Bursitis occurs when the membrane of the bursa becomes irritated and inflamed. This causes an excess in the production of synovial fluid, causing the bursa to swell. When the bursa becomes swollen, it will influence the normal movements of especially your gluteus (buttock) muscles and tendons as well as your ITB. Now when these muscles are contracted, it is painful and your movement becomes limited. Repetitive movement/friction of the muscle or tendon scraping over the bursa, causes the bursa to stay swollen.
This is inflammation of the trochanteric bursae. You can compare the trochanteric bursa to a swollen water balloon and the buttock muscles and ITB to ropes, strapped over this water balloon. These ropes are pulled in different directions and this puts more pressure and compression on an already swollen water balloon. The same happens with trochanteric bursitis. Inflammation of the bursa starts to irritate other structures around as well and this keeps the cycle of pain going. This is why something as simple as lying on your side or climbing stairs causes you hip pain.
The process of inflammation
The fact that it’s called bursitis implicates it has an inflammatory component, but we have to take into account that some of the typical elements of inflammation are not actually present with a typical case of hip bursitis. The 4 elements of inflammation are: pain, swelling, redness and heat. Because the hip bursae are located deep beneath other layers of tissue, you don’t typically see swelling, redness or heat. The only cardinal sign of inflammation that you can go on, is pain.
Inflammation of the bursa is a slow process, which progresses over time. Trochanteric bursitis most often occurs because of friction, overuse, direct trauma or too much pressure. Hip bursitis can be acute due to an injury or trauma, but it can just as easily become chronic.
Chronic hip bursitis
Overuse, extreme movements or muscle strains contibute to chronic trochanteric bursitis and can often lead to ‘Greater Trochanter Pain Syndrome’ (GTPS). The name of this condition is often used as a general term to describe pain around the greater trochanteric region or side of the hip. Trochanteric bursitis is frequently confused with GTPS, but is in fact only a component of GTPS. Other conditions like ITB syndrome also contribute to GTPS. When the pain caused by your throchanteric bursitis becomes chronic, you end up in a vicious cycle of pain and this causes weakness, stiffness.
Take note: Trochanteric hip bursitis cannot simply happen out of its own. Overuse and repetitive friction are the main things to look at. This means that any treatment for hip bursitis cannot simply treat the inflamed bursa. Taking a step back and getting to the root of the problem is the only effective way to treat trochanteric hip bursitis.
There is a very small and rare chance that you could have septic hip bursits. Septic hip bursitis happens when a bursa in the hip area is infected. It is a potentially serious condition that requires medical attention and treatment with antibiotics. Septic hip bursitis will cause similar symptoms to aseptic (non-infectious) bursitis, as well as fatigue, fever, warmth and redness at the hip, and/or an overall feeling of being ill. Recognizing the symptoms of septic hip bursitis can lead to quick and appropriate treatment.