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trochanteric bursitis

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monica111
monica111

hello, I am 49 and was diagnosed with trochanteric bursitis few months ago. I have started with strong pain on the upper outer side of my thight list January and after several attempts following MRI results I was prescribed with Cymbalta 60mg/day. I am on this medication (+ sulpadol) since March 2014. I also underwent to a nerve block procedure on April 23, 2014. I had physio agopunture and muscle stimulation. Although the pain has slighltly dininished, I am still experiencing discomfort. I work as Sr Engineer and spend most of my day at my desk. walk in the evening and doingo some exercising when I have time......

I have recently moved to UK from Ireland (were I received treatment indicated above) and was wondering if there is anything else that I should do to help with resolution of this problem.

thank you in advance

regards

Monica

2 likes, 107 replies

107 Replies

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  • jp66967
    jp66967 monica111

    Posted

    Seven weeks freedom from pain after the injection tends to point to the diagnosis of trochanteric enthesopathy being correct. The fact that the injection took some days to work might mean that the injection was some distance from the "target" and the steroid slowly penetrated the tissues before reaching its intended destination. It might also mean that the injection, although on target, caused (painful) bleeding at the site, which took some days to resolve. Anti-inflammatory medication applied via a "patch" can help, but this is most effective in the slim and skinny.
    • connie1954
      connie1954 jp66967

      Posted

      I have hip bursitis in both hips , and had herniated discs in my low back and neck . I have studied a lot about this and received injections in both bursae three weeks ago , and it helped a little . You can use Voltaren gel on the hips and take anti-inflammatories, however resting the hips is the best thing and then starting physical therapy , like swimming and stretches are good . Also have your doctor get you on prednisone. Also get magnesium chloride , it comes in an oil which is applied to the skin which really helps heal this also . It's such a bear to heal trocanteric bursitis so you may need to do several things , also drinking alkaline water along with these things I've mentioned it helps heal it with time , usually two months . Good luck to you I know it's painful at night but using a foam pillow to lay on that side takes the pressure off of it and I have it in both hips so it's very difficult and I can't lay on my back because of a neck injury . Those new pillows are what you would use in the car or on a plane . God bless you and wish you a speedy recovery.
    • connie1954
      connie1954

      Posted

      I meant use a neck pillow, under your hips and position it so that the opening is around the bursa so that you can rest on that side . Prednisone can help a lot. Also anti-inflammatories whether pills patches or gel , the gel is called Voltaren.
    • Mrs.C
      Mrs.C connie1954

      Posted

      Voltaren is no longer available in the US.

      I was using the max dose of Alleve...which nearly always

      covers old-age joint pains from over-use.   Then Doc

      gave me Mobic with Tylenol.   Chocolate candy would

      have made me happier.   Then:  added Norvoc with is hydrocodone with acetominiphen.   I had to inform Doc that he then had me over the max for acetominophen.   plus after nearly 3 wks. did nothing.     Then:   oxycodone 5mg.....slight blurring of vision that lasted about 45 minutes but NO pain relief.   !!

      Still wants me to continue with Morbic and 6-8 Tylenol  !!

      Allowed me to take 10 mg. oxycodone prior to MRI....THAT at least took the edge off.    He is more concerned about being sued for making me an addict than he is about my jumping off a bridge because of this pain and compromised living.

      I know it is a big problem....but what about my pain ?

      Probably going to get an injection to the nerve root between L4 and L5 which has been found to be quite inflammed.  I can have up to three of those and then must have surgery.     

      I hope all of you can find some solution to give you relief.

