Typical complaints
- pain on the side of the thigh;
- pain when lying on the painful side;
- pain when getting up from a chair;
- not being able to walk for long periods of time;
- radiation down the side of the leg to the knee.
How bursitis of the hip occurs
A long tendon runs along the side of the thigh. This tendon rubs the trochanter with every step: the bony protrusion that you can feel on the side of the thigh. To lubricate this movement, there is a bursa between the tendon and the trochanter. You can compare this structure to a plastic bag with a layer of water in it: the two plastic sheets slide effortlessly over each other.
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Overuse can cause the bursa to inflame and swell, causing pain and discomfort. In young patients we regularly see overuse injuries to the bursa, often due to running.
Almost all patients with a so-called bursitis also have a tendon disorder of the long tendon along the side of the thigh. This concerns an overload of the IT band (iliotibial band). That is why the pain often radiates along the thigh to the knee.
Treatment
The traditional treatment for these complaints is an injection with an anti-inflammatory: corticosteroids. This injection provides local anti-inflammatory and pain relief. In mild cases this is sufficient, but in many cases it is a temporary solution.
Left untreated, these complaints can last a very long time. This is because this tendon and the bursa have a poor natural recovery capacity. What is needed in this case is to stimulate that recovery capacity so that the injury can heal.
Prolotherapy is an injection therapy in which we stimulate the body's own healing response (inflammatory response) with glucose. In this way we give the body the opportunity to repair this injury. This will cause you to have less pain or become pain-free. Not because we use painkillers, but because the painful area has become healthier.
Prolotherapy is always a series of treatments: on average one treatment per week. This usually takes a number of weeks.
What you should take into account
Anti-inflammatory medications such as diclofenac or ibuprofen, and a recent injection of anti-inflammatory drugs (corticosteroids), are not compatible with prolotherapy. These medications actually inhibit the healing response that we want to provoke with the treatment. Paracetamol does not have that effect and is therefore permitted.
Recognizable symptoms
- Pain on the side of the thigh
- Pain when lying on the painful side
- Pain when getting up from a chair
- Not being able to walk for long
- Radiation down the side of the leg to the knee
- Staggering walking because of the pain
Scientific references
- Fitzpatrick J, Bulsara MK, O’Donnell J, McCrory PR, Zheng MH. The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection. Am J Sports Med. 2018 Jan 1:363546517745525. doi: 10.1177/0363546517745525. [Epub ahead of print] PubMed PMID: 29293361.



