Hip Bursitis

Hip bursitis is a painful condition caused by inflammation of a bursa in the hip. Bursae are fluid filled sacs present in joints between bone and soft tissue to reduce friction and provide cushioning during movement.

The bony prominence on the outside of the hip is called the greater trochanter and is a point of tendon attachment at the top of the femur. The bursa overlying it is called the trochanteric bursa. Another bursa is located towards the groin region and is called iliopsoas bursa. There is also a bursa over the ischium which is the bone you sit on when riding a bicycle.  Bursitis of the trochanteric bursa is the most common type of hip bursitis.

Causes

Trochanteric bursitis can occur in young athletes and older adults. Bursitis may sometimes result from an injury or fall to the hip or after a surgical procedure of the hip. Bursitis is often a secondary symptom that develops after another injury that may cause a chronic abnormality in gait.  For example, a patient may develop hip bursitis after an ankle injury on the opposite side causes a limp for a long enough period of time.  Spine disease, rheumatoid arthritis and leg length inequality may also increase the risk for developing hip bursitis.

Symptoms

Trochanteric bursitis results in pain on the outer side of the hip which usually increases with repetitive hip flexion activity. The pain can also be aggravated at night with side lying.

Diagnosis

Focal tenderness to palpation over the lateral border of the hip is the cardinal sign of trochanteric bursitis. To evaluate for other potential causes of hip pain Dr. Fischer may order an X-ray or other advanced imaging.

Conservative Treatment Options

Treatment goals for bursitis are focused on resolving the inflammation and pain. Rest is advised and activities causing the bursitis are restricted. Anti-inflammatory medications are prescribed to reduce the inflammation and pain. Physical therapy and modalities such as heat, ice and ultrasound can be helpful. An injection of corticosteroid medicine may be administered to reduce the inflammation locally. Sometimes a second injection is necessary if the pain returns after a few months. These nonsurgical treatments provide relief from hip bursitis in most cases. 

Surgery

Rarely, Dr. Fischer may recommend surgical removal of the bursa if you do not respond to conservative treatment measures.