What Is bursitis of the hip?
Your body has over 150 bursae. Bursitis is an inflammation of the bursae. Two major bursae are located in your hip and most cases of hip bursitis will heal with rest and at-home care. But medications, steroid injections, physical therapy, fluid removal, and surgery are additional options for treatment and relief.
Bursae are small, jelly-like sacs that cushion areas where tendons, bones, ligaments, and muscles rub against each other. They are filled with a small amount of fluid and act as a cushion in these areas. There are over 150 bursae in the human body. Bursitis is an inflammation of one of these bursae. Bursitis is more common in women and older people, but it can affect anyone.
Your body has 150 bursae. Two major ones are located in your hip. One of the major hip bursae is located at the bony part of your hip bone called the greater trochanter. Inflammation of this bursa is called greater trochanteric pain syndrome (GTPS), or trochanteric bursitis.
Your iliopsoas bursa is the other major hip bursa, located on the inside of your hip by the groin. Inflammation of the iliopsoas bursa is not as common as trochanteric bursitis, but it is treated in a similar fashion.
Symptoms of hip bursitis
Symptoms of hip bursitis include:
- Pain at the side of the hip or outside of the thigh
- Difficulty walking
- Joint stiffness
- Warmth and swelling at the hip joint
- Clicking sensation
The pain is often worse at night, when you are resting on the hip that hurts. It may also be painful to rise from a chair after sitting for a while. You may have severe pain when squatting, going up and down stairs, or walking for an extended period of time.
Causes of hip bursitis
Trochanteric bursitis can be caused by the following:
- Repetitive activities like running, cycling, or stair climbing
- Injuring your hip, such as in a fall
- Rheumatoid arthritis
- Spine diseases such as scoliosis or arthritis
- Bone spurs or calcium deposits of the hip
- One leg being shorter than the other
- Arthritis in the hip, knee, or foot
- Being overweight
- Foot issues such as bunions or plantar fasciitis
- Previous surgery of the hip
Anyone can develop hip bursitis but it is more common in older people and women.
Diagnosis for bursitis of the hip?
If you have symptoms of bursitis, visit your doctor. They will listen to your symptoms and perform a physical exam to check for tenderness of the hip. To make a definite diagnosis, your doctor might ask for X-rays, magnetic resonance imaging (MRI), or an ultrasound.
Treatments for bursitis of the hip
Many cases of bursitis will heal with rest and at-home care. Additionally, the following measures may help:
Rest
Avoid activities that worsen the pain. Apply ice or cold packs at the onset of pain for 10 to 15 minutes, up to three times an hour. After 3 days, you can use heat or alternate heat and ice.
Medication
A nonsteroidal anti-inflammatory drug (NSAID) may help with pain and inflammation. NSAIDs should be used with care and only for a limited time. They can cause stomach irritation and other side effects. Discuss all medication use with your doctor.
A cane or crutches
Devices that help you walk such as canes or crutches may help relieve the pain when needed.
Steroid injection
Your doctor may inject a local anesthetic and a corticosteroid into the bursa. This simple treatment is very effective and can be done in the doctor’s office. It may provide temporary or permanent relief. If the pain returns, another injection may be given several months later.
Physical therapy
Your doctor may prescribe physical therapy to help with hip strength and flexibility. A physical therapist can show you how to do exercises at home to help stretch your muscles. It’s also a good idea to gently move your hip through a full range of motion even while you are resting so that it doesn’t get stiff.
Removing fluid from bursa
In cases of severe bursitis, your doctor may use a needle to remove extra fluid from the bursa.
Surgery
Surgery is not typically needed to treat hip bursitis. Your doctor may recommend removing the bursa only if your problems continue after all nonsurgical treatments have been tried. Your hip can function normally without the bursa. This may be done arthroscopically, using a small camera. A small incision is made and the doctor uses the camera to view the bursa and remove it. This type of surgery is less invasive. It allows you to heal faster than you would from traditional surgery.
Prevention
Regardless of which treatment option works for you, here are some ways to prevent bursitis from recurring:
- Avoid repetitive movements that put stress on the hip joint.
- Swim instead of running or cycling for exercise.
- Use shoe inserts if needed for foot problems or leg-length differences.
- Strengthen your core muscles and hip muscles.
- Avoid standing for long lengths of time.
- Lose weight if needed.
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Risks and side effects of treatments
Some treatments for hip bursitis can have risks and side effects. Here are some common side effects that result from the following treatments:
Nonsteroidal Anti-inflammatory Drugs:
- Indigestion
- Stomach ulcers
- Allergic reaction
- Headache
- In rare cases, liver, kidney, or heart problems
Steroid Injections:
- Pain around the injection site for a few days
- Bruising
- Flushing
- Loss of fat around site of injection
- Increased blood sugar level if you have diabetes
- Increased blood pressure if you have high blood pressure
- Infection that causes redness, swelling, and pain
Surgery:
- Infection
- Nerve or blood vessel injury
- Failure of the surgery
Talk with your doctor to be sure you’re choosing the right treatment for you and minimizing your chance of negative side effects.