What is hip bursitis?
Hip pain can be caused by many conditions, including hip bursitis—inflammation of the bursae. Bursitis of the hip affects one of the small, fluid-filled sacs (bursa, plural bursae) surrounding the hip joint. These spongy bursa sacs serve as little cushions between hard structures like bones and soft tissue like muscle. The hip joint has several bursae, including one that sits atop the pointy bone at the top of the femur (thigh bone). This bony protrusion is the greater trochanter, and the associated bursa is the trochanteric bursa.
Trochanteric bursitis can occur in anyone, but it is more prevalent among middle-aged and older women. Greater trochanteric bursitis causes pain at the point of the hip joint, but it rarely requires surgery. The pain of hip bursitis often comes on suddenly, with a sharpness, and then evolves into a dull pain or ache along the outer side of the hip. Because the pain of bursitis can mimic that of a fractured pelvis or hip, you should seek medical attention if the pain is unbearable or persists for more than a few days.
Unlike osteoarthritis of the hip joint, which can require hip replacement surgery, hip bursitis often responds well to conservative treatments. Lifestyle modifications also may benefit acute flare-ups of bursitis.
What are the symptoms of hip bursitis?
The primary hip bursitis symptoms include:
Inflammation of the hip joint
Pain or clicking with walking
Pain that intensifies when lying on your side
Sharp pain at the outside point of the hip, sometimes running down the outer thigh
Stiffness of the hip joint
While hip bursitis is not a life-threatening condition, its symptoms can be similar to a more serious condition like a fractured pelvis. You should seek medical attention for an accurate diagnosis for any hip pain you experience.
What causes hip bursitis?
Hip bursitis occurs when the bursae become inflamed. Hip bursitis causes include:
Bone spurs on the greater trochanter that scratch the bursa sac
Injury, such as a fall, that tears the wall of the bursa
Leg length inequality, which can cause muscles to rub against the bursa and irritate it
Overusing the hips, such as by participating in frequent, rigorous exercise that repeatedly compresses the bursae
Underlying medical conditions that cause inflammation throughout the body or in the joints can lead to hip bursitis, too. These conditions include:
What are the risk factors for hip bursitis?
Some people with risk factors for hip bursitis may never develop the condition, while other people who have few risk factors might experience chronic bursitis. Risk factors for hip bursitis include:
Hip replacement surgery or another condition that causes one leg to be longer than the other
Middle-aged or older
Repetitive motion activities that involve the hip such as stair climbing
Spine conditions like scoliosis that cause alignment issues affecting the hip bursae
Underlying inflammatory medical conditions
Reducing your risk of hip bursitis
You may be able to lower your risk of hip bursitis by:
Avoiding activities that involve repetitive hip motion
Correcting any leg length discrepancies to normalize your gait
Strengthening core and hip muscles to ensure good posture and avoid putting pressure on the hip bursae
Treating underlying inflammatory medical conditions
It is nearly impossible to completely protect yourself from hip bursitis. As with any medical condition, if you have any risk factors, discuss with your doctor ways to reduce your chances of developing this painful condition.
How is hip bursitis treated?
The goal of hip bursitis treatment is to minimize pain and restore flexibility to the hip joint. Doctors usually start with conservative treatment approaches and escalate to invasive treatments only if necessary. Hip bursitis treatments ranging from conservative to invasive include:
Medications including nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to relieve pain
Physical therapy to stretch the joint and teach hip bursitis exercises to strengthen the hip muscles
Rest or activity modification to avoid activities that make the pain worse
Use of assistive devices, such as a walker, to temporarily relieve pressure from the bursa
Steroid injections to reduce inflammation of the bursa
Surgery to drain or remove the bursa. Surgery is reserved for only the most intractable cases of hip bursitis.
What are the potential complications of hip bursitis?
While painful, hip bursitis is not life threatening. It rarely leads to complications, although it’s possible to develop problems from moving differently, such as limping, to compensate for the pain. Some people may have difficulty sleeping. Treatment for hip bursitis before the pain becomes chronic offers the best chances of recovery. Rarely, you may experience complications from hip bursitis treatment including adverse reactions to medication, such as nausea or internal bleeding from NSAIDs.
Hip bursitis may occur only once, or it may come and go over a lifetime. Fortunately, many cases of bursitis respond well to medications and physical therapy.