Trochanteric Bursitis and Iliopsoas Syndrome

by Jane
(Yorkshire, UK)

The pain started early in January 2012, but being a stalwart runner, I thought a couple of weeks off and it would go away. Wrong.


While I waited for a doctor's appointment, I arranged for weekly physiotherapy sessions. But after five sessions the physiotherapist advised me to ask the doctor for a scan on my hip, as she felt that was where the problem lay and that I was wasting my money on physiotherapy. However, she did suggest orthotic shoe inserts, which turned out to be a huge help with the pain in my legs.

Having been diagnosed with sciatica by two different doctors and told to take Ibuprofen and that “it would go on its own” wasn't the most useful advice when you're in pain and need help.

The doctors told me to continue with exercise, but just walking was extremely painful and sleeping a huge problem. Because sleeping was so hard I decided to invest in a new bed with a mattress especially to help sciatica - no change.

When the sciatica didn't go, an MRI scan was eventually arranged in July 2012 & the problem identified as trochanteric bursitis. A cortisone injection was administered at the end of September, which initially had no effect, but after a second MRI scan was taken at the end of November, the swelling had apparently gone.

The pain in the lower back, hip, outer thigh, groin, knee and big toe, however, had not. I am currently waiting to see the consultant who identified the bursitis to find out what happens next.

I am a 53 year old female who has always exercised, running mainly, which has always helped me combat a stressful job. This pain has made me increasingly depressed, stressed, unable to sleep because of the pain, and changed my life. I have tried to stay positive and optimistic, which has been tough.

Having stumbled across this article, it seems to hit the nail on the head.

No one has mentioned the Iliopsoas muscle and the more I have read, the more convinced I am that this could be the problem.

Could there have been both trochanteric bursitis as well as iliopsoas problems too? I have started trying some of the stretches suggested (just the lunge one to start with) and see how that goes. Being hopeful that this could help...

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Jan 01, 2013
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Possible Tensor Fascia Lata Involvement
by: Stephen from Lower Back Pain Answers

Hi Jane,

It's not uncommon for Iliopsoas Syndrome to be accompanied by dysfunction of the tensor fascia lata (aka TFL) muscle. Often this can be mistaken for trochanteric bursitis.

See my article about this here:

Tensor Fascia Lata

Trigger points in tensor fascia lata can refer pain to all the areas you mention and often develop as a consequence of hip flexor dysfunction.

I have a lot of success treating the tensor fascia lata using manual therapy techniques and I hope to include this topic on the DVDs I'm producing in 2013. (Be sure to sign up for my newsletter so you know when these are released.)

Back Answers Newsletter

The trick with manual therapy treatment of both the TFL and iliopsoas is to work very gently and gradually. I will often spend up to 30 minutes working just on the TFL in different positions and at different angles.

But here's the caveat: if your therapist doesn't have a "less is more" mindset and work very, very gently releasing the muscle in layers, then the muscle can become inflamed and the trigger point referral may fail to be interrupted.

I hope this helps!

Best of luck and Happy New Year!

Stephen @ LBPA


Apr 17, 2013
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Update
by: Jane

Since I wrote this article, I have had a course of Bowen Treatment, which is definitely 'less is more.

I arranged a series of 3 just before Christmas. The 1st didn't seem to help much, but after the 2nd and 3rd I had improved mentally and physically, as by this stage my hip was so stiff it was an effort to roll over in bed and get out!

In the middle of January I had a 2nd cortisone injection and was told to leave it 2 weeks before any exercise. I did this and tried swimming, but it was still painful. Cycling also has been painful. Walking on uneven surfaces ditto.

I have now been signed off by the consultant as there is nothing else they can do for me. The hip pain has diminished compared to last year, but is still there. I have also been getting pain in my foot, calf, leg and buttock. Today I have found out why; after a visit to my GP he has given me the initial document written by the consultant back in July.

Trochanteric bursitis and also bulging discs. The latter has never been mentioned, nor treated and at least now I know why I have been getting this extra pain. The GP has given a handout on exercises for this. Please could you advise of your recommendations? Many thanks.

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