Hip Bursitis (Trochanteric Bursitis)

Located throughout the body are small, jelly-like sacs filled with fluid, known as bursae. These sacs help cushion the joints and reduce friction placed on bones and soft tissues. 

Bursitis is an inflammation of these sacs. 

Hip Anatomy

Trochanteric bursitis specifically occurs when there is inflammation in the bursa that covers the bony point of the hip bone. This point of bone is called the greater trochanter. Trochanteric bursitis, or hip bursitis, is the most common form of bursitis. 

Hip Bursitis Causes

Hip bursitis can occur in anyone, but some people are more at risk than others. For instance, women are more likely to be affected than men, and middle-aged or elderly adults are more likely to be affected than younger adults.

Other risk factors associated with the development of hip bursitis include:

  • Repetitive overuse. Excessive running, stair-climbing, bicycling, or standing for long periods of time can cause bursitis in the hip.
  • Hip injury. If trauma occurs to the point of the hip during a fall, bursitis can develop.
  • Spine disease. Scoliosis, arthritis in the lower spine, and other spine problems can make you more susceptible to hip bursitis.
  • Leg-length inequality. When one leg is shorter than the other by a significant amount, you will naturally place more stress on one leg than the other, which can lead to irritation of the hip bursa. 
  • Rheumatoid arthritis. Arthritis in the hip makes the bursae more likely to become inflamed.
  • Previous surgery. Surgery around the hip or any prosthetic implants in the hip can cause irritation to the bursa.
  • Bone spurs or calcium deposits. These can develop in the tendons that attach the muscles to the trochanter. They can irritate the bursa and create inflammation.

Hip Bursitis Symptoms

Pain at the point of the hip is the most common symptom. This pain will usually expand to the outside of the thigh area. Typically this pain will be worse at night. Prolonged use of the hip like climbing stairs or squatting can also make the pain worse.

The pain is usually described as sharp and intense and progresses to an ache.

Hip Bursitis Diagnosis

Hip bursitis can usually be diagnosed with signs or symptoms, along with a physical exam.

During a physical exam, your doctor will search for tenderness around the point of the hip. X-rays and other imaging tests may be ordered to rule out other possible causes for your symptoms.

Hip Bursitis Treatment

The first line of treatment for hip bursitis does not involve surgery. Surgical treatment only becomes necessary if nonsurgical treatments are unsuccessful. 

Nonsurgical Treatment

Many people with hip bursitis can gain relief with simple lifestyle changes such as:

 

  • Activity modification. Avoiding activities that aggravate your symptoms.
  • Non-steroidal anti-inflammatory drugs. Over the counter medications like ibuprofen, naproxen, and piroxicam can relieve pain and inflammation. These should be used sparingly and at the prescription of your doctor.
  • Assistive devices. Use of a walking cane or crutches for a week or more can help relieve symptoms.
  • Physical therapy. Exercises that are designed to increase hip strength and flexibility can help relieve the symptoms of hip bursitis. 
  • Steroid injection. A corticosteroid injected directly into the bursa can be helpful in relieving pain, either temporarily or permanently. If pain and inflammation do return, more injections given several months apart can be needed. It is important to limit the number of these injections. Repeated corticosteroid injections can cause damage to the surrounding tissues.

Hip Surgery

Removal of the bursa is not detrimental to the function of the hip and may be recommended if other nonsurgical treatments do not effectively alleviate symptoms. 

Most of the time, this will be done arthroscopically, with small cameras and tiny surgical instruments. Open surgery is also sometimes used, with a larger incision made on the hip. Both these procedures are outpatient procedures and do not require grueling hospital stays.

Hip Bursitis Recovery

After surgery, the recovery period is typically very short. Many people find that using a cane or crutches for a few days following their surgery is helpful. 

Most patients are up and walking the evening after surgery. Soreness is natural, and usually fades after a few days.

Hip Bursitis Prevention

Hip bursitis cannot always be prevented, but there are certain measures you can take to prevent inflammation from worsening. You can:

  • Avoid repetitive activities that put stress on the hips
  • Losing any excess weight
  • If you have any leg-length differences, get a properly fitted shoe insert
  • Maintain the strength and flexibility of the hip muscles.
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