Hip Bursitis: Treatments, Symptoms and Causes

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Key Takeaways

Hip bursitis is a condition where small, fluid-filled bursae in the hip joint become inflamed, causing pain and swelling that may impair your mobility.
Hip bursitis may be due to direct injury to the hip joint or repetitive motions that place excess strain on the joint.
Mild cases may be managed nonsurgically, such as through physical therapy and lifestyle modifications. Severe cases may require surgery, where the bursa is removed via arthroscopic procedures.
Preventive care may include maintaining a healthy weight, warming up before exercise, and following a consistent exercise schedule without overexerting the hip joints.

What is Hip Bursitis?

Hip bursitis is a condition characterised by inflammation of the hip bursae, small, fluid-filled sacs that cushion the spaces around bones and other tissues during joint movement. The hip contains two major bursae that are at risk of bursitis: the trochanteric bursa and the iliopsoas bursa. The trochanteric bursa is located on the outer part of the hip and is most commonly affected by bursitis. Meanwhile, the iliopsoas bursa is located on the inner aspect of the hip, near the groin.

Hip bursitis can impact any of these bursae, causing pain and swelling around the hip. Sometimes, the pain may radiate to a larger area, particularly after prolonged walking or other physical activity.

What Causes Hip Bursitis?

Hip bursitis can occur due to any of the following causal factors, some of which may be entirely out of your control at times.

Hip Injury or Trauma

Direct injury to the hip, such as after a fall or intense sports activities, can damage the surrounding tissues and increase the risk of bursitis.

Overuse Injuries

Repetitive stress on the hip during regular activities (such as sports training or standing and walking for long hours) can also put you at risk of bursitis.

Infection

The bursae may be at risk of infection when bacteria enter the bursa through a cut, scrape, or other trauma. It may occur in people who have recently undergone hip surgery or have a weakened immune system.

Arthritis

Arthritis is an inflammatory condition that causes damage to the joints, including the hip. It may lead to joint degeneration, impairing the bursae’s condition and increasing the likelihood of hip bursitis.

Bone Spurs

Bone spurs can suddenly or gradually develop within the tendons attached to where the muscles are connected to the trochanter (close to the trochanteric bursa). This can irritate the bursa, increasing the risk of bursitis.

Posture Issues

Postural conditions can place excess pressure on the bursae. Scoliosis, leg-length defects, and other conditions can impact the shape or function of the hip joint, thereby increasing the risk of hip bursitis.

Risk Factors of Hip Bursitis

Anyone may be at risk of hip bursitis, but some individuals may be more prone to the condition due to various factors. Athletes and manual labourers may be at higher risk than others due to repetitive stress on the hip joint. Underlying conditions, such as arthritis, bone spur formation, and other complications, may also influence the risk of hip bursitis.

Other risk factors may include:

Age: Older individuals may be at higher risk of hip bursitis due to gradual wear and tear on the hip joints.
Gender: Women are more susceptible to hip bursitis than men.

Signs and Symptoms of Hip Bursitis

Symptoms of hip bursitis you may experience include:

Pain around the hip area (or around the groin, if hip bursitis is caused by inflammation of the iliopsoas bursa).
Worsening pain at night.
Pain when making any hip movements.
Pain that extends over the outside of the thigh.
Frequent hip aches or stiffness.
Noticeable swelling or redness (or both).
Numbness or tingling sensations.
Tenderness around the hip area.

Treatment Options for Hip Bursitis

Nonsurgical Treatment of Hip Bursitis

For mild cases of hip bursitis that do not impair your mobility or cause debilitating symptoms (such as persistent pain), nonsurgical treatment can help alleviate your condition.

Medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to help relieve pain and manage inflammation affecting the hip joint and bursae. NSAID use does have side effects, so you may only be prescribed NSAIDs if your doctor deems it necessary. Other medications such as painkillers and other anti-inflammatories may also be prescribed instead.

Cortisone Injections

Cortisone injections involve direct injection of corticosteroids into the bursae to provide temporary pain relief that may last several weeks or months. When pain and inflammation recur, a follow-up injection may be beneficial. However, your doctor will need to limit the number of corticosteroid injections per year to prevent long-term damage to the surrounding tissues.

