Bursae that are not infected can be treated symptomatically with rest, ice, elevation, physiotherapy , anti-inflammatory drugs and pain medication. Since bursitis is caused by increased friction from the adjacent structures, a compression bandage is not suggested because compression would create more friction around the joint. Chronic bursitis can be amenable to bursectomy and aspiration.  Bursae that are infected require further investigation and antibiotic therapy. Steroid therapy may also be considered.  In cases when all conservative treatment fails, surgical therapy may be necessary. In a bursectomy the bursa is cut out either endoscopically or with open surgery. The bursa grows back in place after a couple of weeks but without any inflammatory component.
Should the pain persist despite multiple cortisone injections and quality physical therapy exercise, an MRI may be appropriate. A high quality MRI can visualize the gluteal tendons, and discern whether there is tendinosis or a partial or complete tear of the tendons. Hip arthroscopy surgeons have transferred the expertise gained from shoulder arthroscopic rotator cuff repair to the hip and hip gluteus medius or minimus tears can now be treated and repaired arthroscopically. Thin cameras and instruments are used through poke holes in the skin, allowing visualization of the deep structures. Anchors and sutures are then used to tie the gluteus medius and minimus back down to the bone, in anatomic position. This procedure is rather new, but the preliminary results have been promising. The bottom line is our understanding and treatment of greater trochanteric pain syndrome is expanding rapidly. If you are having lateral sided hip pain, the treatment options for this are expanding, and our techniques are getting more people with chronic lateral hip pain better.
Karen is a 47-year-old teacher who is training for her first 5K road race. She runs 3 to 4 days each week, then walks the other days. Over the past 2 weeks, she has begun to experience pain in the outside of her right hip. Her pain is worst while running and lying on her right side; she experiences hip pain and stiffness when taking her first steps in the morning and walking up stairs, and also notes a dull ache with prolonged sitting and standing. She typically performs stretches for 5 minutes before her runs. Karen had not run consistently before she began training for the 5K.