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trochanteric bursitis
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trochanteric bursitis - March 12, 2007 3:49:00 PM
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joshua5
Posts: 52
Joined: April 19, 2004
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i have a 5'10" 340# guy with troch bursitis. slipped on ice, hit hip. correct me if i'm wrong, but i can expect to see mild results over a period of 6-8 wks (possibly longer) with stretching, graded exercise as tol, education, anti-inflamation meds if perscribed by the m.d., massage and some modalities. i don't use US/stim much but will if it'll clinically help. what am i missing? what works for you? thanks for any replies!
- don't want to mislead.... wouldn't see him for the same tx technique for 8 wks!
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Re: trochanteric bursitis - March 12, 2007 5:50:00 PM
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Keith06
Posts: 13
Joined: November 8, 2006
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Give us some more information on complaints and presentation of the patient. Could be a number of factors causing pain over the lateral hip. Most likely simple bursitis would of resolved at this point.
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Re: trochanteric bursitis - March 13, 2007 4:55:00 AM
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garyd
Posts: 15
Joined: October 6, 2004
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How long ago was the incident of falling onto his hip?
Was there any bruising/contusion as a result?
Any inmaging done, x-rays, etc?
Trendelenburg during gait or single limb stance?
Most research of "greater Trochanteric bursitis when looking at MRI of teh area does not find isolated bursitis. MOst often, there is gluteal tendonitis/tendonopathy as teh primary issue and even gluteal tendon tears.
Given 5'10", 340#, would not be surprised to find gluteal tendonopathy/tear type situation.
Also, how is his lumbar spine mobility. DID his fall cause any l-spine rotation, extension that may be causing some hypomobility at a level taht is influencing the lateral hip. Mobilizing that area can often lead to reduced symptoms and improved gluteal function.
Gary
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Re: trochanteric bursitis - March 13, 2007 4:40:00 PM
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joshua5
Posts: 52
Joined: April 19, 2004
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Keith06, thanks for the reply. i'll give more info below. i never gave an onset date (re: "would have resolved at this point").
Gary/Keith, fall was 2/15/07. obers is a little tricky secondary to morphology. was a bruise at the time but has resolved. xray negative. mri showed swelling and bruising by report. gait is symmetric and looks good. ascend/descend steps half dozen times per day at home. pain at fall was 5-6. eval 3/5/07. pain at eval was 3-4 with a 6 at it's worst. now 2-3. knows home program without questions and tol 20 min on treadmill. haven't looked too hard at the L spine but will. not tender to light palpation but is with moderate pressure. thanks for any replies!
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Re: trochanteric bursitis - March 13, 2007 5:43:00 PM
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Rwantz
Posts: 84
Joined: December 10, 2004
From: Middletown, PA
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I don't imagine that US would reach the area, especially with the amount of adipose tissue present. Estim may be beneficial, but is not going to decrease the swelling. Graded exercise to 1. increase metabolism to minimize swelling, 2. produce muscle pumping to minimize swelling, 3. increase caloric expenditure to improve any secondary complications and increase blood flow to the area.
Bike and treadmill are the obvious choices. Sounds like a difficult case, but seems like reasonable results for what is given.
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Re: trochanteric bursitis - March 18, 2007 5:48:00 PM
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drbuddy
Posts: 429
Joined: July 30, 2005
From: Pennsylvania
Status: offline
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It may sound couterintuitive, but if all else fails, try cross friction STM to the area. Using IASTM(www.sastm.com) has worked well for me (just be careful if it is too sensitive in the area).
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Re: trochanteric bursitis - March 25, 2007 3:30:00 PM
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TLB
Posts: 353
Joined: September 13, 2002
From: Arizona
Status: offline
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Have you tried massaging his temples bilaterally it does wonders for trochantic bursitis, much more effective than STM. Sorry, my sarcasm seems to know no bounds, for God's sake look Lumbar please.
_____________________________
Todd
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