This condition is an inflammation of the trochanteric bursa, a fluid-filled sac that lies between the femur and the iliotibial band, a thick, wide tendon on the outside of the hip joint. This condition can cause pain and swelling on the outer side of the hip.
Bursitis is the painful swelling of the bursae, the small sacs that provide cushioning between the bones, tendons and muscles. Hip bursitis, also known as trochanteric bursitis, occurs when the bursa at the head of the femur (thigh bone) is affected. When the bursa becomes inflamed and fills with fluid, it can create painful friction in the joint. Hip bursitis may occur as a result of uneven leg length, prior hip injury or surgery or rheumatoid arthritis. Hip bursitis most frequently develops in patients over the age of 50, and is more often found in women than men.
Symptoms of Hip Bursitis
The most common symptom of hip bursitis is pain at the point of the hip. The pain typically extends to the outside of the thigh area, and is often described as extremely intense. For some patients, the pain tends to become worse during the night, especially if they lay directly on the affected hip. The pain may also intensify when a person climbs up steps, does exercises such as squats or walks for a long period of time.
Causes of Hip Bursitis
Hip bursitis can occur in anyone, but aging increases the risk of developing the condition. Some possible causes of hip bursitis may include:
- Injury caused by overuse of the hip
- Iliotibial band syndrome, a condition brought on by overuse of the thigh or knee
- Previous hip injury or surgery
- Spinal diseases such as scoliosis
- Leg-length inequality, since the hip bursa may become irritated more easily when one leg is shorter than the other
- Rheumatoid arthritis
- Bone spurs or calcium deposits, which irritate the bursa and lead to inflammation
Diagnosis of Hip Bursitis
In order to diagnose hip bursitis, a comprehensive physical examination will be performed. The doctor will focus on the hip area in order to determine the presence and location of tenderness around the joint. Additional imaging tests, such as MRI scans or X-rays, may also be performed to rule out other possible hip injuries or conditions.
Treatment for Hip Bursitis
Treatment of hip bursitis usually involves a combination of lifestyle changes and nonsurgical techniques. The treatment plan may include restricting strenuous activities that tend to worsen symptoms of the condition, participating in a physical therapy program to increase hip strength and flexibility and taking over-the-counter non-steroidal anti-inflammatory medications. In some cases, corticosteroid injections may also be helpful in relieving the pain that results from hip bursitis. The effects of such an injection may last for several months.
Only in rare cases is surgery necessary to treat hip bursitis. However, if conservative methods fail to provide relief and normal daily activities are affected, the bursa may need to be surgically removed. This procedure can be performed arthroscopically, through several small incisions made over the hip. A flexible tube with a camera, or arthroscope, is placed in one incision to obtain a clear view of the joint. Specialized tools are then inserted into a second incision in order to remove the affected bursa. The surgery is minimally invasive and is performed on an outpatient basis, enabling patients to return home the same day. Following the procedure, patients may need to use a cane or crutches for several days. Patients may also experience some temporary soreness post-surgery.
Prevention of Hip Bursitis
While hip bursitis is not always preventable, certain measures can be taken to ensure that the condition does not become progressively worse. Preventative measures that may alleviate symptoms of hip bursitis include avoiding activities that place stress on the hips, resting the affected leg, applying ice to the hip area and performing exercises that maintain the strength of the hip muscles.