Hip Bursitis

What is Hip Bursitis?

Bursitis are tiny, jelly-like sacs that are found all throughout the body, particularly in the knee, heel, hip, shoulder, and elbow.
They are positioned between soft tissues and bones, carrying a tiny amount of fluid, serving as cushions to lessen friction.
A bursa’s irritation is known as bursitis.

Bursitis can result from friction or stress on the bursa caused by specific positions, motions, or illnesses. Pain may arise from the inability of muscles and tendons to move freely due to bursa damage.

Reduce your weight, work on your hip and core muscles to increase their flexibility and strength, and get physiotherapy to help prevent hip bursitis or worsening inflammation. Hip bursitis can initially cause painful, stabbing pain on the outside of the hip. In later stages, the condition is characterized by chronic pain in the area around the injured hip.

The hip joint’s anatomy:

A bursa is a little sac made of tissue that holds some fluid within to help lubricate the region where friction is present. The bursa is a typical structure, and the body can even create one in reaction to friction.

Hip Bursitis types:

Bursae on the inside or outside of the hip might develop hip bursitis. Your hip bursitis kind can be determined by the location and level of infection of the damaged bursa.

Hip bursitis primarily manifests in three ways:

• Trochanteric bursitis

Situated on the exterior of your hip, the trochanter is the bony bump that protrudes from the top of your thigh bone. Trochanteric bursitis, or pain on the outside of the hip and outer thigh, can happen when the trochanteric bursae become inflamed.

• Ischial bursitis or iliopsoas bursitis

Inflammation of the bursae on the inside of the hip (the groin side) can occasionally result in pain in the upper buttock or groin.

• Septic hip bursitis

Hip bursitis, or septic hip bursae infection, is the result of hip bursae infection. Serious symptoms such as fever, exhaustion, and nausea can also be brought on by septic hip bursitis.

Hip Bursitis causes:

Although hip bursitis may affect anyone, women and middle-aged or older individuals are more likely to get it.
Compared to women and the elderly, it is less common in younger persons and men.

Hip bursitis has been linked to the following causes, which are as follows;

• Prolonged walking, sitting, standing, bending, stair climbing, and lying on the hip are among the activities that aggravate symptoms.

• Injury to the hip: The patient may get an injury to his hip by falling on it, bumping it, or lying on one side of his body for an extended amount of time.

• Calcium deposits, also known as bone spurs, may form in the tendons connecting the muscles to the greater trochanter as a result of disease or degenerative processes. They might make the bursa more irritated and inflamed.

• Overuse injuries, also known as repetitive stress injuries, can happen while cycling, jogging, climbing stairs, or standing for extended periods of time.

• Leg-length inequality: People’s gaits are affected and their hip bursa may become irritated when one leg is noticeably shorter than the other. which eventually causes hip bursitis.

• An increased risk of bursa inflammation is associated with rheumatoid arthritis. This is due to the formation of bone spurs over the joint surfaces under these conditions. which could aggravate and inflame the bursa.

• Prior surgery: Bursitis can also be caused by hip replacement implants or other hip-related operations that irritate the bursa.

Signs and symptoms:

• Symptoms at the hip or pelvic area are the primary indicators of trochanteric bursitis.
• Outside the thigh region is usually where the pain is felt.
• Sharp and acute pain is the typical characterization in the early stages. Still, the pain may eventually intensify into an aching and cover a wider portion of the hip joint.
• Lying on the affected hip, getting out of a chair after spending a long time seated, and nighttime are the times when the pain usually gets worse.

Diagnosis:

During a thorough physical examination, the doctor will search for any discomfort around the hip’s point in order to diagnose hip bursitis.

After examining the patient’s medical history, the diagnosis of hip bursitis is made in the clinic based on the location of the hip discomfort and particular painful spots on the outside of the hip.

In order to rule out other potential injuries or conditions, they could also do other tests. Magnetic resonance imaging (MRI) scans, X-rays, and bone scans are examples of imaging investigations that might be included of these exams.

In order to identify the source of your joint inflammation and pain, your doctor may prescribe blood tests or analyze fluid from the inflammatory bursa.

Risk factor:

Hip bursitis can affect anyone, but women and those in their middle or senior years have a higher risk of developing it. It is less common among younger people and men.

The following risk factors have been connected to the formation of hip bursitis.

