Hip Bursitis: Symptoms, Treatment, & Exercises

What is bursitis of the hip?

Bursitis is the painful swelling of bursae. Bursae are fluid-filled sacs that cushion your tendons, ligaments, and muscles. When they work normally, bursae help the tendons, ligaments, and muscles glide smoothly over bone. But when the bursae are swollen, the area around them becomes very tender and painful. Trochanteric bursitis is swelling affecting the bursae of the hip.

Bursitis does not only happen in the hip. It can also occur in the shoulder, knee, and elbow joints. Bursitis may be acute (short-lived) or chronic (long-lasting).

Symptoms of bursitis of the hip

Symptoms include joint pain and tenderness. You may also see swelling and feel warmth around the affected area. The pain is often sharp in the first few days. It may be dull and achy later. You may notice it more when getting out of a chair or bed. You may also notice it when sitting for a long time and when sleeping on the affected side.

Acute bursitis usually flares over hours or days. Chronic bursitis can last from a few days to several weeks. Chronic bursitis can go away and come back again. Acute bursitis can become chronic if it comes back or if a hip injury occurs.

Over time, the bursae may become thick, which can make swelling worse. This can lead to limited movement and weakened muscles (called atrophy) in the area.

What causes bursitis of the hip?

Several things can lead to hip bursitis, including the following:

• Repeated overuse or stress of the hip
• Rheumatoid arthritis
• Gout
• Pseudo gout
• Injury of the hip
• Infection with bacteria, such as Staphylococcus aureus (or a staph infection)
• Diabetes
• Spine problems, such as scoliosis
• Uneven leg lengths
• Bone spurs (bony growths on top of normal bone) on the hip

How is bursitis of the hip diagnosed?

Your doctor will examine you and ask about your symptoms. Sometimes certain tests may be needed to rule out other conditions that can cause similar symptoms. These tests may include X-rays and magnetic resonance imaging (MRI).

Can bursitis of the hip be prevented or avoided?

You can avoid getting bursitis by not putting too much strain on your hips. Avoid activities that are especially difficult or painful. And take breaks to rest your hips. When you exercise, remember to warm up your muscles and then stretch to prevent injury. If you’re overweight, losing weight can help reduce pressure on your joints, including the hips.

Building strength in your hips with an approved workout routine can greatly reduce your chances of getting bursitis. Ask your doctor what types of exercise are best for you.

Bursitis of the hip treatment

Treatment for bursitis usually involves doing strengthening exercises and stretching. This helps prevent muscle atrophy—and can also be used to prevent bursitis, not just treat it. You should avoid activities that cause pain. Ask your doctor about exercises to help build strength in the area. Your bursitis may affect your ability to function normally. If so, you may need physical therapy to help you move again. This is especially true if you have chronic bursitis.

You can also use nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (brand names: Advil, Motrin) or naproxen (brand name: Aleve) to relieve pain and swelling. You also may want to use an ice pack on the area to reduce swelling.

If these treatments don’t help, you may need to have fluid taken out of the bursa. Or you may need steroid shots to reduce pain and swelling. Steroid shots are usually very effective in treating bursitis. You may need another shot after a few months.

Surgery is rarely needed to treat bursitis. It’s used only when all other treatments fail. For people who do need surgery, it’s a simple procedure. The doctor removes the bursa from the hip. The hip can function normally without the bursa. Usually, the surgery doesn’t require a long hospital stay. The recovery period is typically short.

Living with bursitis of the hip

If you have chronic bursitis, try to minimize flare-ups by stretching each day to increase range of motion. And avoid activities that you know will result in pain. Repetitive-motion activities are especially bad for bursitis. If you do have a flare up, remember that resting your hip is important. Without proper rest, healing is delayed.

Questions to ask your doctor

• What could have caused my symptoms?
• What is the best treatment option for me?
• How long before I can expect relief from my symptoms?
• Is it possible that my symptoms could return?
• Is it safe for me to exercise? What kind of exercise should I do?

Resources

National Institutes of Health, MedlinePlus: Bursitis

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

Hip Bursitis – OrthoInfo – AAOS

Bursae are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction.

Bursitis is inflammation of the bursa. There are two major bursae in the hip that typically become irritated and inflamed. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis.

