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Trochanteric Bursitis and Homoeopathy

For well formatted and illustrated article, please see attached pdf file...

Trochanteric Bursitis and Homoeopathy.pdf

Contents

Definition. 1

Etymology. 1

Symptoms. 1

Causes. 2

Diagnosis. 2

Differential diagnosis. 3

Treatment. 3

Management. 3

Ice. 3

Physiotherapy. 3

Prognosis. 3

Prevention. 3

Homoeopathic treatment. 3

Common remedies for Trochanteric bursitis. 3

Bibliography. 4

 

Definition

Trochanteric bursitis is characterized by painful inflammation of the bursa located just superficial to the greater trochanter of the femur (Psora). The superficial trochanteric bursa is located over the greater trochanter and is the most commonly inflamed bursa. A deep trochanteric bursa lies deeper and can become inflamed in more severe cases.

Etymology

Syn: Greater trochanteric pain syndrome (GTPS)

Symptoms

Patients typically complain of lateral hip pain, though the hip joint itself is not involved. The pain may radiate down the lateral aspect of the thigh. The most classic physical finding is point tenderness over the greater trochanter, which reproduces the presenting symptoms-

  • Pain and swelling over the side of the hip
  • Referred pain extending down the lateral thigh and to the knee
  • Pain worse while lying on affected side
  • Pain upon getting up from a deep chair or after prolonged sitting (e.g. in a car)
  • Pain when climbing stairs
  • Pain in sitting with the legs crossed
  • Pain worse when walking, cycling or standing for long periods of time

Every Low back or Hip pain extending down to leg is not sciatica.

Causes

The trochanteric bursa may become inflamed by a group of muscles or tendons rubbing over the it and causing friction against the femur (Causa occasionalis/ Psora). It can occur traumatically from a fall or an impact contusion or lateral hip surgery (causa occasionalis).

This pain comes on gradually due to repetitive irritation to the bursa from such walking or running with poor hip control, walking into fatigue, or cycling, especially when the bicycle seat is too high.

It is can also occur as a result of-

  • Scoliosis (Psora/ Syphilis)
  • Unequal leg length (Causa occasionalis/ Syphilis)
  • Poor hip control due to weak hip muscles (Psora/ Syphilis)
  • Hip arthritis (Psora/ Sycosis)
  • Back Pain (Psora)
  • Calcium deposition in the gluteal tendons running over the bursa (Psora/ Sycosis)
  • Rheumatoid arthritis (Psora/ Sycosis/ Syphilis)
  • X Ray hip joint AP/ Lateral views
  • CT/ MRI Scan of hip joint
  • CBC
  • CRP

Diagnosis

Differential diagnosis

Either it may be true Trochanteric bursitis or Pseudotrochanteric bursitis. If similar pain is due to any cause other than inflammation of Trochaneric bursa, it is called as Pseudotrochanteric bursitis which may be due to-

  • Lumbar radiculopathy (L2, L3) (Causa occasionalis/ Psora/ Sycosis/ Syphilis)
  • Lumbar facet syndrome with pain referred to the lateral thigh (Causa ocassionalis/ Psora)
  • Entrapment neuropathies involving the subcostal, and the lateral cutaneous branches of the iliohypogastric nerves (Causa occasionalis/ Psora/ Sycosis/ Syphilis)
  • Undisplaced femoral neck fracture (Causa occasionalis)
  • Adiposa dolorosa (Psora/ Sycosis)
  • Hip abductor muscle strain (Psora)

Treatment

Management

Ice

Regular application of ice packs for 15 minutes daily is highly recommended to reduce pain and swelling.

Physiotherapy

Physiotherapy is the most important thing in treating Trochanteric Bursitis. Bursa inflammation is best relieved by techniques or exercises that reduce the inflamed structures, like ice, electrotherapy, acupuncture, deloading taping techniques and soft tissue massage. A series of progressive and tailored rehabilitation exercises to address the hip control issues are necessary.

Prognosis

Trochanteric bursitis has a tendency to return due to insufficient rehabilitation.

Prevention

Muscle weakness or fatigue is a major cause of trochanteric bursitis. Wearing adequate footwear which supports any biomechanical imbalances in feet is a key preventative measure.  A footwear assessment or gait analysis is helpful.