    • connie1954
      connie1954 Mrs.C

      Posted

      I just got some bowl Taryn gel only a couple of months ago and still have a standing prescription. I know absolutely that they sell it in Mexico and it's the 12 hour gel however the best anti-inflammatory patches are, Flector . However my insurance would not cover them and they are expensive . But they would help tremendously . I know many people who've had bursa injections and it doesn't really matter whether they're done with ultra sound or not , the medicine usually always ends up getting in there. The problem is they just don't really work and they can damage and do damage tendon and bone. Best of luck to you I just had an arthroscopic bursectomy on my right hip and I'm going to do it on my left and be pain free the rest of my life . I'm so excited it's the fourth day after surgery and I have absolutely no pain . Godspeed and good luck to you dear
    • connie1954
      connie1954

      Posted

      Sorry voice to text , Voletaren gel.
    • mark50648
      mark50648 connie1954

      Posted

      I had a cortisone injection week before Thanksgiving. Really worked well but has now completly worn off and I am back to the bad pain I had before the shot. Sucks.
    • mark50648
      mark50648 connie1954

      Posted

      I asume you were told to do PT to strengthen your hip muscles.That is what I am doing now. I will give it 6 weeks and if I do not see my inflamed bursa get better I will ask my Ortho Dr. to remove this inflamed bursa.
  • diane04260
    diane04260 monica111

    Posted

    Hello Monica

    I am a 55yr old woman and have just recently been diagnosed( last week).I have had pain however for two years. Prior to this I had been told I had Sciatica....So I have been doing all th wrong things which have irritated the condition and now my pain is almost unbearable. I am due to have the injections next friday at the surgery however I do not think any x ray will be used.

    I have found that swimming really relieves the pain and I have been going on a regular basis... Also there is a device called a TENS which you can buy for use when sitting however I have yet to try it myself

    • NadineHope
      NadineHope diane04260

      Posted

      I have a Tens machine which, at my worst, was an absolute life saver! They can be found for around £15-20 and are worth the gamble. I had such a bad back due to the Trochanteric pain that I used it to get through some otherwise grim days just to sit or just manage around the house and eventually at work. I had a steroid injection a month ago and doing quite well, occasionally taking ibuprofen or putting ibuprofen gel on my hip.

      I haven't tried swimming so will see if it helps. The worst part of this is becoming less active.

    • mark50648
      mark50648 NadineHope

      Posted

      What is this Ibuprofen gel? Never heard of this? Name?? THX
  • connie1954
    connie1954 monica111

    Posted

    Yes, I too have been battling this for six months end after the second ultrasound guided steroid injection three weeks ago I am starting to do better by using many things . First a lot of natural anti-inflammatories such as clothes which you can put in powder form capsules., Vitamin C and 5000 mg of fish oil a day , also vitamin C and glucosamine and lots of it per day. Do stretches twice a day , especially the easy yoga ones where you are stretching those five muscles. Don't work or sit for long periods of time . And for sleeping I found that a neck pillow, helps you sleep on your side by positioning it around your bursa . I have it on both hips , and I have herniated and bulging disc in my back and neck . So I went for the first three months and lucky if I got one hour of sleep at night . Since been on two rounds of prednisone and the Cortizone shots and all the anti-inflammatories and stretching and foam roller I'm starting to finally turn the corner away from so much pain . You have to do a lot of physical therapy when the inflammation is down and look forward gluteal muscle strengthening PT . You can find those online . I got my trochanteric bursitis in both hips after a car accident because I had sacroiliac joint dysfunction along with a bad back . My heart goes out to all of you who suffer this horrible horrible painful disease . I just know that it takes a lot of work end giving up sugar white flour end eating lots of red berries, almonds , green tea capsules end anti-inflammatory foods and spices . God bless you and I pray you find results because I know it's possible to get rid of this.
  • connie1954
    connie1954 monica111

    Posted

    My name is Connie and I just put a long post on the board but I forgot to tell you that it's most important that you get a walker and don't put any pressure on your hips especially when getting help from a chair , end limit for walking as much as possible. I just posted the long letter which explains a lot of the things that you have to do simultaneously over a period of time and rest to heal trocanteric bursitis . I hope you feel better soon
    • jp66967
      jp66967 connie1954

      Posted

      Hello Connie,

      If you have resistant bilateral "trochanteric bursitis" as well as sacro-iliitis you should be tested for rheumatois arthrosis.

