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Hip (Trochanteric) Bursitis

  • What is hip bursitis?

    Hip bursitis

    Hip bursitis is the swelling of a bursa, a small jelly-like sac that acts as a cushion between the bone and the overlying soft tissues to reduce friction between them.

    There are 4 bursae surrounding the hip joint and they include:

    • Trochanteric bursa

      The trochanteric bursa is located on the outside of the hip between the greater trochanter of the femur (leg bone) and the gluteal muscles. Inflammation of this bursa is called trochanteric bursitis and is a common cause of hip pain.

    • Iliopsoas bursa

      The iliopsoas bursa is located in the groin area between the large psoas muscle and femur bone. When this bursa becomes inflamed, the condition is referred to as iliopsoas bursitis.

    • Ischial bursa

      The ischial bursa, also known as ischiogluteal bursa, is located between the hamstring muscle and the ischial tuberosity of the pelvis in the buttock area. Ischial bursitis, also known as ischiogluteal bursitis, Weaver's bottom or Tailor's bottom is a rare and infrequently recognised bursitis of the buttock region.

    • Gluteal medius bursa

      The gluteal medius bursa is located between the gluteus medius muscle and the greater trochanter. It is near the trochanteric bursa. A gluteus medius tendinopathy is a painful condition caused by inflammation in the tendons of the gluteus medius muscle.

  • The causes of hip bursitis include:

    • Injury to the point of the hip, which can be caused by falling on the hip, bumping the hip on the edge of a piece of furniture or lying on one side of the body for a prolonged period.
    • Repetitive activities such as sports or work-related tasks that lead to overuse of the hip joint such as running uphill, cycling, climbing or standing for long periods.
    • Spinal conditions affecting the posture, including scoliosis and arthritis of the lower spine.
    • Unequal leg length where the difference is more than an inch, which can lead to imbalance.
    • Past surgery around the hip or implants in the hip.
    • Bone spurs or calcium deposits, which develop within the tendons attached to the trochanter (upper end of the thigh bone).

    Risk factors for hip bursitis

    • Frequently going up and down the stairs
    • Sports that include repetitive hip movement such using stair-climbers, running or climbing.

    Preventing hip bursitis

    • Make lifestyle changes to reduce overuse or repetitive activities that place unnecessary pressure on the joint
    • Build up activity levels gradually
    • Limit impact or force, and repetition in your activities
    • Correct or treat underlying problems such as leg length difference
    • Practice good posture and good techniques during daily activities, sports and work
    • Use a good shoe insert to correct leg length differences
    • Maintain strength and flexibility of the hip muscles
    • Use a walking cane or crutches for at least a week if needed
  • Hip bursitis can result in swelling, pain and tenderness at the bursa. This hip pain can be aggravated with prolonged walking, squatting or stairs climbing. In severe cases, surgery to remove the bursa is required.

    Symptoms of hip (trochanteric) bursitis include:

    • Pain or ache
      • When moving
      • When sleeping on the affected hip
      • When sitting on a hard surface for a long time
      • When getting up after being seated
      • Which spreads over the outside of the thigh and may spread down the outside of the thigh
    • Hip swelling
    • Tenderness at the bursa
  • Hip bursitis can be diagnosed based on your medical history, a physical examination and one or more diagnostic tests.

    • Physical examination

      To diagnose hip bursitis, your doctor will conduct a physical examination to evaluate your history of hip pain and its location.

    • Imaging tests

      X-ray images can't always positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort. Ultrasound or MRI might be used if your bursitis can't easily be diagnosed by a physical exam alone.

    • Laboratory tests

      Your doctor might order blood tests or an analysis of fluid from the inflamed bursa to pinpoint the cause of your joint inflammation and pain.

  • Hip bursitis treatment is often a combination of:

    • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling
    • Corticosteroid injections into the joint to reduce inflammation and pain
    • Aspiration of bursa fluid to relieve pressure
    • Physiotherapy to increase your range of motion
    • Avoiding pressure on the affected joint
    • Avoiding activities that require climbing

    If these measures are ineffective, your doctor may recommend surgery to remove the bursa.

    Persistent hip pain can severely impact your quality of life. If you are experiencing hip pain, make an appointment to have it professionally evaluated so that it can be diagnosed and treated.

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  • Left untreated, symptoms of hip bursitis can worsen, interfering with daily activities and affecting your quality of life.

    The bursa may also become infected, causing a fever, redness or swelling which require antibiotics.

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