Another bursa — the iliopsoas bursa — is located on the inside (groin side) of the hip. When this bursa becomes inflamed, the condition is also sometimes referred to as hip bursitis, but the pain is located in the groin area. This condition is not as common as trochanteric bursitis but is treated in a similar manner.

Hip bursitis most often involves the bursa that covers the greater trochanter of the femur, although the iliopsoas bursa can also become inflamed.

Reproduced and adapted from The Body Almanac. (c) American Academy of Orthopaedic Surgeons, 2003, p. 151.

The main symptom of trochanteric bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may become more of an ache and spread across a larger area of the hip.

Typically, the pain is worse at night, when lying on the affected hip, and when getting up from a chair after being seated for a while. It also may get worse with prolonged walking, stair climbing, or squatting.

Hip bursitis can affect anyone, but it is more common in women and middle-aged or elderly people. It is less common in younger people and in men.

The following risk factors have been associated with the development of hip bursitis.

• Repetitive stress (overuse) injury. This can occur when running, stair climbing, bicycling, or standing for long periods of time.
• Hip injury. An injury to the point of your hip can occur when you fall onto your hip, bump your hip, or lie on one side of your body for an extended period of time.
• Spine disease. This includes scoliosis, arthritis of the lumbar (lower) spine, and other spine problems that may affect the way you walk.
• Leg-length inequality. When one leg is significantly shorter than the other, it affects the way you walk, and can lead to irritation of a hip bursa.
• Rheumatoid arthritis. This makes the bursa more likely to become inflamed.
• Previous surgery. Surgery around the hip or prosthetic implants in the hip can irritate the bursa and cause bursitis.
• Bone spurs or calcium deposits. These can develop within the tendons that attach muscles to the trochanter. They can irritate the bursa and cause inflammation.

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To diagnose hip bursitis, the doctor will perform a comprehensive physical examination, looking for tenderness in the area of the point of the hip. They may also perform additional tests to rule out other possible injuries or conditions. These tests can include imaging studies, such as X-rays, bone scanning, and magnetic resonance imaging (MRI) scans.

Your doctor will check for tenderness over the bony point of the hip bone.

Reproduced and adapted from AD Armstrong, MC Hubbard (eds.): Essentials of Musculoskeletal Care, ed. 5. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2016, p. 663.

Nonsurgical Treatment

The initial treatment for hip bursitis does not involve surgery. Many people with hip bursitis can experience relief with simple lifestyle changes, including:

• Activity modification. Avoid the activities that worsen symptoms.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen, naproxen, piroxicam, celecoxib, and others, may relieve pain and control inflammation. Use NSAIDs cautiously and for limited periods. Talk with your doctor about the NSAIDs you use. NSAIDs may have adverse (negative) side effects if you have certain medical conditions or take certain medications.
• Assistive devices. Use of a walking cane or crutches for a week or more when needed.
• Physical therapy. Your doctor may prescribe exercises to stretch out the IT band and/or increase hip strength and flexibility. You may do these exercises on your own, or a physical therapist may teach you how to stretch your hip muscles and use other treatments such as rolling therapy (massage), ice, heat, or ultrasound.
• Steroid injection. Injection of a corticosteroid along with a local anesthetic may also help to relieve symptoms of hip bursitis. This is a simple and effective treatment that can be done in the doctor’s office. It involves a single injection into the bursa. The injection may provide temporary (months) or permanent relief. If pain and inflammation return, another injection a few months after the initial injection may be helpful, but figuring out the cause of the bursitis is important to treat it definitively (in a complete way). It is important to limit the number of injections, as use of corticosteroid injections for a long time may damage the surrounding tissues.

Illustration shows a corticosteroid injection into the trochanteric bursa.

Surgical Treatment

Surgery is rarely needed for hip bursitis. If the bursa remains inflamed and painful after you have tried all nonsurgical treatments, your doctor may recommend surgical removal of the bursa. Removal of the bursa does not hurt the hip, and the hip can function normally without it.