    • connie1954
      connie1954 jp66967

      Posted

      Thank you so much for that, most days I feel like I'm living in a prison called my house end don't sleep much at all , today seeing the surgeon about a possible bursectomy with IT band release and clean up the debris and fraying. Is that something that can be seen in my blood work? Because my primary care physician just ordered some blood work and I noticed one for the bursitis . It's called , C-Reactive protein,Quant. I've been going through this too long and also have herniated and bulging discs in my L4, l5 & S1 , also a failed neck surgery with a double discectomy . At my wits end . Thank you so much for your help I really really appreciate it end am using a lot of tens unit therapy to besides natural anti-inflammatories . My heart goes out to anyone who is suffering this horrible disease
    • jp66967
      jp66967 connie1954

      Posted

      Hello Connie,

      C-reactive protein is an "inflammatory marker", and is a general test for inflammation which could be anywhere in your body. It is often used as a "starter investigation" in (for example) rheumatoid arthritis.

      However, as you list many other problems it might be wise to consider the correctness of your diagnosis before being subject to surgery, A "true" bursitis is demonstrable on ultrasound and MRI, which should preceed surgery for confirmation. I am not sure about the "ilio-tibial band". When this abnormality occurs it gives knee pain. Perhaps the surgeon is thinking of a fascia lata release. Mmmm.

      If you can possibly get "aqua-physiotherapy" or treat yoursef in a pool, that should be your starting point. I could give you more specifics if you can have a swimming pool available.

    • Mrs.C
      Mrs.C connie1954

      Posted

      Hi Connie..I did not read that you had been to Physical Therapy...is that correct or did I miss it?      They can be of great help with the

      ''Bursitis'' problem as well as some relief for your other issues.

      I am in the Medical profession...a Clinical Lab Scientist...and having had many orthopedic surgeries...plus some others...and also just from common knowledge...Surgeons see something they think they can fix with a ''knife'' and take the challenge.

      Most times there is a good reason with a positive rehab with it.

      Sometimes, however. there are more conservative actions that are the better choice.

      You need frequent and ongoing PT first of all.  The IT band isn't really anything in itself but an area along the thigh muscles..quadraceps etc.  where several muscles and tendons come together and even cross over.  So again...significant PT could solve the pain of your IT band.  You are online here so you should be able to ''Google'' many sites that demonstrate

      easy stretches for that area.

      Most cases of the Tro/Bursitis are solved by the more conservative measures...anti-inflammatories, rest, ice and

      physical therapy.  I am guessing that you, like me, are not

      an athlete, but perhaps a 60ish woman, slightly overweight and prone to sitting.  That results in the quadraceps (on top of thighs) becoming very short...because that is usually all that we ask them to do.   But when we stand or walk, etc. those short muscles rub over the bursa and irritate it significantly until it is inflamed.   The key is to straighten out your legs all day long to re-teach those muscles that they are supposed to be long and not short.   PT will get you started and you CAN continue them at home...and perhaps forever.   I am told that the inflammation will calm by itself once I get those muscles elongated like they should be.   

      I would definitely get a second opinion by an Orthopedic surgeon, in fact some insurances now require it and NOT

      someone in the same office !!   Doctors expect this these days.

      And you do NOT apologize or be embarrassed about it.

      The Docs seldom even know.  You call the office and have

      your chart sent to Dr...........      Sometimes you will get agreement and sometimes you won't but you owe it to yourself and your quality of like to not give up.....just yet.

      I personally would demand an MRI before this surgery.

      And...as a professional I can assure you as has jp...that there is NO blood test for this condition.   CRP tests include finding out which of three sub-proteins is high.  One is cardiac, one is brain and lungs and one is muscles.  That indicates the area of inflamation.  And there are numerical numbers given as to the intensity of the problem.   You can ask to get a copy of your

      lab results...see what your number is and compare to what

      the acceptable ranges are.  CRP's are most usually done to ascertain a heart attack.  However, they are not always diagnostic...so the results are included with other findings before making a true diagnosis.

      Just an opinion here, but I would suggest that the ''natural'' anti-inflammatories are not effective.   Please get an Rx for Mobic...

      taken with Tylenol and FÖOD and some ''orthopedic peas' ??

      That is the term we use for a large pack of frozen green peas

      that you use as an ice pack.  When it starts to soften, the time

      is up for your icing...but continue on through the day.

