Hip bursitis refers to a painful condition caused by an inflammation of a bursa in the hip. Although there are several bursas located around the hip joint that can be affected by bursitis, the most common type of hip bursitis is trochanteric bursitis.
A bursa is a fluid filled sac present in joints between the bone and soft tissue. The function of a bursa is to act as a cushion and to reduce friction during movement. There are several bursas around the hip joint, but the two that typically become irritated and inflamed are the trochanteric bursa located at the bony point of the hip and the iliopsoas bursa located on the groin side of the hip. Iliopsoas bursitis is seen less often than trochanteric bursitis, but is treated in a similar manner.
Trochanteric bursitis can affect anyone but it occurs more often in middle aged or elderly women than in men or younger individuals. It may be caused by an acute injury sustained during a fall, as a result of banging the hip, or from prolonged pressure on the area. Oftentimes the condition is the result of activities that create repetitive friction between the bursa and the overlying muscles and tendons. Running or bicycling long distances are two activities that can generate repetitive stresses that may contribute to the development of hip bursitis. Additional risk factors associated with the condition include spine disease, leg-length inequality, rheumatoid arthritis, gout, previous hip surgery, as well as bone spurs or calcium deposits.
Hip bursitis usually causes pain, aching, and stiffness. The symptoms are different depending on the type of hip bursitis you have.
Symptoms of trochanteric bursitis may include the following:
- Pain on the outside of the hip that can spread to the buttock and down the outside of the thigh
- Increased discomfort with activities such as lying on the affected hip, getting up from a chair, prolonged walking, running, or climbing stairs
- Tenderness when you press on the affected area
- Swelling from increased fluids in the bursa
- Redness and warmth (from inflammation or infection)
Iliopsoas bursitis on the other hand involves pain and tenderness that radiates from deep in the groin region, or front of the hip, that can extend down the front of the thigh to the knee.
Diagnosis of hip bursitis begins with a history and physical examination. Imaging tests may be ordered to further evaluate the hip and rule out other possible injuries or conditions. Blood tests and a culture of the bursa fluid may be performed to check for infection or diseases that can cause bursitis.
In many cases nonsurgical treatments are able to provide relief from hip bursitis. Rest along with restriction of activities causing the bursitis is advised. Non-steroidal anti-inflammatory drugs can help to reduce the inflammation and pain. Physical therapy to increase hip strength and flexibility, the application of heat, ice, or ultrasound treatments may also be recommended. In some cases an injection of a steroid along with a local anesthetic can provide relief. If the bursa continues to remain painful and inflamed after all of the conservative treatments have been tried, a surgical procedure may be necessary.