A newer technique that is gaining popularity is arthroscopic removal of the bursa. In this technique, the bursa is removed through a small (1/4-inch) incision over the hip. A small camera, or arthroscope, is placed in a second incision so the doctor can guide miniature surgical instruments and remove the bursa. This surgery is less invasive, and recovery is quicker and less painful than with open surgery.

Both types of surgeries are done on an outpatient (same-day) basis, so an overnight stay in the hospital is not usually necessary. Early research shows arthroscopic removal of the bursa to be quite effective, but this is still being studied.

After surgery, you can expect a short rehabilitation period. It is reasonable to be up and walking the evening after surgery. Most patients find that using a cane or crutches for a couple of days is helpful. The soreness from surgery usually goes away after a few days.

Although hip bursitis cannot always be prevented, there are things you can do to prevent the inflammation from getting worse:

• Avoid repetitive activities that put stress on the hips.
• Lose weight if you need to.
• Get a properly fitting shoe insert for leg-length differences.
• Maintain strength and flexibility of the hip muscles.

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Bursitis of the hip joint: protect yourself from disability They serve as shock absorbers during physical stress of the joints. Therefore, inflammatory processes in bursitis affect the mobility and sliding of fibers along the bone surface of the joint.

Hip bursitis affects the musculoskeletal system, affecting one of the bursae. The hip joint itself contains a large number of synovial sacs with fluid, but bursitis can affect only certain ones, such as the ischial, vertical, or iliopsoas.

Hip bursitis is common among professional athletes, especially those involved in long-distance running. The danger of this inflammation lies in the fact that without proper and timely treatment, the patient may lose the ability to move without assistance. And with complications, blood poisoning can occur, which will lead to death. In this regard, it is very important to respond to the first signs of bursitis in time and immediately seek help from a specialist.

Causes of hip inflammation

Inflammation in the hip joint occurs due to many factors, including:

• uncontrolled stress on the joint;
• acquired pathology of the spine, such as scoliosis, arthrosis, arthritis, etc.;
• overweight;
• flat feet;
• leg length asymmetry;
• thigh bone injury;
• osteophytes and deposits of calcium salts;
• consequences of surgery in the area of ​​the hip joint, etc.

According to statistics, the disease is more common in women over 40 than in men or younger patients. Despite the list of factors that cause bursitis, the most common cause is trauma, bruises and abrasions. Also, the cause may be infection with microbes with cuts, minor wounds and abrasions in the joint area.

Hip bursitis symptoms

The main symptom of hip inflammation is a sharp pain felt on the outside of the thigh. Since the onset of inflammation, pain may intensify, and their intensity may increase. But over time, the pain subsides – this is due to the spread of inflammation.

In addition to severe pain in the joint, other symptoms appear:

• a slight swelling forms in the area of ​​the affected joint;
• edema occurs;
• the general body temperature rises, sometimes up to 40 ° C;
• increased pain on flexion or extension of the joint;
• weakness in the body and general malaise.

Often, with hip inflammation, the patient feels a sharp pain on the outer part of the thigh, which creates discomfort in the supine position on the affected side. Often there is a problem with sleep.

Hip bursitis causes discomfort when walking up stairs, and in some cases the pain may become more intense. Acute pain occurs in the initial stages of the course of the disease. When the inflammation develops to a chronic form, the pain is dulled, and the symptoms become less noticeable.

Diagnosis of hip inflammation

Hip bursitis requires accurate diagnosis by qualified doctors. Symptoms of this inflammation can be confused with other diseases, such as arthritis. Therefore, if you suspect hip bursitis, it is recommended to seek help from a specialist.

When diagnosing, the doctor performs a visual examination of the affected area, followed by palpation. The patient should talk about the degree of pain, the circumstances of the manifestation, etc. An Auber test procedure is also possible (in case of suspicion of trochanteric bursitis).

The main diagnostics is carried out in two stages:

1. analysis of the nature of the pain;
2. special examination by X-ray.

MRI and bone scans are performed to exclude other diseases and pathologies associated with the hip joint. At the end of the diagnosis, the doctor makes an injection of an anesthetic to confirm the diagnosis. If the patient is relieved, then the diagnosis is correct, treatment can be prescribed.