Successful weight management minimizes excess stress on the hip joints, which can alleviate pressure on the bursa. The following points are most important to avoid Trochanteric bursitis-

  • Must avoid or modify activities and positions, which cause pain
  • Avoid sitting with knees higher than hips
  • Avoid lying on side
  • Avoid sitting with legs crossed or sitting on legs so that the hip is rotated
  • Avoid sitting on the edge of the seat and contracting the muscles that flex the hips

Homoeopathic treatment

Common remedies for Trochanteric bursitis

acon. aesc. agar. agn. all-s. am-c. Am-m. ammc. androc. ant-c. ant-t. apis Arg-met. arg-n. arge-pl. arn. ars-h. ars. asar. asc-t. Aur. bar-c. Bell-p. bell. brass-n-o. brucel. Bry. CALC. caps. carb-ac. CARB-AN. carb-v. Carbn-s. card-m. caust. chel. chin. Coloc. con. dros. dulc. eup-per. euph. ferr-p. ferr. fic-m. fl-ac. gels. graph. ham. helon. Hep. Hydr. Indg. Iod. iris Kali-bi. Kali-c. Kali-i. kali-s. kalm. kreos. Lac-c. lach. lap-la. Led. lil-t. Lyc. Lycpr. mag-c. mand. Med. melal-alt. merc-i-r. merc. mez. Nat-s. nat-sil. nux-m. Nux-v. ozone pall. petr. Ph-ac. PHYT. plan. plut-n. podo. psor. puls. rhod. RHUS-T. rhus-v. rumx. Ruta sacch-a. Sang. sanic. scol. sel. Sep. SIL. spong. stann. staph. Stict. stront-c. succ-ac. Sulph. syc. tarent. ther. tritic-vg. vanil. xan. zinc.

Bibliography

 Chapter 5. Differential Diagnosis > Causes of Hip, Trochanteric, Pubic, and Thigh Pain  Dutton's Orthopaedic Examination, Evaluation, and Intervention, 3e... Table 5-14 Potential Causes of Trochanteric, Pubic, and Thigh Pain Dislocation and fracture dislocation of the hip Labral tear Hip or pelvis fracture Pubic stress fracture Femoral neck stress fracture Osteoarthritis of the hip ..

 Chapter 6. Adult Reconstructive Surgery > Trochanteric Bursitis Current Diagnosis & Treatment in Orthopedics, 5e... patients lying on their side, can be an inciting cause. Trochanteric bursitis is one of several disorders that falls under the term “greater trochanteric pain syndrome,” which includes gluteus medius and minimus tears and “snapping hip.” It affects about 1.8 patients per 100 per year.

 Common Musculoskeletal Injuries > Trochanteric Bursitis Exercise Physiology... Figure 30-13. Trochanteric bursitis in the hip region. Trochanteric bursitis is characterized by painful inflammation of the trochanteric bursa between the greater trochanter of the femur and the gluteus medius…

 Encyclopedia Homoeopathica

 Greater trochanteric pain syndrome Murtagh's General Practice Companion Handbook, 6e
View on: Murtagh Collection...Also known as trochanteric bursalgia, it is very common in mid-age to elderly females presenting with pain over lateral surface of the greater trochanter.

 Hip and Knee Pain > Trochanteric Bursitis (Posterolateral Hip Pain) Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e ....] The trochanteric bursae lie between the gluteus maximus and the posterolateral greater trochanter, with a deep and superficial component..

 Radar 10

 Rehabilitation of Common Musculoskeletal Conditions > GREATER TROCHANTERIC PAIN SYNDROME CURRENT Diagnosis & Treatment: Physical Medicine & Rehabilitation

 Differential Diagnosis > CAUSES OF HIP, TROCHANTERIC, PUBIC, AND THIGH PAIN Dutton's Orthopaedic Examination, Evaluation, and Intervention, 4e...TABLE 5-15 Potential Causes of Trochanteric, Pubic, and Thigh Pain Dislocation and fracture dislocation of the hip Labral tear Hip or pelvis fracture Pubic stress fracture Femoral neck stress fracture Osteoarthritis of the hip Septic arthritis of the hip Reiter syndrome...

Views: 45

Comment by Kavitha Kukunoor on October 3, 2017 at 6:12pm

Very nice Info Dr Rajneesh.

Comment by Dr Rajneesh Kumar Sharma MD(Hom) on October 3, 2017 at 11:35pm

Thanks Kavitha....

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