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As physical therapists, we are big believers in the power of exercise and “conservative care” treatment to help with conditions as diverse as neck pain after a car accident, hip pain diagnosed as “bursitis”, plantar fasciitis, and low back pain. It is extremely gratifying when we can help people avoid surgery or medication and get back to what they love without the use of overly invasive methods.
One of the conditions that responds very well to physical therapy is hip pain that is on the outside of the hip and often called “hip bursitis.” Often people will come in to physical therapy and say that the outside of their hip or leg is really painful when they walk long distances, when they run, or when they sleep on that side of their body. Sometimes, they will describe pain like this that has lasted for months or years and has not responded to rest or stretching. This is when physical therapy can be most valuable!
What we have found in medical research (and physical therapy research), is that there is often more going on than inflammation of the bursa (aka “bursitis”), and that could be why an injection at the bursa may help for a little while, but not completely “cure” the issue. Usually, there is some amount of tendon pain involved at the outside of the hip and there could also be contributions from some IT band pain or muscle tightness or pain in the “glute” muscles.
All that is to say that physical therapy can provide treatments for all of these things and make better long-term progress than just a single steroid injection can (or just rest or stretching!). In fact, there is some research to show that doing dry needling for muscles in that area is just as effective as doing an injection with a steroid! How about that?!
Physical therapy treatments will also include the prescription of exercises that are best to strengthen the muscles around the irritated tissues (e.g., tendons, bursa, IT band etc.) and can even strengthen tendons to make them more robust! There are also important lifestyle things that can help reduce pain in the short term that physical therapists can recommend such as using a walking stick to take pressure/load off the outside of the hip.
To learn more, check out the link to the short infographic and 1-page document about how physical therapy can help hip pain.
From Article Above: 'This JOSPT Perspectives for Patients is based on an article by Brennan et al, titled “Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial”' (J Orthop Sports Phys Ther 2017;47(4):232-239. doi: 10.2519/jospt.2017.6994).