Hip Bursitis
Bursae are jelly-like sacs containing a small amount of fluid and are positioned between bones and soft tissues, acting as cushions to help reduce friction during movement.
There are 2 common areas involved in hip bursitis:
Trochanteric bursitis: inflammation of the bursa around the bony prominence (the greater trochanter of the thigh bone) on the outside of the hip
Iliopsoas bursitis: inflammation of the iliopsoas bursa, located next to the iliopsoas muscle/tendon (the muscle that helps with bending the hip), on the inside of the hip
Symptoms
The most common symptom of hip bursitis is pain at the point of the hip, either outer thigh or inner hip, where the bursa is inflamed. Pain is usually described as sharp and intense in the early stages and becomes more of an ache and spreads across a larger area of the hip later.
The pain can be worse at night, when lying on the affected hip and with prolonged walking, climbing the stairs, or squatting.
Causes
Hip bursitis can affect anyone but those with the following factors are at a higher risk:
Repetitive stress injury
Occurs when running, climbing the stairs, cycling or standing for long periods of time.
Hip injury
Occurs when you fall onto your hip, bump your hip, or lie on one side of your body for long periods of time.
Hip or Spine disease
Can follow hip or spine arthritis, or scoliosis.
Leg-length inequality
Leg-length inequality affects the way you walk and can lead to irritation of a hip bursa.
Rheumatoid arthritis
Increases the likelihood of the bursa becoming inflamed.
Previous surgery
Having had surgery around the hip or prosthetic implants inserted can irritate the bursa and cause hip bursitis.
Bone spurs or calcium deposits
These can develop within the tendons that attach muscles to the trochanter, irritating the bursa and causing inflammation.
Diagnosis
Your orthopaedic specialist will start off with a physical examination to look for tenderness in specific areas of the hip. Hip bursitis can usually be diagnosed clinically, although you may be required to undergo an X-ray, MRI or ultrasound scan to rule out underlying causes of the hip bursitis, or to rule out other problems with the hip.
Treatment
Treatment for hip bursitis usually does not involve surgery. Non-surgical treatments include modifying activities, using assistive devices, e.g, a walking stick, to off load the hip for a short while, and taking nonsteroidal anti-inflammatory medications. Physical therapy is also recommended to stretch out the inflamed and tight muscles. If the inflammation persists, a steroid injection, usually done in the clinic, can be considered to rapidly provide relief.
Surgical treatments are reserved for recalcitrant cases that do not respond to conservative treatment or recur frequently. Endoscopic bursectomy is a minimally invasive, keyhole procedure that removes the inflamed bursa, and can be performed as day surgery, allow rapid recovery, and return to activities.
Every case is different; hence it is best to consult an orthopaedic specialist for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you suspect you are suffering from hip bursitis and let us help you enjoy a better quality of life.
