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What is Hip Bursitis? Pain Overview

by Jaydee Vykoukal, PT, DPT July 04, 2018 0 Comments


Hip Pain

Understanding exactly what is bursitis of the hip and the causes is the first step in solving your pain. Hip bursitis is one of the most common sources of hip pain, and although the condition isn’t usually serious, it can cause discomfort and reduced mobility. If hip bursitis is accompanied by infection (not common), it is much more serious and requires medical attention. Read on to learn more about the signs and symptoms of infectious and non-infectious bursitis and discover how to treat bursitis of the hip.

What is Bursitis of the Hip?

A bursa is a fluid-filled sac that reduces friction between joint tissues, particularly near large muscle tendons. These sacs (bursae) are in the proximity of larger joints throughout the body, including the shoulders, elbows, knees, and hip area. When a bursa becomes inflamed, it is called bursitis.

There are two major bursae of the hip:

The Trochanteric Bursa

The greater trochanter and trochanteric bursa is located near the outer bony edge of the upper thighbone, at the side of the hip (the widest part of our hips). Trochanteric bursitis is the term given to inflammation of this particular bursa. It is sometimes linked to iliotibial (IT) band syndrome, and their symptoms can be similar.

The Ischial Bursa

This bursa is located in the pelvis and near the ischial tuberosity, which is often known as the “sit bone.” When the ischial bursa becomes inflamed, it’s called ischial bursitis. Less commonly, it’s casually referred to as "weaver's bottom" or "tailor's bottom” because it can develop after prolonged periods of sitting on a hard surface.

Hip Bursitis Causes

Hip bursitis is typically caused by inflammation due to injury. This type of trauma typically causes the bursa to fill with blood and the bursa lining and soft tissue to become inflamed. Even when the body reabsorbs the blood, the inflammation remains and causes pain and other symptoms. When there is no bacterial infection in the bursa, it is called aseptic bursitis. Hip bursitis may also be caused by a bacterial infection, known as septic bursitis, although this is much less common. 

Risk Factors and Causes

Several factors increase your risk of developing hip bursitis. They include:

  • Injury or trauma

    A sudden bang or knock on the hip can lead to a form of bursitis called traumatic bursitis. Overuse or repetitive activities can cause a strain injury, a type of mini-trauma.

  • A history of bursitis

    Having had bursitis in the past increases your risk of developing the condition again.

  • Hip bursitis can affect anyone

    It’s most common in people aged 40 and older.

  • Previous hip surgery

    Surgery around the hip can increase the risk of hip bursitis because it may cause inadvertent trauma to the bursa.

  • Other medical conditions

    People with inflammatory medical conditions such as diabetes, gout and rheumatoid arthritis are more likely to get hip bursitis.

  • Being overweight or obese

    Carrying excess body weight is a risk factor for both hip and  knee bursitis.

  • Reduced immune function

    Having a condition that suppresses the immune system may increase the risk of septic bursitis. Conditions that may do this include HIV/AIDS, leukemia, and viral hepatitis. Chemotherapy drugs also reduce immunity.

  • Biomechanical flaws

    If your lower limbs or back are out of alignment, it may cause excess pressure on the hip and eventually lead to bursitis.  Knee osteoarthritis, scoliosis, leg length discrepancies, and iliotibial band syndrome may all cause alignment issues.

  • Bone spurs or calcium deposits

    Having bone spurs (small protrusions of bone) or calcium deposits around the hip can irritate the bursa and lead to hip bursitis.

Hip Bursitis Symptoms

The two main symptoms and signs of hip bursitis are:

Hip Pain

In people with hip bursitis, pain is the most common symptom. The pain is often sharp and searing in the initial stages before changing to a duller, aching sensation. Pain usually gets worse during periods of inactivity or after repetitive hip movements, such as walking or running.

Trochanteric bursitis tends to cause pain in the outer hip, while iliopsoas bursitis causes symptoms around the buttocks. Over time, the pain may radiate to other body parts such as the lower back and groin.

Tenderness and Swelling

Hip bursitis can lead to tenderness at the side of the hip or buttocks. This symptom can get worse when lying down. Swelling or inflammation of the bursa may also be evident at the injury site or down into the legs and even feet.

Hip Bursitis Infection Symptoms

People with septic bursitis will experience other symptoms of an infection, in addition to pain and tenderness. These symptoms include:

  • Fever
  • Fatigue
  • Warmth around the affected hip
  • Inflammation of the bursa
  • Reddening of the skin

Hip Bursitis Diagnosis

To diagnose hip bursitis, your healthcare provider or physical therapist will likely take your medical history, ask you to describe your symptoms, examine the hip for swelling and pain, as well as perform a variety of other tests.

If necessary, there are two main types of imaging tests, which are helpful for ruling out other hip related issues.

  • X-ray

    This test allows the doctor to see if osteoarthritis or a fracture is causing the pain. X-rays also detect calcium deposits in the bursa.

  • MRI Scan

    An MRI of the hip bursitis site will highlight any abnormalities in the soft tissues of the hip, including swollen bursa or tendon damage.

Hip Bursitis Recovery Time

Many people ask: “how long does hip bursitis last?” The length of time it takes to resolve the condition depends on its severity and other factors. Usually, hip bursitis goes away within a week or two using home remedies and anti-inflammatory medications. Infectious hip bursitis recovery is also relatively quick, as long as you take antibiotics.

In cases of hip bursitis surgery (very uncommon), recovery time varies depending on the type of surgery you have. Usually, the surgery is done on an outpatient basis meaning you don’t need to stay overnight in the hospital. Soreness typically goes away after a few days, during which time you may need to use crutches or a cane. Physical therapy may be necessary to help recover.

Prevention

To prevent hip bursitis, try the following:

  • Always stretch the hips and surrounding muscles before exercise.
  • Maintain a healthy weight to reduce stress on the bursa and keep track of your weight using a  digital bathroom scale.
  • Wear supportive footwear and use orthotic inserts to fix biomechanical problems.
  • Avoid overuse and continual repetitive movements that put stress on the hip joints, including hill walking and stair exercises (okay in moderation if you pay attention to your symptoms).

Dealing with Hip Bursitis

Hip bursitis is a painful condition that can limit your movement. Luckily, it’s an easily treatable ailment. Some of the best cures for bursitis of the hip include rest, activity modification, and ice. You can provide further support to the hip joint using hip braces, knee pillows, and crutches. Hip bursitis symptoms that are accompanied by fever, fatigue, and warm or red skin require prompt medical attention as they suggest an infected bursa.

Sources:

https://familydoctor .org/condition/bursitis-of-the-hip/

https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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