There are two main conditions we see commonly that create pain in the lateral part of the hip—trochanteric bursitis and soft tissue strains. There is perhaps a third. I often find lateral hip pain in patients with osteoarthritis of the hip, which primarily hurts in the groin region. Osteoarthritis of the hip is the subject of a different article available on this website.
1) Trochanteric Bursitis
There are three bursae around the greater trochanter of the hip joint, and they can become inflamed due to repetitive activities that irritate them—activities such as running, dancing, and tennis. Sometimes a direct trauma will inflame the bursae, such as falling and landing on the hip. At times the problem can develop simply from the activities of daily life, as I have observed with many patients. It occurs more frequently in women than men, probably because of their wider hip structure. Often there will be pain radiating down the lateral aspect of the thigh.
I’ve had good luck treating trochanteric bursitis. I follow two strategies when choosing points to needle—the classical approach, which calls for treating the acupuncture meridian that traverses the area as well as with other acupuncture points to balance the energy of the body to promote healing, and the modern anatomical approach where we choose specific tissues that are affected. The modern approach includes releasing trigger points in the iliotibial band and tensor facia latae muscle to reduce pain and to take pressure off the bursae.
Results are usually good. The patient can often feel 50% relief in 2-3 treatments and complete relief in 3-12 treatments, depending on the severity of the problem.(1) In case there is no relief after 4 treatments, we discontinue therapy.
2) Soft tissue strains along the hip joint.
These injuries usually occur during sporting activities that involve running, jumping or twisting, with running being the most common. As with bursitis, the problem occurs more commonly in women than men.The most common area affected is the gluteus medium muscle. At the moment of injury, the athlete might feel a sharp pain, or perhaps nothing nothing at all. As time passes, the pain begins or increases and there is stiffness and subjective weakness of the muscles. (2)
It has been my experience that soft tissue injuries generally respond quite well to acupuncture, depending on the seriousness of the strain. If it is grade one, mild, or grade two, moderate, we can expect a good result. Grade 3, or severe, will require the attention of an orthopedic physician.
Part of the acupuncture treatment will involve the release of trigger points in the soft tissue around the hip, as these can create chronic pain problems if not deactivated.
The number of acupuncture treatments required for rehabilitation depends on the grade of the strain, but generally, we can expect significant relief to occur over the course of 2-6 treatments over 2-3 weeks.(3) It is often the case that there will be a pelvic imbalance that has contributed to the problem—an elevated ilium on the side of the injury due to an imbalance of the hip adductors and abductors. It is advisable to correct this condition, and a combination of acupuncture and PNF (proprioceptive neuromuscular facilitation) can be very effective for such muscle imbalances.
(1) Matt Callison, L.Ac., Sports Medicine Acupuncture, San Diego, CA. Acusport Education, 2019, p704
(2) ibid., p 705