Hip Bursitis web based movie
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 of the hip is called greater trochanter and is present on the outer side of the upper thigh bone or femur. The bursa overlying it is called trochanteric bursa. Another bursa is located towards the groin region and is called iliopsoas bursa. Bursitis of the trochanteric bursa is more common than that of iliopsoas bursa.
Inactivity/muscle weakness: Sometimes patients develop greater trochanteric bursitis after a period of illness or inactivity. The abductor muscles may become weak and this can increase pressure on the bursa.
Pinched nerves in the lower back (herniated lumbar disc or spinal stenosis) can also cause weakness of the abductor muscles and contribute to developing trochanteric bursitis.
Trochanteric bursitis is occasionally seen in people involved in sports such as football and soccer, which involve a lot of running. This can lead to overuse and irritation of the bursa causing inflammation.
Bursitis may sometimes result from an injury or fall to the hip or after a surgical procedure of the hip. Spine disease, rheumatoid arthritis and leg length inequality increases the risk for developing hip bursitis.
Some patients develop bone spurs (osteophytes) on the greater trochanter that can irritate the trochanteric bursa.
Trochanteric bursitis results in pain on the outer side of the hip, which usually increases with prolonged walking or climbing stairs. The pain is felt more while getting up from a chair and at night when lying on the affected side.
Inflammation of the iliopsoas bursa however results in pain in the groin region.
Tenderness and swelling in the area of pain over the bursa during the physical examination of the hip confirms the diagnosis of Hip Bursitis. To check for any bone spurs that could be causing irritation of the bursa your doctor may order an X-ray. If the reason for the pain is not very clear the doctor may order an MRI to view the soft tissues and structures not visible on X-ray.
Treatment goals for bursitis are focused on resolving the inflammation and pain and strengthening the hip abductor muscles. Anti-inflammatory medications may be prescribed to reduce the inflammation and pain. Patients may be instructed in doing a home exercise program to increase the tone of their hip muscles. Physical therapy may be prescribed and may include muscle strengthening exercises, treatments with heat, ice and ultrasound. An injection of corticosteroid into the bursa may reduce the inflammation and pain. Sometimes multiple injections are necessary if the pain returns. These nonsurgical treatments provide relief from hip bursitis in the majority of cases.
Your doctor may recommend surgical treatment of your hip bursitis if it does not respond to conservative measures. Of the small percentage of patients that require surgical treatment for hip bursitis, the most common reason is bone spurs on the outer surface of the trochanter. These can often be seen on x-rays. Surgical treatment of this condition involves surgically shaving the outside of the bone to create a smoother surface.
© James B. Grimes, MD Orthopaedic Surgeon Minimally Invasive Hip Knee Shoulder Surgery Bakersfield California