      (Be sure to mark the package clearly so that someone doesn't

             serve your ''ice pack'' for dinner.    ha )

      Emis Moderator comment: I have removed the link as it went to a "Page not found". If users want this information please use the Private Message service to request the details.

      http://patient.uservoice.com/knowledgebase/articles/398331-private-messages

    • Mrs.C
      Mrs.C jp66967

      Posted

      I have sent you a long post...which is being moderated.

      But...I had forgotten that you are UK....and I am US...

      and many of my comments and/or suggestions may 

      not be applicable.    Sorry about that.....

    • jp66967
      jp66967 Mrs.C

      Posted

      It is unlikely to make any difference. I am familiar with practices in both UK and USA. The illness entities are, after all is said, universal. But thank you for telling me.
    • connie1954
      connie1954 Mrs.C

      Posted

      Thank you Mrs. C for your comments . And I appreciate your medical and scientific knowledge. Yes I have been through physical therapy end have been doing it every day including icing resting stretches end natural anti-inflammatories like clothes powder and lots of glucosamine and fish oil, etc. I recently about 2 1/2 weeks ago got ultrasound guided injections in both my bursa , each side . And it is so true about your quadriceps being tight . I have been working with lots of scratches and a foam roller like crazy including lots of rest . They are now starting to feel better and I had already scheduled an arthroscopic bursectomy with debridement and ITB windowing . However at this time I'm going to postpone it for a while as things are starting to feel better . My brother is a doctor and also has a physical therapy side to his practice end I have learned a lot online from friendly people as yourself . Thank you for your comments and God bless you and everyone who suffers with this horrible painful problem . It just takes time a lot of work a lot of rest and a lot of prayer .
    • connie1954
      connie1954

      Posted

      I'm sorry I meant clove powder put into capsules , as it is a very very strong anti-inflammatory . Along with all the other natural anti-inflammatories . Thank you
    • connie1954
      connie1954 jp66967

      Posted

      Thank you for your comment, however I have been tested and again just recently and I absolutely do not have any arthritis . Four weeks and so I had a bursectomy on my right hip for my bursitis and I'm doing quite well , now I'll wait and see if I will do my side .

      Thank you for all your helpful knowledge and tips . I have had surgery and herniated and bulging discs in my lower back and sacroiliac joint dysfunction however , nothing compared to the kind of pain I have dealt with especially at night from the trochanteric bursitis in both hips . Which was caused by a car accident.

      I have loved reading these posts and hearing from others and now that I'm not alone , good luck to everyone and blessings . Especially to Dr. Jolly who owns the VAX-D machine that helped my low back. Had I not done that before the car accident there was no way I could've dealt with the bursitis and all the physical therapy

    • jp66967
      jp66967 connie1954

      Posted

      Hello Connie,

      Was the bursa removed from your trochanteric region sent for histological (pathological) examination? That is the definitive test for rheumatoid arthritis (and other pathologies).

      If only a single blood test was done for "rheumatoid factor" that could be negative since there is a condition known as "sero-negative rheumatoid". What is your HLA-B27 reading (given that you have sacro-iliac pathology as well as vertebral pathology). What is your ESR and ultra-sensitive CRP?

      Feel free to pass this note to your GP when you ask him, as you should. [He might need to ask the surgeon]

      Best Wishes,

      jp66967

    • connie1954
      connie1954 jp66967

      Posted

      Dear JP 66967,

      Yes I had all the blood work done before the operation end everything was in normal ranges I have absolutely nothing wrong not even high cholesterol or high blood pressure and have no arthritis , they did not do a pathology of the bursa I guess because he said of the way it looked . I'm still waiting for a reply back but they were both injured in a car accident on this hard seat cushions that I was jammed into on both hips . Thank you for all the help end may you have a happy Thanksgiving and I'm thankful for all your advice

