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Hip bursitis is a condition that can greatly impact mobility and daily activities if left untreated. In this article, we share about the symptoms to look out for, the available treatment options and preventive measures.
By Arete Orthopaedic Centre
Medically Reviewed by Dr Wang Lushun
What Is Hip Bursitis?
Hip bursitis is the inflammation of one or both of the bursae in the hip. The bursae are fluid-filled sacs that cushion tendons, ligaments, and muscles to help reduce friction. When these bursae become inflamed, it can cause pain and discomfort in the hip joint.
Types of Hip Bursitis
There are two primary types of hip bursitis:
Trochanteric Bursitis
This is the most common type. Trochanteric bursitis occurs when the bursa located on the outer side of the hip, near the greater trochanter, becomes inflamed.
Iliopsoas Bursitis
This affects the bursa located on the inside of the hip, near the groin area. While less common than trochanteric bursitis, it is usually diagnosed and treated the same way.
Symptoms: How to Recognise Hip Bursitis
Trochanteric bursitis and iliopsoas bursitis present different symptoms due to the different locations of the affected bursae.
Trochanteric Bursitis
The pain typically occurs in the outer hip and may radiate down the thigh
The outer hip is usually tender to the touch
The pain gets worse when lying on the affected hip
Pain often worsens with activities like walking or climbing stairs
Iliopsoas Bursitis
Pain is felt deep in the groin or front of the hip
Discomfort increases with hip flexion activities such as bringing the knee towards the chest
Causes a snapping sensation in the hip
Less tenderness on the outer hip
Causes and Risk Factors: How Does Hip Bursitis Happen?
Hip bursitis can arise from a variety of factors such as:
Injury to the Hip Joint: A direct trauma to the hip from a fall or accident can inflame the bursae, causing bursitis.
Repetitive Activities: Activities like running, cycling, and climbing can lead to overuse of the hip joint.
Improper Posture: Poor posture while sitting or standing can strain the hip muscles and bursae, eventually leading to irritation and inflammation.
Unequal Leg Length: Having one leg shorter than the other can alter the hip’s biomechanics, leading to uneven weight distribution and increased stress on the shorter side.
Spinal Abnormalities: Conditions like scoliosis can affect posture and gait, placing abnormal stress on the hip joints.
Bone Spurs or Calcium Deposits: Extra bone growth or calcium buildup near the hip joint can irritate the bursae and trigger bursitis.
Several factors can also increase the risk of developing hip bursitis. These factors include:
Age: Hip bursitis is more common among middle-aged and older adults.
Occupation: People with physically demanding jobs are more prone to overuse trauma and injuries.
Hobbies: Both types of hip bursitis are common in athletes who participate in sports that involve repetitive hip movements.
Weight: Excess weight increases pressure on the hip joint, which can contribute to the development of hip bursitis.
Past Surgery Around the Hip: Hip surgeries can cause changes in movement patterns and irritation of the bursae, increasing the risk of hip bursitis.
Diagnosing Hip Bursitis: What to Expect
Diagnosing hip bursitis typically includes an assessment of medical history, physical examination, and imaging tests.
Medical History:The orthopaedic doctor will ask detailed questions about the patient’s symptoms, including the location, duration and intensity of pain.
Physical Examination: The doctor will perform a physical examination to examine the hip joint, looking for tenderness and swelling.
Imaging Tests: They may also perform imaging studies, such as X-rays, bone scanning, and magnetic resonance imaging (MRI) scans to rule out other possible injuries or conditions and confirm the diagnosis.
Treatment Options for Hip Bursitis
Hip bursitis treatment includes non-surgical and surgical options:
Non-surgical Treatment
Most cases of hip bursitis usually improve with conservative treatments. These include:
Rest: Resting and avoiding activities that can aggravate the pain is key.
Ice: Applying ice wrapped in a towel on the area for around 10 minutes at a time, several times a day, can help reduce inflammation.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Painkillers, such as paracetamol or ibuprofen, can help ease the pain.
Assistive Devices: Using a walking cane or crutches can help relieve pressure on the affected area.
Physiotherapy: Physiotherapy and exercises can strengthen the muscles in the affected area, increasing the range of motion.
Injections: A corticosteroid drug injected into the bursa can relieve symptoms of hip bursitis.
Surgical Treatment
Surgery is rarely needed for hip bursitis. However, if the bursa remains inflamed and painful, the doctor may then recommend surgery.
Bursectomy: This involves the removal of the inflamed bursa,
either through minimally invasive techniques (keyhole surgery) or open surgery. While the bursa
is removed, this does not impair hip function, as a new, healthy bursa will typically regenerate
over time. Bursectomy is often considered for cases of recurrent or chronic septic bursitis.
Tendon Repair and Iliotibial Band Release: These surgical
procedures may be considered for hip bursitis caused by iliotibial band syndrome when
conservative treatments, including physiotherapy, have been unsuccessful in providing adequate
pain relief and functional improvement.
Osteotomy of the Greater Trochanter: This procedure involves
cutting off a small portion of the greater trochanter, a bony prominence on the femur. Osteotomy
is typically reserved for severe cases of hip bursitis where other treatments have failed. This
procedure aims to reduce friction and irritation of the bursa by altering the bone-to-bone
contact.
Preventing Hip Bursitis
To reduce the risk of developing hip bursitis, consider these basic lifestyle changes:
Maintain a healthy weight
Avoid repetitive activities that put stress on the hips
Exercise regularly to strengthen the muscles supporting your joints
Practise good posture when sitting and standing
Warm up properly before exercising and playing sports
Take regular breaks when performing tasks that put pressure on a joint
Avoid wearing high heels if possible
FAQs About Hip Bursitis
What is the difference between hip tendonitis and bursitis?
Hip tendonitis is an inflammation of a tendon, a band of tissue that connects muscle to bone. Bursitis, on the other hand, is the inflammation of the bursa, a fluid-filled sac that cushions tendons, ligaments, and muscles to help reduce friction.
Will bursitis go away on its own?
Some cases of bursitis, especially the mild ones, may improve on their own. However, most cases require conservative medical treatment to resolve more effectively.
What happens if hip bursitis is left untreated?
If left untreated, hip bursitis can lead to chronic pain, stiffness of the hip joint, muscle weakness, and limited mobility. In some cases, untreated hip bursitis can contribute to the development of hip osteoarthritis.
Dr Wang Lushun is an experienced orthopaedic surgeon with a special interest in hip and knee surgery.
Formerly the Head of the Hip and Knee Division at Ng Teng Fong Hospital, he received several awards in
recognition of his service quality and patient outcomes. With over 18 years of experience, Dr Wang is known
for his expertise in sport surgeries, complex joint replacements, and minimally invasive techniques.
Trusted
Leadership on Orthopaedic Advisory Boards
Skilful
Double Fellowships at Centres of Excellence
Experienced
Senior Consultant with Over 18 Years of Experience
