The hip joint is a ball-and-socket joint that allows the leg to move in many directions. There are also two small sacs of fluid, called bursae, that sit between the hip joint and the surrounding tissues. These bursae help to reduce friction between the bones and the muscles, tendons, and ligaments around the hip joint.
What is hip bursitis?
Hip bursitis is inflammation of the bursa in the hip joint. Trochanteric bursitis is a common cause of hip pain.
What is Trochanteric bursitis?
Trochanteric bursitis is inflammation of the bursa around the greater trochanter, a bony prominence on the outside or lateral point of the hip. Inflammation is often the result of friction from overlying tendons or bone. It is a common cause of lateral hip pain on one side. Middle-aged women are most commonly affected, though young female athletes may also be affected.
What causes trochanteric bursitis?
Trochanteric bursitis can be caused by repetitive trauma from overuse such as running and exercising, incorrect posture, tendon inflammation, a low energy trauma from a ground level fall or sustained immobilization that compresses the bursa, and sometimes the cause is unknown.
What are the risk factors?
Risk factors include:
- arthritis of the lumbar spine
- any spine condition that alters the way you walk
- rheumatoid arthritis
- leg length discrepancies
- prior hip surgery
- bone spurs around the bursa that cause inflammation.
What are the symptoms?
- gradual onset of lateral hip pain (pain on the outside of the hip and thigh) it can also be felt on the buttocks.
- sharp and intense pain that often improves with over-the-counter anti-inflammatory medications (NSAIDS).
- pain at night
- pain when lying on the affected hip
- pain when getting up after sitting for an extended period
- pain that worsens with walking, climbing stairs or squatting
How is it diagnosed?
A physical exam is the gold standard for diagnosis. Your clinician will perform an orthopaedic physical exam to reveal tenderness in the area and perform tests to rule out a hip fracture and other conditions. They will order imaging studies to evaluate the hip including x-rays, and an MRI. With this information, they will form a diagnosis and discuss your treatment options with you.
What are the treatments for trochanteric bursitis?
Initial treatment is nonsurgical, activity modification, assistive devices like a cane, pain management with NSAIDS, and physical therapy to strengthen the quadriceps muscles and stretching of the IT Band to improve strength and flexibility. Running and jumping form will be evaluated and improved.
Steroid injections that target local inflammation can provide pain relief. Your clinician may recommend platelet-rich plasma injections for symptom relief. Extracorporeal Shock Wave Therapy (ESWT) is an effective treatment for trochanteric pain. Surgery is rarely an option, but a newer procedure, arthroscopic removal of the inflamed bursae may be offered. Most patients can find complete resolution of symptoms with nonsurgical management.
What are the treatments for iliopsoas bursitis?
This type of hip bursitis and is often referred to as ‘hip bursitis’, but it causes groin pain. It occurs when the bursa around the iliopsoas tendon in the groin, becomes inflamed. The iliopsoas tendon attaches the thigh muscle to the hip bone. Iliopsoas bursitis is often associated with hip disease but can occur as an isolated condition. It can be difficult to diagnose, and imaging is always required to differentiate it from hip diseases. This type is mainly caused by arthritis, acute trauma, or an overuse injury from sports activities. It is usually seen in people who perform strength training, uphill running and competitive tract and field. It is less common than trochanteric bursitis, but treatment is the same as for trochanteric bursitis.
At Orthopedic Specialists we have the knowledge and experience to diagnose and treat your hip bursitis. Contact us to schedule your consultation. We have offices in Mission Hills, Tarzana, West Hills, and Westlake Village for your convenience.