Hip Bursitis (Trochanteric Bursitis)
Hip bursitis (trochanteric bursitis) is an irritation or swelling of the trochanteric bursa. The bursae are small, fluid-filled sacs on the outer side of the femur, which act as a cushion for the iliotibial band, a thick tendon in your leg.
What You Need To Know About Hip Bursitis
- What is Bursitis of the Hip?
- What Causes Hip Bursitis?
- Hip Bursitis Symptoms
- How is Hip Bursitis Diagnosed?
- Hip Bursitis Treatment
What is Bursitis of the Hip?
Bursae are closed, jelly-like sacs in the shoulders, elbows, hips, knees, and heels. They are positioned between bones and soft tissue and help reduce friction throughout the body.
There are two bursae in the hips known as the trochanteric and the ischial bursa. When overuse or repetitive motion cause the trochanteric bursa or the ischial bursa to become inflamed, doctors refer to this condition as bursitis.
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What Causes Hip Bursitis?
Your bursitis can become inflamed as a result of repetitive motion that puts stress on the hip. Friction or excessive pressure on your hip as a result of your occupation or hobbies lead to bursitis.
Hip bursitis can develop in anyone regardless of sex or age. But it commonly affects women and seniors.
Some common causes or risk factors that can lead to hip bursitis include:
Repetitive exercises or stress on the hips, such as stair climbing, bicycling, or sports.
Traumatic hip injuries, such as falling, bumping, or lying on your hip.
Disparities in leg length that put extreme irritation on a hip bursa
Past surgical procedures on the hips that irritate either bursa
Bone spurs, calcium deposits on tendons attached to hip muscles
Bacterial infections on the hip bursa
Inflammation or tears on the gluteus medius tendon
Hip Bursitis Symptoms
The most telling sign of hip bursitis is pain on the outside of the hip. It may either be a dull or sharp-aching pain that can spread to the thigh or buttock. Typically, the intense pain in the early stages diminishes to a chronic, dull ache. However, movement such as sports, prolonged walking, stair climbing, walking, and other physical activities may increase pain severity.
People afflicted with trochanteric bursitis commonly experience heightened discomfort when lying on the affected hip or getting up after sitting down.
How is Hip Bursitis Diagnosed?
Physicians often call hip bursitis "the great mimicker" because the symptoms can easily be associated with other conditions, such as hip osteoarthritis, tendonitis, snapping hip syndrome, and iliotibial band syndrome. Make sure to disclose all symptoms in a detailed manner to help assist your physician throughout the exam for an accurate diagnosis.
A doctor will examine your hips and perform tests to determine if hips are tender and inflamed during a physical examination. A physician may also use imaging tests, such as x-rays, bone scans, and magnetic resonance imaging (MRI) to examine the symptomatic area. X-rays help physicians rule out bone and joint conditions and inspect the hips for calcification. They may also administer an injection of local anesthesia to help relieve pain.
Hip Bursitis Treatment
There are both surgical and nonsurgical treatments for hip bursitis. Many patients may find solutions like rest, medication, crutches, antibiotics, or physical therapy alleviate their discomfort. But others may need to opt for surgical options.
There are several non-surgical approaches to help treat hip bursitis:
Avoid activities that worsen symptoms and strain the hips.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or piroxicam, help reduce inflammation and pain. However, relief is often brief, and extended use of NSAIDs may come with adverse side effects with other medications.
Corticosteroid or local anesthetic injections help relieve symptoms. A doctor may inject a single shot to provide a temporary or permanent reduction in pain and inflammation. A physician may recommend additional injections separated months apart.
Physical therapy to help increase flexibility and strength in the hips. A physical therapist can provide at-home exercises, splinting, and stretches along with ultrasound, heat, or ice treatments.
Crutches, canes, or other assistive devices will take weight and stress off the affected hip.
In rare instances, a doctor may recommend surgery to remove the troublesome bursa. A surgeon may use an arthroscope to help locate and safely remove the inflamed bursa. A person can function normally without the removed bursa.
Another surgical solution is known as a tendon repair and iliotibial (IT) band release. A surgeon will help loosen a tightened tendon to reduce friction on the trochanteric bursa. Additionally, an IT band release will help lengthen an IT band to rescue irritation. Lastly, a surgeon may recommend an osteotomy and shave off a small portion of protruding bone to lessen bursa stress.