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You may or may not be familiar with the term “bursae,” but these fluid-filled sacs perform an important function in your body. Situated between the bones and the tendons that make up a joint, bursae form a protective cushion that helps prevent friction as joints move. But like the bones and tendons in your joints, bursae are prone to inflammation. When this happens, bursitis is the result, and hip bursitis—officially called trochanteric bursitis—is a very common cause of hip pain, particularly in women.
“Bursitis is a common cause of musculoskeletal pain and often prompts orthopaedic consultation,” says Daniel Aaron, MD, a clinical instructor in the Department of Orthopaedics at Brown University.
“One of the challenges facing clinicians is to differentiate bursitis from conditions with similar symptoms, including arthritis, tendinitis, fracture, tendon or ligament injury, and tumor,” explains Dr. Aaron, who has carried out research into hip bursitis as well as bursitis in the elbows, knees, and heels. “Additionally, bursitis arises from infectious and noninfectious causes, and distinguishing between the two can be challenging.”
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What Causes Hip Bursitis?
Often, the cause of hip bursitis can’t be pinpointed. But you may develop it after a fall onto your hip or after an injury—even bumping into furniture. Overuse of your hip joints also can make you predisposed to hip bursitis; for example, if you have a job that requires standing for long periods of time, or if you frequently run or cycle, you may be at risk. Conversely, hip bursitis also can result from spending extended periods of time lying on one side.
Structural problems with your hip joint (for example, if one leg is longer than the other) also can underpin hip bursitis. So too can poor posture that might occur as a result of arthritis in your spine, as can conditions that affect the shape of your spine (for example, scoliosis). Other possible causes of hip bursitis include bone spurs in the hip; having had surgery on your hip (including hip replacement); and conditions like rheumatoid arthritis and gout, as well as infections such as Staphylococcus aureus.
“A thorough history and physical examination is required for accurate diagnosis,” Dr. Aaron says, “and in some cases, medical tests also may be used to help the clinician identify bursitis and determine whether or not infection is involved.”
Hip Bursitis Symptoms
If you have hip bursitis, you’ll experience pain on the outside of your hip when engaging in activities and when you’re sitting down. If you sleep on the affected side, the pressure on the area affected will likely disturb your slumber. The pain of hip bursitis starts out as sharp and intense, but usually evolves into more of a dull ache.
It’s important to address hip bursitis, since it can cause you to cut back on physical activity, which, in turn, could cause the muscles of your hips to atrophy. Pain-relieving drugs, such as nonsteroidal anti-inflammatory medications (NSAIDs), can help to ease the pain and the swelling of hip bursitis, as can heat and ice packs. You should try to avoid sleeping on the affected side.
It also is important to address any structural or postural issues that may render you vulnerable to chronic hip bursitis. If your legs aren’t the same length, for example, shoe inserts could help mitigate the difference. Also, being overweight or obese can cause hip bursitis; excess weight exerts a great deal of stress on your hip and knee joints, and has been linked to arthritis.
Treatment: How to Relieve Hip Bursitis Pain
Your doctor will likely advise you to rest while your hip bursitis clears up. It might be a good precaution to purchase a cane or crutches to help take some of the pressure off your hip joint as you walk (see our post “Polyarthritis: What It Is and How to Live with It”). Once the discomfort is gone, you can start gentle range-of-motion exercises, and you may be referred for physical therapy.
If a conservative approach doesn’t relieve your hip bursitis pain, your doctor may draw the fluid from the affected bursa, and also recommend corticosteroid injections to reduce the swelling. In rare cases, the bursa may need to be surgically removed. It’s possible for the hip joint to function normally after bursa removal.