Hip Bursitis

There are three main types of hip bursitis:

• Greater trochanteric bursitis affects the bursa on the outer side of the hip and is the most common type.
• Ischial bursitis affects the bursa under the sitting bone (ischial tuberosity).
• Iliopsoas bursitis affects the bursa located in front of the hip joint, near the iliopsoas muscle.

People with hip bursitis may notice:

• Pain on the outer side of the hip that worsen with walking, climbing stairs, or long periods of sitting.
• Tenderness pressing over the affected area.
• Occasional swelling around the hip area.
• Stiffness of difficulty moving the hip joint.
• Night pain, especially when lying on the affected side.

Hip bursitis can occur due to several factors, including:

• Repetitive movements or sports that put stress on the hip.
• Age-related wear and tear.
• Prolonged sitting or frequent hip movements.
• Trauma, such as a fall directly onto the hip.
• Overuse without proper conditioning or warm-up.
• Posture or gait issues that place extra strain on the bursae.
• Underlying conditions, such as osteoarthritis, rheumatoid arthritis, or gout.

Doctors diagnose hip bursitis using the following methods:

• Comprehensive assessment of medical history and symptoms.
• Physical examination of the hip joint: This helps detect pain or any other hip joint abnormalities.
• Imaging studies:
  • Radiographs (X-ray) to rule out fractures or arthritis, which may have similar symptoms.
  • Ultrasonography to detect bursa inflammation.
  • Magnetic resonance imaging (MRI) to examine the soft tissues around the hips and identify bursitis and other hip joint issues.
• If there is swelling, fluid may be withdrawn from the bursa and tested to rule out infection.

Treatment can be either non-surgical or non-surgical:

• Non-surgical treatments:
  • Resting and avoiding activities that exacerbate symptoms.
  • Applying ice packs to reduce inflammation.
  • Medicines to reduce pain and inflammation:
    • Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.
    • For severe inflammation, corticosteroids can be injected directly into the bursa for relief.
  • Physical therapy to improve flexibility, strengthen hip muscles, and correct posture or walking patterns.
  • Using cushions, supportive shoes, or orthotics to reduce stress on the hip.
• Surgical treatment: Surgery is rarely necessary but may be considered if all treatments fail. The procedure usually involves removing the inflamed bursa (bursectomy) or addressing underlying hip problems contributing to the condition.

Patients are advised to consult with their doctor if:

• Hip pain persists for more than a few weeks despite rest and home care.
• Pain interferes with daily activities such as walking or sleeping.
• Swelling, redness, or fever develops, which may indicate infection.
• Conservative treatments like medication and physiotherapy do not provide relief.

You can lower your risk of developing hip bursitis by:

• Warming up properly before exercise.
• Avoiding repetitive movements that strain the hips.
• Maintaining a healthy weight to reduce stress on the joints.
• Using correct posture while sitting, standing, or walking.
• Strengthening and stretching hip muscles through regular exercise.

Patients with hip bursitis should consult an orthopaedic specialist. In some cases, a physiotherapist may also be involved to help with exercises and posture correction.