Hip bursitis is a common problem that causes pain over the outside of the upper thigh and hip joint. A bursa is a fluid filled sac that allows smooth motion between two surfaces. In the hip, a bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the firm tendon that passes over this bone. When the bursa becomes inflamed, each time the tendon has to move over the bone, pain results. Because patients with hip bursitis move this tendon with each step, symptoms of this condition can be quite painful.
Hip bursitis is commonly seen in runners or athletes who participate in running-oriented sports (e.g. soccer and football). Hip bursitis is sometimes associated with patients who fall onto their upper thigh, causing traumatic bursitis. The symptoms are similar to a hip pointer. Patients who have had surgery, such as hip fracture surgery or hip replacement, may complain of pain over the outside of the hip. These symptoms are often due to irritation to the bursa causing hip bursitis.
The diagnosis of hip bursitis is made most reliably on physical examination, such as the one you would receive here at American Spine and Pain Med Group. The most common symptoms of hip bursitis include tenderness over the bony prominence of the upper/outer thigh and swelling over the bursa.
As with any medical condition, other problems that can cause similar symptoms should be considered. Hip bursitis is usually a clear diagnosis, and the symptoms can be distinguished from other conditions. However, some cases of hip bursitis can be confused with other medical conditions. These include iliotibial band tendonitis, hip pointers, meralgia paresthetica, and low-back conditions.
Other causes of pain in this area include hip joint problems, such as hip arthritis and labral tears, but these problems usually cause symptoms in areas other than the outside of the thigh.
Treatment of hip bursitis usually begins with some simple steps, and progresses depending on the individual's response to these treatments. Most people can find relief from their symptoms with noninvasive treatments. However, some people have challenges curing their symptoms of hip bursitis, and may require more invasive treatments.
The best treatment for hip bursitis, or any form of bursitis is aimed at controlling the inflammation caused by this condition. The general treatment of hip bursitis consists of:
Rest. This usually means a period of time not participating in sports or activities that aggravate your symptoms. As a general rule of thumb, any activity that causes hip bursitis pain should be avoided as this only contributes to inflammation of the bursa.
Anti-inflammatory Medications. Anti-inflammatory medications (e.g. Motrin, Aleve, Naprosyn) will help control the inflammation associated with hip bursitis. These medications are helpful for the pain as well as diminishing inflammation.
Ice the Injury. Icing the area of hip bursitis often helps to alleviate the symptoms of hip bursitis. Especially after exercise, ice can control inflammation, and stimulate blood flow to the injured area.
Aspiration/Drainage of the Bursa. In some patients who have a significant amount of fluid that has collected within the bursa, a needle can be placed into the bursa to remove the fluid. This is rarely needed in cases of hip bursitis, but when it is done it may be combined with a cortisone injection.
Cortisone Injection. A cortisone injection may also be given into the bursa in patients with pain. The cortisone injection is helpful because it can be both diagnostic and therapeutic. In cases where hip bursitis may be one of several diagnoses being considered, cortisone can be given to see if the shot helps to alleviate symptoms.