• The  rheumatoid arthritis

This will probably cause the bursa to get inflamed.

• Prior to surgery

Bursitis can result from bursa irritation carried on by hip replacement implants or surgery surrounding the hip.

• Hip injuries

Hip problems can arise by falling onto the hip, hurting your hip, or lying on one side of the body for a lengthy period of time.

• Deposits of calcium or bone spurs

These can form in the tendons connecting the muscles to the trochanter. These could make the bursa worse and more inflammatory.

• Damage caused by overuse or repetitive stress

Riding, running, climbing stairs, and prolonged periods of activity might cause this.

• Additional health problems of the lower body

Hip bursitis can result from instability brought on by problems with the legs, knees, hips, and spine. You have a higher risk if you have conditions including pinched nerves, scoliosis, and osteoarthritis in the knee.

Treatment for Hip bursitis:

Non-surgical Treatment:

The initial course of treatment for hip bursitis does not require surgery. Simple lifestyle adjustments can provide relief for many individuals suffering from hip bursitis. 

These include;

• Use NSAIDs (nonsteroidal anti-inflammatory medications):

Pain and inflammation may be reduced and controlled by ibuprofen, naproxen, piroxicam, celecoxib, and other medications. NSAIDs should, however, only be taken sparingly and under strict supervision. Before using NSAIDs, it’s important to speak with a doctor because they may have negative side effects from specific illnesses or medications.

• Utilize assistive technology

As necessary, using crutches or a walking cane for at least a week. as a result of the hip joint being under reduced stress when utilizing assistive devices.

• Injection of steroids

A local anesthetic and corticosteroid injection can also help reduce the symptoms of hip bursitis. It is possible to deliver this simple, effective medication in a doctor’s office. A single injection is given to the bursa. The injection may provide temporary relief or long-term (month-long) relief. If the discomfort and inflammation return, one or more further injections spaced a few months apart can be required. As the danger of structural damage grows with continuous corticosteroid injection use, it is imperative to limit the number of injections.

Surgical treatment:

Hip bursitis rarely requires surgery. It is advised to have the bursa surgically removed if nonsurgical treatments fail to relieve the bursa’s inflammation and pain. The hip may operate normally even in the absence of the bursa, and its removal causes no harm to the joint.

A more recent method that is becoming more and more common is arthroscopic bursa ectomy. This technique involves making a tiny (1/4-inch) incision above the hip in order to remove the bursa. An incision is made, and a tiny camera known as an arthroscope is inserted to guide tiny surgical instruments and remove the bursa. Recovery from this procedure is quicker and less painful, and it is less bothersome.

An overnight hospital stay is typically not required for either type of surgery because it is performed as an outpatient procedure (same-day). According to preliminary studies, bursa removal with arthroscopic surgery is highly successful.

Physiotherapy treatment:

Hip bursitis is very well treated with physiotherapy. It helps hip mobility restoration and pain relief without interfering with the healing process.

Treatment without Surgery:

A course of physiotherapy can help patients in getting back to their regular lives and activities. Results can be obtained in as little as two to eight weeks with the right stretching and strengthening regimen. Based on the problem, different healing times apply. In the initial 24 to 48 hours after the diagnosis, the physiotherapist might suggest;

• Avoid walking or any other painful activities to give the region rest.
• The area will heal if you use cold packs for 15 to 20 minutes every two hours.
• For additional services, such medicine or imaging testing, speak with a doctor.

Physiotherapist work with you to achieve;

• Improve Movement

A physiotherapist will select particular exercises and therapies to assist in regaining the hip and leg’s natural range of motion. They may start by moving your hip joint in a “passive” manner before moving on to active stretches and exercises that you can undertake on your own.

• Increase Your Flexibility

In addition to teaching you how to stretch these muscles on your own, the physiotherapist will identify any tight muscles in your legs or spine.

• Improve Balance

After an injury, it’s also critical to regain balance. The physiotherapist will provide exercises to enhance one’s ability to balance.

• Improve strength

A weak or damaged hip muscle is frequently linked to hip bursitis. In every phase of recovery, there are workouts that will promote healing. Your physiotherapist will select and instruct the right exercises and apparatuses to gradually regain your strength and flexibility. These could involve the use of weightlifting equipment, stretch bands, cuff weights, and cardio training machines like stationary bikes or treadmills.

