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, 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.
A bursa is a fluid-filled sac that reduces friction between joint tissues. These sacs (bursae) cushion larger joints throughout the body, including the shoulders, elbows, knees, and hips. When a bursa becomes inflamed, it is called bursitis.
There are two major bursae of the hip:
The Trochanteric Bursa
The trochanteric bursa is located near the edge of the thighbone, at the side of the hip. 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 near the pelvic 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. Some of the injuries that might cause hip bursitis include banging the hip against an object or straining it during activity. This type of trauma causes the bursa to fill with blood and the bursa lining 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, although this is much less common. An infected hip bursa is termed septic bursitis. It may result from crystal deposits in the bursa due to gout or from calcinosis caused by an autoimmune condition called scleroderma.
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. 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, but 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 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:
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 groin. Over time, the pain may radiate to other body parts such as the lower back and buttocks.
Hip bursitis can lead to tenderness at the side of the hip or groin. This symptom can get worse when lying down.
Hip Bursitis Infection Symptoms
People with septic bursitis will experience other symptoms of an infection, in addition to pain and tenderness. These symptoms include:
Warmth around the affected area
Reddening of the skin
Hip Bursitis Diagnosis
To diagnose hip bursitis, your doctor 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.
There are two main types of imaging tests, which are helpful for bursitis diagnosis:
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 Treatment
The treatment for hip bursitis depends on the presence of an infection. Septic hip bursitis requires immediate medical treatment to prevent the bacteria from spreading to other parts of the body or into the bloodstream.
Home remedies for hip bursitis can be used if there is no infection present. Many of the following treatments are sufficient to bring about hip bursitis relief.
Rest and Activity Modification
The first step in treating hip bursitis is to control inflammation. As overuse of the joint is typically at the root of bursitis, it can be helpful to rest the hip joint as much as possible until the pain and swelling subside.
When treating hip bursitis, running and other high-impact activities should be avoided until symptoms have gone. Standing or sitting for long periods of time can also aggravate an inflamed bursa. Other hip bursitis exercises to avoid include those that involve traversing inclines, such as hill walking and stair climbing.
Apply an ice pack to the affected hip after exercise or repetitive motions that put stress on the joint. Ice provides quick relief from pain and swelling.
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Bio-mechanical problems that affect gait and stride contribute to bursitis. Heal an inflamed bursa, or prevent bursitis from happening in the first instance, by correcting misalignment in the body.
Often, foot problems such as plantar fasciitis or over-pronation of the foot contribute to these types of misalignment. Address these problems by wearing supportive footwear and appropriate orthotic inserts, such as these plantar fasciitis insoles.
Hip Brace for Bursitis
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Wearing a hip brace can provide compression to the affected joint, which increases circulation and reduces inflammation. The best hip brace for bursitis will also support the groin and surrounding muscles to relieve aches and pains and prevent further damage to the bursa.
Many people with hip bursitis struggle to sleep at night. Using a knee pillow can improve comfort during sleep while also relieving pressure on the bursa. Knee pillows sit between the legs to align the spine and hips and increase circulation in the lower body.
Canes and Crutches
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Having a swollen and sore bursa can make moving about uncomfortable. You can reduce some of the pressure on the affected hip by using a quad cane or pair of forearm crutches when symptoms are particularly bad. Assistive devices like these are especially beneficial when recovering from hip bursitis surgery or other types of medical treatment.
Physical Therapy for Hip Bursitis
Some people with hip bursitis may benefit from physical therapy. A qualified therapist can teach you exercises to stretch and strengthen the hip muscles to prevent future cases of hip bursitis. These exercises will also speed up the healing of existing bursitis conditions. Physical therapy includes other interventions such as massage and ice.
Hip Bursitis Exercises
Your doctor may recommend some gentle exercises for your hip. The best hip bursitis stretches include:
Bridges extend the hip flexors and surrounding muscles to support and stabilize the joint. Begin by lying on the floor and bending your knees at a 45-degree angle. Push through your heels so that your hips lift off the floor. The knees, hips, and shoulders should be in line. Hold this position for five seconds before slowly lowering your hips to the ground. Repeat ten times.
This exercise strengthens and stretches the IT band to cure hip bursitis caused by a tight IT band. To perform a lying lateral leg raise, lie down on your uninjured side. Place your hand on the floor in front of you for balance. Raise the top leg up as far as you can (without straining) before slowly lowering it again. Repeat this movement fifteen times, up to three times a day.
Leg circles improve flexibility in the hip and groin. Begin by lying flat on your back. Lift the leg of the injured off the ground and make small circles. Don’t lift your leg any higher than you can comfortably tolerate. Keep your leg straight throughout the exercise. The motion should be coming from your hip. Perform five rotations before resting. Repeat five to six times.
Medication for Bursitis in Hip
With bursitis of the hip, pain relief is key. Over-the-counter anti-inflammatory medications (NSAIDs)—including aspirin, ibuprofen (Advil), and naproxen (Aleve)—can provide short-term pain management.
If NSAIDs don’t significantly improve symptoms, you may need a corticosteroid injection to bring down swelling. To guide the hip bursitis injection to the right place, your doctor may use an ultrasound. Hip bursitis that is accompanied by an infection will require antibiotic treatment.
Hip Bursitis Surgery and Medical Treatment
Rarely, severe or chronic hip bursitis is treated by draining the bursa with a needle. This procedure is known as aspiration. You will likely receive a cortisone shot at the same time.
Surgery for hip bursitis is also rarely used. The type of operation carried out will depend on the person’s symptoms and the underlying cause of the bursitis. Your doctor may recommend a bursectomy to remove the affected bursa or an osteotomy to shave off any excess bone that is irritating the bursa. If the IT band is causing hip bursitis, the surgeon may lengthen or repair the band as necessary.
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, 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.
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 repetitive movements that put stress on the hip joints, including hill walking and stair exercises.
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.
Jessica Hegg is the content manager at ViveHealth.com. Avid gym-rat and nutrition enthusiast, she’s interested in all things related to staying active and living healthy lifestyle. Through her writing she works to share valuable information aimed at overcoming obstacles and improving the quality of life for others.
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