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.
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.
At Alliance Physical Therapy, we provide 24/7 access to online appointments, most requests are scheduled within 48 hours. With thirteen convenient locations, we are able to serve the Northern VA, DC and Richmond regions. Our offices are located in Alexandria (Near Alexandria Hospital) , Alexandria / Mount Vernon , Fairfax , Richmond / Willow Lawn, Richmond / Colonial Heights , Springfield , Stafford , Tysons Corner , Woodbridge , Woodbridge / Opitz Blvd. , Manassas , Richmond / Midlothian and downtown Washington DC .