • Barbara March 9, 2017 at 11:31 am #

      Sharon,
      I’m so glad my blog has helped you in some small way. I wish I could help more. It sounds like you’ve been through so much, and yet you persevere and continue to try to make progress with your pain. I hope Sit Like A Man helps you. I know it’s hard, but try to have patience with your docs. I know they’re so concerned about your cancer and other medical issues, that they might overlook something like hip bursitis. It’s hard to see the forest for the trees.
      I wish you the best. Thanks for reading my blog.

  58. Kara Johnson March 22, 2017 at 9:39 pm #

    Hello. I am 34 years old and I started having hip pain last year when I was pregnant. My baby is now 10 months old and it is only getting worse. I thought it would feel better once I lost the baby weight (which I have), but nope it didn’t help! I have the pain in both hips but one side is worse than the other. It is usually the worst in the morning when getting out of bed and then when trying to go to sleep. It’s also painful when even sitting down. I saw a doctor and without much thought or examination he said it was bursitis and gave me a shot in both hips. For about 2 weeks it felt better but is back with a vengeance. Are there any tests I should ask for to confirm this or see if it’s something else? I am too young to live in this much pain, especially with 2 small children to chase around! Also, I am still breastfeeding so I haven’t really taken any medication for the pain. I know it’s safe to take Advil but I just prefer to not take medication while breastfeeding. Love your blog. I was just reading some of it to my husband so he could see I wasn’t crazy!

    • Barbara March 24, 2017 at 8:55 pm #

      Kara,
      It’s rare to need a test, like an MRI, to diagnose hip bursitis. If you’re tender right over the point of the hip (to the side) then it’s 99% certain to be bursitis. It can be gluteal tendinosis, but that would be rare at your youthful age. It’s not unheard of, for a woman to get hip labral tears while delivering babies. But to get it in both hips would be unlikely. Labral tears usually cause groin pain and NOT lateral hip pain. As you can tell from my blog, and especially from the responses to it, hip bursitis can take a LONG time to resolve. It took about 9 months for mine to get better.

  59. Molli April 4, 2017 at 11:05 pm #

    I’ve had bursitis in both hips for a couple weeks now. My right side is much better than my left. Almost no pain on the right. My left side is worse at night when I’m sleeping. I’ve tried every position I could think of, pillows between my knees, pillows under my knees or under my hips when lying on my back. Nothing seems to help, once the pain starts I can’t get back to sleep. Any other suggestions to prevent or even lessen the pain at night would be a HUGE help!! Thanks!

    • Barbara April 5, 2017 at 10:56 am #

      Please read my blog called Sit Like A Man and my blog called Don’t Work Through the Pain.

    • Barbara April 9, 2017 at 3:05 pm #

      Molli,
      If it’s really hip bursitis, you could try a memory foam mattress topper. It helped me. Hope you’ve read my Sit Like A Man blog.

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