Hip Surgery, Orthopedic Surgery

September 5, 2022

Symptoms & Solutions: Hip Bursitis


Hip bursitis occurs when a fluid-filled sac in the hip joint becomes inflamed, often due to arthritis, overuse, or injury. While hip bursitis can typically be managed with non-invasive remedies, there are also some surgical options for treatment.

What is Hip Bursitis?

Bursitis is a condition that occurs when the bursa becomes inflamed. Bursae are fluid-filled sacs that allow your tendons, ligaments, and muscles to glide smoothly over bone. Hip bursitis occurs when a bursa in the hip joint becomes inflamed due to injury, arthritis, or other causes.

Forms of Hip Bursitis

There are two major bursae in your hip joint, each of which can become inflamed and cause hip bursitis. In addition, septic hip bursitis can occur if a bursa becomes infected.

  • Trochanteric bursitis occurs when the bursa covering the point of your hip bone becomes inflamed. It causes discomfort and aches on the outside of the hip.
  • Iliopsoas bursitis occurs when the bursa on the inside of the hip becomes inflamed. It causes pain in the front of the hip or the groin area.
  • Septic hip bursitis is a rare, potentially severe condition that requires antibiotic treatment. It can cause fatigue, fever, warmth or redness at the hip, and an overall feeling of illness.

Symptoms of Hip Bursitis

The symptoms of hip bursitis may include:

  • Stiffness of the hip joint
  • Hip pain that’s worse at night
  • Sensitivity to touch and motion
  • Swelling and redness

See your doctor if you notice restrictive joint pain, a sharp or shooting pain when slight pressure is applied, or a fever.

What Causes Hip Bursitis?

Hip bursitis can be caused by the following:

  • Injury. A direct impact to the hip joint can result in a hematoma, or the bursa filling with blood. The hematoma may aggravate the bursa and cause inflammation.
  • Friction. Bursitis can occur if the iliotibial (IT) tendon, which runs down the outside of your thigh, moves back and forth over the trochanteric bursa.
  • Muscle strains. Strains in the muscles around the hip can cause tenderness. For examples, tears or inflammation of the gluteus medius—a muscle that moves the leg from side to side and turns it in and out—can cause hip bursitis.
  • Infection. Bacterial infections such as staphylococcus aureus (staph infection) can inflame the bursa.
  • Overuse. Repeated stress on the hip joint can cause hip bursitis.

Hip bursitis can also be caused by conditions such as rheumatoid arthritis, tendonitis, gout, and diabetes. In addition, bone spurs in the hip, uneven leg lengths, and spine issues such as scoliosis can lead to hip bursitis.

Diagnosing Hip Bursitis

Determining the cause of your hip bursitis is the first step in treating it effectively. To diagnose you with hip bursitis, your physician will perform a comprehensive physical examination. Typically, he or she will check for tenderness over the skeletal point of the hip bone.

Your physician may also require you to undergo more medical examinations to rule out other possible injuries or conditions. Tests may include imaging studies, such as x-rays, bone scans, and magnetic resonance imaging (MRI) scans.

Some questions you may want to ask your doctor include:

  • What is causing my symptoms?
  • What is the most suitable treatment option for me?
  • How long will it take to recover?
  • Could my symptoms reoccur?
  • Will I need to make any lifestyle changes? If so, what do you recommend?

How to Prevent Hip Bursitis

Not all forms of hip bursitis can be prevented. However, you can reduce your chances of occurrence and the severity of flare-ups by altering the way you do specific activities.

For example:

  • Lift things carefully. If you need to lift something heavy, be sure to bend your knees. Keeping your knees stiff while lifting places extra strain on the hip bursae.
  • Warm up and stretch. Warming up before starting strenuous activities helps protect your joints from injury.
  • Maintain a healthy weight. More body weight means more strain on the joints.
  • Exercise regularly. Building up your muscles can help shield your affected joint.
  • Take frequent breaks. Be sure to rest between jobs, sports, and other activities.

Hip Bursitis Solutions

Nonsurgical Treatments for Hip Bursitis

Not all cases of hip bursitis require surgery. In fact, simple lifestyle changes, such as avoiding activities that may worsen your bursitis, can provide relief from symptoms.

Some non-surgical treatments for hip bursitis include:

  • Non-steroidal anti-inflammatory drugs (NSAIDs). Medications like ibuprofen, naproxen, piroxicam, celecoxib, and others may relieve pain and control inflammation. Ask your doctor which NSAIDs are right for you.
  • Physical support systems. Using a walking cane or crutches for a week or two to take stress off the hip joint may provide relief.
  • Physical therapy. Your doctor might prescribe exercises to stretch the IT band and improve your hip’s strength and flexibility. You may do these exercises on your own or alongside a physical therapist. A physical therapist might also recommend other treatments, such as massage, ice, heat, or ultrasound therapy.
  • Steroid injections. Injection of a corticosteroid (along with a local anesthetic) may help relieve symptoms of hip bursitis. A single injection into the affected bursa could provide months of relief. Talk to your doctor to see if this option is right for you.

Surgical Treatments for Hip Bursitis

Surgery is rarely required for hip bursitis. However, if the bursa remains inflamed and painful after you have tried the nonsurgical options listed above, your doctor may recommend surgical removal of the bursa. This procedure does not damage the hip, and the hip can function normally without the bursa.

Arthroscopic bursa removal removes the affected bursa through a small incision over the hip. A small camera, or arthroscope, is placed in a second incision so your surgeon can guide miniature surgical instruments to remove the bursa. Arthroscopic surgery is less invasive than open surgery, and recovery is quicker and less painful.

No matter the method of your bursa removal surgery, an overnight stay at Arkansas Surgical Hospital is not typically necessary. The rehabilitation period is relatively short: you will likely be up and walking around the evening after surgery, and any soreness at the surgery site usually goes away after a few days. Using a cane or crutches for a few days after your procedure may also help with recovery.

Talk to Your Doctor About Hip Bursitis

The orthopedic surgeons at Arkansas Surgical Hospital have years of experience treating hip bursitis. If you’ve been suffering from severe hip pain, contact us at (877) 918-7020 or request an appointment online to discuss your options. Our surgeons can develop a hip bursitis treatment plan that works for you.

Photo by Anna Shvets

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