When you experience hip pain and tenderness, simple tasks like walking or standing can become more difficult. While there are many causes of hip pain, one common culprit is bursitis (a condition that can also affect the shoulder, elbow, foot or knee).
Bursitis is the inflammation of the bursa, a small sac filled with fluid that acts as a cushion between the joints and soft tissues for smooth movement. As an orthopedic doctor who specializes in hip conditions, I treat many patients with bursitis who are eager to relieve their pain quickly and get back to their regular activities. Here are answers to the questions my patients most commonly ask:
What Causes Hip Bursitis?
Hip bursitis occurs when the bursa becomes inflamed or irritated, generally because of a strain or injury to the tissue. For example:
- Bumping your hip against a hard surface or falling on it can cause bursitis to develop.
- Standing or kneeling for long periods can put too much stress on the bursa.
- Repetitive motions involving the hip, such as long-distance cycling or using a stair-climbing exercise machine, can be a factor.
- Other possible contributors are arthritis, obesity, diabetes, bone spurs, uneven leg lengths, or spine issues such as scoliosis.
Your hip has two major bursae. One bursa is located at the bony outer part of the hip called the greater trochanter. Inflammation in this large bursa, which is the more common type of hip bursitis, is also referred to trochanteric bursitis or “greater trochanteric pain syndrome.” The other bursa, called the iliopsoas bursa, is on the inside of the hip.
Anyone can develop hip bursitis, although it becomes more common with advancing age and is seen more frequently in women.
What are the Symptoms of Hip Bursitis?
The main complaint of hip (trochanteric) bursitis is pain at the outside point of the hip that may radiate down the thigh. The pain may begin as sharp and searing but eventually may become more of a dull ache. It tends to worsen when standing up from a chair, climbing stairs or lying down on the painful side, often making sleep difficult. You may experience swelling or redness in the area, or a shooting pain when applying pressure to the affected area.
By contrast, groin pain is the chief complaint among those with inflammation in the iliopsoas bursa.
How is Hip Bursitis Treated?
Conservative methods and therapies usually help with hip pain caused by bursitis. Nonsurgical treatment options for hip bursitis include:
- Rest: Give the inflammation time to subside. Until symptoms are gone, avoid activities that could strain the hip area and aggravate the condition.
- NSAIDs: Non-steroidal anti-inflammatory medications such as ibuprofen or naproxen can alleviate discomfort.
- Ice: Applying an ice pack several times a day can help control pain and swelling.
- Physical therapy: A rehabilitation therapist can assist with exercises to strengthen hip muscles, build flexibility and increase range of motion. Similar treatment options may include massage, heat or ultrasound therapy.
- Assistive devices: Splints, crutches or a cane can help you get around while keeping weight and pressure off the hip.
- Steroid injections: Injecting a corticosteroid into the bursa may relieve bursitis symptoms quickly. This type of injection may be provided at the same time as aspiration for some patients. For many patients, more than one injection may be necessary.
- Biologic injections: Blood-based and stem cell therapies are growing quickly within the field of orthopedics. At Dickson-Diveley Orthopaedics, we are using these injections to treat bursitis and other conditions where the patient has inflammation and damaged tissue. I discuss the use of stem cell injections further in this video:
Is Surgery Necessary for Hip Bursitis?
Surgery is rarely required for treating hip bursitis, but if conservative methods of treatment are not effective, the bursa can be removed arthroscopically with small incisions. This procedure does not affect the hip’s normal function, and the recovery period is usually relatively short.
How Can I Prevent Hip Bursitis?
Of course, like all matters of health, prevention is ideal. To decrease your risk of developing hip bursitis:
- Maintain a healthy weight
- Start a safe stretching routine
- Use shoe inserts to compensate for uneven leg lengths (if applicable)
- Focus on activities that don’t place undue stress on the hip area
About the Author
Scott A. Wingerter, M.D., Ph.D. is a board-certified and fellowship-trained orthopedic surgeon specializing in joint preservation and replacement surgery. His focus is on total joint replacement of the hip and knee, hip resurfacing, partial knee replacement, minimally invasive surgery, and hip arthroscopy.
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