• Teach a Home-Exercise Program

You can learn the stretches and strengthening exercises to do at home from a physiotherapist. We will adjust the workouts to meet your individual needs.

Treatment after surgery:

Following surgery, recovery can take some time. Still, every patient’s recovery period changes. It’s important to get the hip moving as soon as possible. This has to be balanced, still with the requirement for protecting the tissues and muscles that are recovering.

Ice, heat, ultrasound, electrical stimulation, tape, and targeted exercises are a few examples of these. To relieve pain and spasms in the muscles, they could also apply massage and other manual therapies.

Range-of-motion exercises and a gradual transition to active stretching and strengthening are part of the treatment. Typically, active rehabilitation begins two to three weeks following surgery. Thus, mild isometric strengthening exercises might be started by a therapist. These workouts strengthen the muscles without interfering with the tissues’ ability to heal.

After four weeks, individuals might begin undertaking more vigorous strengthening exercises. The goal of exercise is to increase the buttock and hip muscles’ strength and control.

Certain exercises aim to activate the hip in ways that are comparable to the activities you perform in sports and at work. Therefore, the therapist will work with you to choose activities that minimize the amount of stress on your hip joint.

The therapist will also show you some strategies to stay away of potential issues in the future.

Recovery:

Making adjustments to your daily routine may be necessary if you have ongoing hip bursitis. Make an effort to stretch each day to reduce flare-ups. You will be able to move more freely as a result. Additionally, if you’ve discovered that certain repetitive motion activities aggravate your bursitis, you might try to avoid them. Recovery your hip after exercise and during a flare-up is particularly crucial.

It is primarily up to you to decide how you want to change your life in order to heal. In the end, patients who require surgery will recover slightly longer, but not painfully or for a lengthy time.

How may hip bursitis be avoided?

If you take good care of your hips, you can prevent hip bursitis from getting worse or avoid having it totally.

Among the steps you may take are;

• If you’re overweight, lose some weight. It’s a reliable method of relieving hip pressure.

• Adjusting one’s way of life to lessen repetitive motions or overuse that strain joints unnecessarily.

• If you find yourself doing a task repeatedly, take breaks.

• Exercise correctly. Being active is fantastic, but make sure you train correctly. This includes stretching, warming up, and paying attention to your body.

• keeping the hip muscle strong and flexible

• Don’t spend too much time laying on one side.

• Utilizing correct movements and techniques in sports, daily life, and at work.

• To deal with variations in leg length, use a quality shoe insert.

Summary:

Hip bursitis is an inflammation of a bursa in the hip that serve as cushions to prevent muscles and tendons from rubbing against bone. Hip bursitis is the most frequent cause of hip discomfort. Since the adult body contains 160 bursae, which are bursa in plural, you can also get bursitis in other joints like the elbows, knees, or shoulders.

Hip bursitis, or swelling near the hip joint, makes it painful to move about. Fortunately, it usually helps to take a few weeks off. If you experience hip pain that does not go away after a few days, see a doctor right once. The best course of action to relieve your pain while your hip heals will be decided in consultation with your healthcare provider. They will also provide guidance on preventing bursitis in the future.

FAQ:

References:

• AAOS – Ortho Info – Hip Bursitis (n.d.). aaos.org/ortho info/diseases-conditions/hip-bursitis/

• The symptoms and treatment of hip bursitis are provided by Aurora Health Care (n.d.). Health Care Aurora. Hip bursitis is one of the conditions that can be treated with orthopaedic services at Aurora HealthCare.

• K. Whitbourne (2023, Dec. 14). How Does Trochanteric Bursitis Occur? The website of WebMD provides information on trochanteric bursitis.

• Image 1, Bursitis of the hip. (n.d). hip bursitis article on www.drandrewmorris.com.au

• Image 2, On June 28, 2021, Andrachuk, J. A Comprehensive Introduction & Overview of Trochanteric Bursitis. Dr. Andrachuk. The trochanteric bursitis blog at https://johnandrachukmd.com/

• Image 3, Advancement in Health. (2024, February 7). How to Identify Iliopsoas Bursitis/Tendonitis and What Is It? Gaining Health. www.upswinghealth.com. Iliopsoas bursitis-tendonitis: https://upswinghealth.com/conditions/