    • connie1954
      connie1954 jp66967

      Posted

      Yes I live in the United States and I used to be a nursing assistant and worked in hospitals on the orthopedic floor for many years , but more so I have doctors and nurses in my sisters and brothers end I read veraciously on online concerning medical journal papers and everything . I was wondering what your training field was in . I am so thankful for your helpful suggestions . I may have to have, another cervical surgery because my double discectomy , is causing the upper and lower areas to crumble as it was all titanium instead of bone grafting . But I know a fantastic neurosurgeon here , who did my brother's surgery after he broke his neck in a preseason game for the 49ers back in 85 . He's had three but this one was the charm . Have a happy happy Thanksgiving and bless you
    • connie1954
      connie1954 Mrs.C

      Posted

      Hi Mrs. C ,

      Thank you for your comments . I have posted so many comments and I guess you must've missed them all . I have been in constant PT for this and for all my other injuries for eight years . My brother is a doctor who also treats me and has a large physical therapy side to his practice . My pain doctor however, ordered an MRI of my hips , after a car accident six months prior , and confirmed in the MRI that I had trocanteric bursitis in both hips . Most people in my family are in the medical field . Including doctors Peays, nurses and I myself used to work as a nursing assistant and hospitals on the orthopedics floors . I do a lot of reading especially since I got this horrible infection or I should say bursitis , not infection . It was caused from my hips been slammed very hard against the hard side pillows of my car seat which lift up to make them.

      I am four weeks postop from having arthroscopic bursectomy debridement and ITB windowing and my right hip is doing great . I've been doing physical therapy post surgery . However my left hip will probably need the same surgery . I know that the injections do not work for a lot of people and they're very damaging to tendons and bone so I didn't want to have anymore besides the two sets I've had . Thank you and please take care and happy holidays

    • mark50648
      mark50648 connie1954

      Posted

      Hi Connie- Did you end up having the Bursectomy? If so did it work? THX  Mark
    • connie1954
      connie1954 mark50648

      Posted

      Hi Mark, each day I am getting healed a little more and stronger. I don't wait too much because I have a severe neck injury . However I responded to Mrs. C in earlier posts end you can check those out . For people who have other issues and bursitis in both hips , , sometimes having that bursectomy surgery is really the only sure way to get rid of it once and for all . I use voice to text so pardon any errors in my writing . Yes for sector he's done arthroscopic the easiest to come back from and you literally can go home and start walking on that hip the next day for the same day. I have had both of them done in the last 3 1/2 months now and I am doing very well , just having the last surgery on December 31 which is 2 1/2 weeks ago doing a lot of PT each day but it's very easy . Within two weeks I won't have to do much at all just keep riding a bike and strengthening my glutes. For anyone who is suffering with this horrible illness please do your homework online and find them good or so surgeon who can maybe do it arthroscopically and make sure you get IT band windowing and debridement . You can look that up online under any surgeons website who does it . However my surgeon did not make me do much treatment at home following, like some surgeons do so he was very easy , and it depends upon your circumstances . Happy new year and please make it a good one wishing you all the best , Connie .
    • connie1954
      connie1954 jp66967

      Posted

      Dear JP,

      I posted several other comments during and after my 2% in the last three months which are working out extremely well . I can tell you have a lot of medical training and so appreciate your post to help others . I had extensive blood work done before and knew that the cause was a car accident , which pushed my hips very hard into some seat cushions on the sides. You can track my other posts to Mark and some other people , but postop I am doing very well now and highly recommend this for those people who can't get rid of this within a year or two . I did my homework online by checking out other surgeons websites, sorry about any errors , as I use voice to text because my neck is so bad . That one won't be so easy to heal as I have all titanium in there . Good luck to you and thank you again , make this a great new year . Sincerely Connie

    • mark50648
      mark50648 connie1954

      Posted

      Going to see my Ortho Dr, tomorow and se what he says if I am a good canidate for this Burectomy surgery or not. I have started PT. My lower back is very bad too. I do have an appt. in 2 weeks for a cortisone shot in my hip bursa. I had one on Nov.18th and it worked really good but then I played golf for 7 days in a row and I should have not done that becuae the shot wore off on Jan.1st and I am in more pain with my bursa and lower back before I got the shot. So when I get this next shot I will go easy and just concentrate on PT stuff.  But I will let you know what Dr. Mike Ayers says on the Bursectomy surgery. THX  Mark 
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