Hip Bursitis is inflammation of a bursa that results in swelling, pain, and tenderness at the bursa.
A bursa is a small jelly-like sac that acts as a cushion between the bone and the overlying soft tissues to reduce friction between them.
There are two major bursae of the hip:trochanteric bursa and ischial bursa.
The trochanteric bursa is located on the outside of the hip between the greater trochanter of the femur (leg bone) and the gluteal muscles. Inflammation of trochanteric bursa is called trochanteric bursitis. It is a common cause of hip pain.
The ischial (ischiogluteal) bursa is located between the hamstring muscle and the ischial tuberosity of the pelvis in the buttock area. Ischial bursitis is a rare bursitis of the buttock region.
The other two bursae of the hip are: iliopsoas bursa and gluteal medius bursa.
The iliopsoas bursa is located in the groin area between the large psoas muscle and femur bone. Inflammation of iliopsoas bursa is called iliopsoas bursitis.
The gluteal medius bursa is located between the gluteus medius muscle and the greater trochanter. It is near the trochanteric bursa. Inflammation in the tendons of the gluteus medius muscle is called gluteus medius tendinopathy.
- Pain or ache when moving, sleeping on the affected hip, sitting on a hard surface for a long time, and getting up after being seated.
- Pain may extend over the outside of the thigh and may radiate down the outside of the thigh.
- Swelling and tenderness at the affected bursa.
- May be aggravated with stair climbing, prolonged walking or squatting.
- Repetitive stress (overuse) injury that occurs when climbing up the stairs, cycling, running or after standing for a prolonged period of time.
- Bone spurs or calcium deposits can develop within the tendons that attach to the trochanter (the bony outgrowth at the upper end of the thigh bone).
- Hip injury that occur from falling onto your hip, bumping your hip on the edge of a piece of furniture or lying on one side of your body for a longer time.
- Leg-length inequality is a condition whereby one leg is shorter than the other leg by more than 1 inch.
- Spine disease such as lumbar arthritis (in the lower spine) or scoliosis (curved spine).
Your doctor would first question your general health and symptoms before conducting a thorough physical examination.
Diagnosis is made based on your reported symptoms, physical examination, and investigations.
Imaging test such as an X-ray may be ordered so your doctor can rule out other causes of hip pain. Ultrasound or MRI might be used as well.
Blood tests or an analysis of fluid from the inflamed bursa may be done to determine the cause of joint inflammation and pain.
Treatment depends on the specific location of the bursa, but the aim is to rest the bursa, decrease inflammation, and allow time for recovery.
- Avoid pressure at the affected joint.
- Avoid activities that require climbing.
- Physiotherapy to increase range of motion.
- Medications such as painkillers or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can relieve pain and reduce swelling.
- If you are not responding well to the treatments above, your doctor may recommend corticosteroid injections to reduce inflammation.
- Aspiration of bursa fluid to relieve pressure.
If the bursitis is persistent despite treatment, surgical excision of the bursa is possible.
Gleneagles Hospital works with orthopaedic specialists to assist patients through diagnosis and treatment. The caring and multidisciplinary team of healthcare professionals are available for consultation and to provide the best care.