Hip bursitis is the painful inflammation of one or more bursae near the hip joint.
A bursa is a thin, slippery sac made of a soft material called a synovial membrane. This membrane produces and contains a viscous fluid called synovial fluid.
The hip bursae reduce friction between the hip bone and surrounding structures, allowing the joint and surrounding tissues to move freely avoiding pain and inflammation.
Bursitis occurs when a bursa’s synovial membrane becomes irritated and inflamed. The inflamed membrane produces excess synovial fluid, causing the bursa to swell and become painful.
The trochanteric bursa is the most commonly inflamed bursa in the hip. It is located over the greater trochanter – a bony knob at the top of the thigh bone.
Inflammation of the trochanteric bursa is called trochanteric bursitis or hip bursitis.
Sometimes, the iliopsoas bursa, located near the groin, under the iliopsoas muscle may become inflamed.
This type of bursitis is called iliopsoas bursitis or iliopectineal bursitis and may also be referred to as hip bursitis.
- The most common causes of hip bursitis are:
A direct injury, such as a fall or direct impact, causing the bursa to fill with blood. The blood may irritate the bursa and cause inflammation. - Repeated friction from surrounding soft tissues, such as a tight iliotibial band or inflamed gluteus medius tendon.
- Excessive pressure over the outside of the hip by sleeping on a hard surface.
An inflamed bursa causes a variety of symptoms and signs around the hip joint.
- Most individuals with trochanteric bursitis feel a dull ache or sharp pain at the outside of the hip, where the upper thigh curves out.
- If the iliopsoas bursa is affected, the pain is felt in the inner thigh or groin area.
- Pressing on the skin over the inflamed bursa causes pain.
- The pain may radiate into the lower back or buttock, and may extend down the outside of the thigh towards the knee.
- The symptoms typically flare up with repetitive hip movements, such as walking or running, or after prolonged periods of rest, such as sleeping or sitting.
Hip bursitis is generally treated with nonsurgical treatments, which include:
- Taking rest and avoiding activities that aggravate and inflame the bursa.
- Taking a short course of anti-inflammatory medication or using topical pain relievers to reduce pain and inflammation.
- Applying a cold pack near the hip joint can be helpful to reduce both pain and inflammation.
- Performing exercises and physical therapy to strengthen the quadricep and gluteal muscles and stretch the iliotibial band, relieving pressure on the bursa.
If the symptoms are not successfully relieved with these methods, injection treatments may be recommended.
- A significantly swollen bursa may be aspirated or drained using a needle.
- A severely inflamed bursa is sometimes treated with a platelet-rich plasma injection to reduce inflammation and swelling.
In rare cases, surgery may be recommended to treat the painful bursa.
- A complete removal of the painful bursa is called bursectomy.
- A tight IT band irritating the bursa can be corrected with a procedure called iliotibial band release. The band is lengthened to relieve pressure on the bursa.
- Friction and irritation from the greater trochanter is treated by trimming or shaving off a small portion of the protruding bone.
Hip bursitis generally heals well with medical treatment. Most patients experience complete symptom resolution without any long-term effects.
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