Hip Bursitis

Hip bursitis is a common condition characterized by inflammation of one or more of the bursae in the hip. The inflammation associated with bursitis can lead to pain and limited mobility. Trochanteric bursitis is common in middle-aged to elderly patients and is twice as common in women.

Overuse hip bursitis is common in running, cycling and long-distance running, standing for long stretches, and any activity that stresses the hip joint. soccer enthusiasts, baseball, football and fencing participant.

The primary symptom of hip bursitis is pain at the site of the inflamed bursa. The pain is localized to the outside of the hip, buttocks and upper thigh. This pain may initially be sharp and intense, especially during movements that exert pressure on the bursa, such as walking, climbing, or sitting in a low chair. As the condition progresses, the pain may become more of a dull ache that spreads across the hip and into the outside of the thigh. Other common symptoms include:

• Lateral hip tenderness.
• Pain that is referred to the outside of the thigh and into the knee.
• Pain at night when lying on the affected hip and when rising from a chair after being seated for long periods.
• Stiffness or tenderness in the hip joint, particularly in the morning or after prolonged periods of inactivity, prolonged sitting and sitting with crossed legs.
• Limited range of motion in the affected hip
• Pain with weight bearing exercise such prolonged walking, stair climbing and squatting.

Hip bursitis can result from any one or several risk factors, either alone or in combination. With repeated compression due to trauma, overuse, weak hip muscles that cause abnormal hip movements can cause the bursae to become inflamed.

• Repetitive Motion or Overuse: Activities that involve repetitive movements or prolonged pressure on the hip, such as running, stair climbing, or bicycling, can lead to overuse of the hip joint and bursa.
• Muscle Tightness: Greater trochanteric pain syndrome is a common cause of hip pain that affects the bursa, tendons and muscles.
• Trauma: A direct blow or sudden impact to the hip can cause bursitis. This might happen during a fall, a sports injury, or a car accident.
• Preexisting Conditions: Referred pain from certain spine conditions like arthritis of the lumbar spine. Hip arthritis. Bone spurs. Rheumatoid arthritis. Gout and diabetes can predispose individuals to develop bursitis.
• Postural Issues: Imbalances or abnormalities in posture, including differences in leg lengths or scoliosis, can place unusual stress on the bursae around the hip joint.

Hip pain is a common and challenging symptom that can be associated with many hip conditions. Dr. Kaplan will need to rule out all potential causes. He will review your medical history and inquire about your symptoms when they began and what causes additional pain.

He will perform an orthopedic examination palpating for pain and tenderness near the point of the hip, may test for pain in the tendons and muscles and to rule out other potential causes of your pain. He may also observe your gait (how you walk) looking for a limp.

If you have a fever, this may indicate an infection. Dr. Kaplan may order blood tests. He may order X-rays to rule out fractures or calcifications. An MRI may be ordered to evaluate the bursa, tendinitis and soft tissue tears, and an ultrasound can evaluate the bursa.

The primary goals of treatment are to reduce compressive forces on the hip, strengthen gluteal muscles and treat inflamed and irritate bursa. Over 90% of cases can be successfully treated with conservative management.

Nonsurgical management includes weight loss, anti-inflammatory medication for pain, physical therapy, and avoiding activities that cause prolonged stretching of the hip muscles such as sitting crossed legs and sleeping in a side-lying position with the top knee flexed and touching the bed.

Cortisone steroid injections may help reduce the inflammation and can be very successful in treating this condition. Platelet-rich plasma (PRP) injections can help improve pain and function because it stimulates and accelerates tissue repair and healing. Due to cost to the patient, PRP injections are typically tried after cortisone injections.

Adjunct therapies may include shock wave therapy, therapeutic laser treatment to promote healing.