Wednesday, January 2, 2008

Greater Trochanter Bursitis

My right hip (aka "greater trochanter") bursitis has been waking me up at night, hardly what I need while pregnant. I've had this bursitis pain constantly for the past 7 years. Around the one-year mark, I went to a doctor who knows me well, and had four corticosteroid injections. The injections hurt, the swelling from the injections lasted about two weeks and hurt the whole time, and then the regular bursitis pain came back. So we tried again, tweaking the injection formula for me, and it never helped. We also tried large doses of NSAIDs with the same lack of luck. I figure I must be doing something regularly, for seven years, to keep it so irritated. *sigh*

So it's time to look for other ideas.

Here's an overview of trochanteric bursitis treatment. The good information here is to stretch tight iliotibial bands (ITB) as well as tensor fascia lata (TFL). I've had the corticosteroid injections and I wear my orthotics. I haven't used deep heating, but it feels a lot better when it's warm/hot than when it's cold! So maybe I should try ITB and TFL stretches, and use a heating pad.

The most helpful "cure" for me tends to be physical therapy. Previous research turned up that hip bursitis is often a tight piriformis muscle, and sure enough, my right piriformis is significantly tighter than the left. I was surprised because I'm used to my benign hypermobility, and here I am with a very tight piriformis. So not only does PT work on me in general, I've got the lack of range of motion to back up this specific case too. Here's a description of, with link to pictures of, trochanteric bursitis rehabilitation exercises. It targets piriformis and iliotibial, the main culprits. (However, when my ITB is tight, I get a characteristic pain in my knee that feels like I twisted my kneecap. The pain is on the edge of my patella, from the bottom to the outer side. I haven't had that in a while. ITB stretches are good, but I think piriformis stretching is best for my right hip bursitis.)

Heading to the fringe, there's also a list of herbs for bursitis and tendinitis (the number of leaves represents the confidence level). Willow is just aspirin, and I've tried that route, so I'm not interested. Ginger might have promise, and possibly magnesium (Mg also helps glucose tolerance / insulin resistance).

So I think I'll stretch my right piriformis muscle right now, and maybe put a heating pad on it tonight.

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