Bursitis of the Hip

One of the most intriguing parts of the human body is the hip joint. It offers you stability yet does not compromise on movement. But like everything else, it can malfunction and cause you severe problems.

One such condition that we commonly see in the outpatient setting is known as Bursitis of the Hip, which is also one of the most common causes of hip pain.

Fortunately, it can be easily managed and rarely becomes complicated. And even if it does, there are enough treatment modalities to manage it amicably.

Let us delve into what Bursitis of the Hip is, and what are its causes and treatment.

What is Bursitis of the Hip?

Bursitis of the Hip (also known as Sub Trochanteric Bursitis) is  inflammation of the bursa around the outer side of the hip joint. A bursa is essentially a fluid-filled sac that acts as a shock absorber to reduce the friction between the hard bones and soft tissues like muscles and tendons.

There are two different bursae in the hip, one known as trochanteric bursa located on the outside of the hip at the greater trochanter of the femur (the longest bone of your body). The greater trochanter is a sort of knob at the outer end near the top of your thigh bone (femur).

The other bursa is the iliopsoas bursa and is located on the inside of your hip. Our discussion will centre around the trochanteric bursa and its inflammation as it is much more common and is basically what professionals mean when they say hip bursitis.

Causes:

Some of the common causes of Trochanteric Bursitis or Hip Bursitis are

• Injury to the hip due to falling directly onto the hip
• Incorrect posture may be a cause especially in diseases like Scoliosis where your back is chronically bent
• Bony spurs or Calcium deposits which are bony outgrowths that irritate your hip bursa
• A complication of previous surgery to the hip
• Overuse of the hip joint
• Tension in the surrounding soft tissues like in the Iliotibial band that runs from the hip to the knee joint
• Other diseases like gout, psoriasis, rheumatoid arthritis, and thyroid diseases

In summary, Hip Bursitis occurs in middle-aged or older adults due to either trauma, overuse, or any previous disease process that may affect the bursa.

Symptoms:

Symptoms of Hip Bursitis occur mostly when you are doing an activity or when you lie down on the side of the problem as the bursa gets stretched.

The typical symptom is pain on the outside of your hip. The pain may start by being sharp but slowly transitions to being dull. You may feel this pain by pressing onto the outer side of your hip.

If left untreated, the pain goes down towards your thighs.

In some severe cases, there may be joint inflammation and redness with associated fever. If you feel these symptoms for more than 14 days, you should go to a doctor.

Diagnosis:

Before anything else, your doctor will perform a physical exam. This will be followed by an X-ray if needed. The doctor may also ask questions or perform tests to rule out other diseases that may be the primary cause of hip bursitis.

Sometimes, doctors may perform an ultrasound or MRI to get a clear picture. An anaesthetic may be injected, and if the pain goes away, that confirms hip bursitis.

Treatment:

The necessary remedies that need to be done are noninvasive nonsurgical and can be done at your home as well.

First and foremost, you need to rest as much as possible and avoid unnecessary mobility. This gives your hip the time to heal itself without being in use regularly.

Secondly, a simple ice pack may prove to be effective. This is done for 10-15 mins after every 3-4 hours. The ice numbs the area and also helps reduce the level of swelling and inflammation.

A few OTC (Over-the-counter ) anti-inflammatory medications may also help. These include ibuprofen and naproxen. Prescription medicine that may be beneficial is Celecoxib.

When you visit your doctor, he may also give you a corticosteroid injection. This again helps to decrease inflammation. This may be accompanied by aspiration of the fluid in the swollen bursa, which was causing the problem.

Some experts recommend controlled physical therapy to help you regain your flexibility and strengthen the muscles around your hip.

A recent modality is shock wave therapy, which has helped two-thirds of the patients improve their symptoms. It involves sending low energy waves through the skin to relieve the symptoms.

Surgical Options:

The surgical options are available to treat hip bursitis and may be sought if every other modality fails. Now the surgeon may remove the whole bursa (bursectomy), or he may just remove some of the bony ridges in the greater trochanter. This leads to decreased friction between the bursa and the femur and can help the pain.

Now, these procedures may be combined, or one may be preferred to the other, which depends on the individual patient.

Prevention:

They say (rightly) that prevention is better than cure. So if this ailment threatens you, there are a few things you can do to decrease the risk.

First and foremost, you need to lose some weight. Being overweight tends to put a more significant load on your hip and makes hip bursitis worse.

Avoid sporting activity may help to slow down the inflammatory process, and things like splints, canes, or shoe inserts may also give some much-needed rest to your body.

Now exercise may also help some people but in a controlled environment. And if you are in a recovery phase, you should always do extensive warm-ups before any workout.

Summary:

Hip Bursitis is the inflammation of the bursa in the outer side of the hip.

It may be caused by overuse, injuries around the region, or other related diseases.

The treatment involves rest, medications, and surgery as a last resort. But the best way to be free of hip bursitis is prevention by weight loss, calculated exercise, and avoiding strenuous activities.

For more information on this and related orthopedic conditions, please contact Dr. Gowreeson Thevendran. Dr. Thevendran is a specialist orthopedic surgeon and an expert in Sports Medicine. You  can also visit his practice at  www.orthofootMD.com.