Treatment process for bursitis

For bursitis, the patient should limit any physical activity on the hip joint and avoid activities that increase pain. Neutralization of pain and prevention of the development of the disease occurs with the help of non-steroidal anti-inflammatory drugs prescribed by a doctor.

Mild inflammation of the joint is treated on an outpatient basis and consists of a single injection of drugs into the damaged synovial sac. If the treatment does not give the desired effect, the patient is given another injection.

The complex treatment also includes rehabilitation exercises. After stopping the inflammatory process, the patient is prescribed electrophoresis, ultrasound and therapeutic exercises. The main goal of effective treatment of bursitis is not to relieve symptoms or inflammation, but to prevent the chronic development of the disease.

Surgery is reserved for severe cases where standard treatment does not work. The only solution is to remove the damaged bag. The procedure includes the following steps:

1. dissection of the injured part of the thigh;
2. arthroscope installation – allows the surgeon to freely remove the synovial sac;
3. direct removal of the affected sac.

The removal operation itself is characterized by a minimal risk of trauma and a less painful rehabilitation process. Over time, a new bag is formed, and the properties of the joint are normalized.

Folk remedies for bursitis will help relieve inflammation, but it will be extremely difficult to achieve the main goal of treatment. With an improper attitude to the process of treatment or recovery, bursitis can become chronic, which will complicate subsequent treatment, and in the worst case, lead to complications.

Possible complications

If the first signs of inflammation of the hip joint are not responded to in time or treatment is neglected, complications such as:

• destruction of the joint;
• spread of infection into tissues;
• inflammatory processes in the blood.

In severe bursitis, there is a risk of septic shock leading to death and amputation of the leg.

Disease prevention

First of all, it is necessary to monitor the condition of the musculoskeletal system. For this, it is necessary to treat scoliosis, flat feet in a timely manner, compensate for the asymmetry of the body, etc. The patient needs to minimize the risks of hip injuries and monitor the stress on the joint.

When playing sports, it is important to follow safety rules. A healthy lifestyle will have a positive effect on the state of the musculoskeletal system, but it is important to control the load and not stress the hip joint.

Photo: ru.freepik.com

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Akshin Beyukovich Bagirov

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How to relieve pain and swelling in hip bursitis

Hip bursitis is an inflammation that occurs in periarticular formations – synovial bags. This process is accompanied by pain, swelling, redness and stiffness of movements. Most often, bursitis affects women of middle age and older.

There are drug treatments for the disease. However, before contacting them, it is better to try to alleviate your condition using harmless natural methods.

Stretch

Fitness may seem like the last thing you need when you’re suffering from hip bursitis. However, stretching exercises can help reduce discomfort and pain. It will be useful to learn and regularly perform exercises such as the glute bridge, circular movements of the legs in the prone position, stretching the thigh in the prone and sitting positions. Do not start exercising until you are sure that you know how to do the exercises correctly. Bursitis will benefit from physical activity that does not put a lot of stress on the joints, such as swimming or water aerobics. You can do joint gymnastics in our video library.

Find a comfortable sleeping position

When you have hip bruxitis, it is usually uncomfortable and painful to sleep in certain positions, such as lying on your side. What position should you take to sleep well? If you are used to falling asleep lying on your side, do so, just put a small pillow under your hip or between your knees – this will relieve pressure on the joints. Back sleepers can place a small pillow under their knees or hips.

Use ice

I must say that everyone reacts to cold treatment differently, but for many it helps to relieve pain, swelling and redness in the joint area, since ice reduces inflammation. Use an ice pack wrapped in a towel or a cold compress for the procedure. It should be applied to the affected area for 20 minutes. Discuss the possibility of having this procedure with your doctor.

Use heat

Cold brings relief for three days from the onset of bursitis. Then the doctor may advise you to switch to heat treatment. Thermotherapy improves local blood circulation, relaxes the muscles around the affected joint, and helps increase the flow of nutrients. For the procedure, a bottle of hot water, a heating pad, a hot wet towel are suitable. You can just relax in a warm bath. The pharmacy also sells special hot compresses that are applied to the skin for a certain time.

Take Natural Supplements

Since the pain and swelling of bursitis causes inflammation, reducing it can help relieve joint discomfort. Your doctor may prescribe anti-inflammatory drugs such as ibuprofen.