Hip Bursitis

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What is bursitis?

Bursas act as cushions between bones and soft tissues, such as skin. They contain a small amount of lubricating fluid that acts like a cushion, which allows soft tissues to move smoothly over the bone. Bursitis is inflammation of the bursa. 

 

There are two major bursae in the hip. One of them covers the bony tip 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 of the hip. When this bursa becomes inflamed, it is called iliopsoas bursitis.

 

What are the causes of bursitis?

There are multiple causes of bursitis, and the following are the common causes: 

  • Trauma. A blow to the hip can cause the bursa to swell.

  • Repetitive stress (overuse) can cause bursitis. It can occur when you run, climb, cycle or stand for long periods.

  • Medical conditions. Rheumatoid arthritis is associated with elbow bursitis.

 

Symptoms of bursitis

The severity of symptoms varies significantly from patient to patient. For some patients,  symptoms are not constant and may come and go. Symptoms of nerve impingement in the hip may include:

  • Pain at the point of the hip

  • Swelling on the skin of the side of the hip

  • Pain is worse at night, when lying on the affected hip

  • Pain is worse with prolonged walking, stair climbing, squatting or getting up from a chair

 

When should I seek medical help?

There are circumstances when hip pain might be caused or accompanied by severe issues. If such symptoms are present, it is best to seek immediate medical attention to avoid further complications:

  • A deformed joint

  • Inability to move your leg or hip

  • Inability to bear weight on the affected leg

  • Severe pain in the hip

  • Any signs of infection (fever, chills, redness)

  • Recent history of trauma

 

Diagnosis

To diagnose any hip bursitis, your doctor will take your case history and past medical history into account. They will check to see whether it is tender at the hip point or whether there is swelling. To measure the range of motion of your hip, your doctor will have you move your hip in different directions.

 

Other tests which may help your doctor confirm your diagnosis include fluid testing. Your doctor may take a sample of bursal fluid with a needle to diagnose whether gout or infection is causing the bursitis.

 

Treatment

You can implement the following treatments if an infection is not the cause of your bursitis.

  • Activity changes. Avoid activities that cause pressure on your hip.

  • Medications. You may use oral medications such as ibuprofen to reduce swelling and relieve symptoms.

  • Steroid injection. Injection of a corticosteroid and a local anaesthetic may also help relieve symptoms of hip bursitis.

If swelling and pain do not respond to these measures after a few weeks, your doctor may recommend removing fluid from the bursa. If an infection is the cause of bursitis, your doctor will prescribe antibiotics to fight the disease.

 

Your doctor may recommend surgery if your bursitis does not improve after medication and other nonsurgical treatments. The goal of the surgery is to remove the bursa altogether.

 

Prevention of bursitis in the hip

There are ways to prevent bursitis in the hip. Here are some examples:

  • Avoid activities or postures that put pressure on the hips, such as lying on your hips. 

  • Maintain a healthy weight.

  • Get proper footwear.

  • Regular exercise to maintain the strength and flexibility of hip muscles.