Physical Therapy

Physical therapy sessions can help improve the hip joint’s strength and flexibility over time. You will be assigned a physiotherapist who will develop a suitable physical therapy plan to improve your hip condition gradually. Activities will start slowly to help you ease into things while minimising stress on the hip joint.

Aspiration

If a bursa is swollen, aspiration is carefully performed to remove excess fluid to relieve pain and swelling. The collected fluid is used in laboratory tests to determine whether the bursa is infected.

Lifestyle Changes

Changes to your daily lifestyle can also produce results over time. Ensure that you obtain sufficient rest and do not place excessive strain on your hip joint. These changes occur alongside regular physical therapy sessions and light home exercises to facilitate your recovery. You can apply ice to the hip area to manage swelling and use crutches to reduce pressure on the hip as you move around.

Surgical Treatment of Hip Bursitis

Surgery is a last resort for treating hip bursitis, and is only recommended if conservative, nonsurgical treatments are unable to resolve the condition. In some cases, surgical removal of the bursae may alleviate symptoms without affecting hip function.

Hip Arthroscopy

Hip arthroscopy is a minimally invasive surgical procedure to remove the bursae. It involves making small incisions around the hip, allowing the surgeon to insert an arthroscope that is equipped with a light and a camera. The arthroscope projects video footage of the hip joint’s interior, enabling the surgeon to insert surgical instruments through other incisions and perform the necessary procedures to treat hip bursitis.

The surgeon will use these tools to carefully resect (or remove) the bursae. Additional procedures may be performed as well if necessary, such as removing bone spurs that could impinge on nearby muscles, nerves, or blood vessels.

How Hip Bursitis Is Diagnosed

Diagnosing with a Physical Exam

A comprehensive physical examination will help your doctor determine if there is swelling, tenderness, or a limited range of motion affecting your hip joint. They may also ask follow-up questions to assess your overall condition, including your current medications and whether you recently injured your hip. Depending on your condition, you may experience discomfort during the examination; notify your doctor of how you feel.

Testing for Greater Trochanteric Bursitis

During the physical exam, your doctor may ask you to lie on your side, with the painful area facing upwards. Then, they will carefully palpate the area of the trochanteric bursa. If the doctor detects tenderness in the area, it may indicate a risk of hip bursitis. Further testing, such as imaging, can be performed to confirm the diagnosis.

Diagnosing with Imaging Tests

Additional tests can help confirm the diagnosis, especially if the physical exam does not give a satisfactory result. These tests could also help distinguish your condition from other conditions with similar symptoms.

X-ray scan: An X-ray can clearly show dense structures such as bone, allowing the doctor to determine if there are any fractures or other damage to the hip joint. X-rays taken at multiple angles can provide a clearer picture of the hip joint’s condition.
Ultrasound: An ultrasound scan uses high-frequency sound waves to visualise the hip bursae and other structures and to assess for fluid accumulation or swelling, which may indicate hip bursitis.
Magnetic resonance imaging (MRI): This test may be ordered to evaluate the condition of the bursae and the surrounding hip joint structures, including soft tissues. It can produce clear images of muscles, ligaments, cartilage, and tendons, allowing the doctor to identify additional damage to these structures.

Tips to Prevent Hip Bursitis from Recurring

Your doctor will provide post-surgery instructions to prevent a recurrence of hip bursitis.

Warm up first: Before exercising, begin with simple warm-up activities such as stretching. Doing so helps prepare your body for the intense workout ahead.
Maintain proper posture: Good posture helps minimise stress on the hip joints and may also alleviate gait irregularities that could impact the joints. For example, avoid supporting your entire body weight on one leg when standing.
Regular exercise: Maintain a consistent weekly exercise regimen to support physical health. Twenty minutes of exercise three times per week may be sufficient, but you may adjust your schedule accordingly based on your current health status. Include strengthening exercises for your hip and leg muscles to improve joint stability and reduce pressure on the bursae.
Avoid overexertion: Overexertion can place undue strain on the hip joints and increase the risk of hip bursitis. Take breaks in between sessions to give your body sufficient time to rest. If you are trying a new exercise, start slow and gradually build up as you become familiar with it.
Manage your weight: Maintaining a healthy, well-balanced diet and monitoring your weight are essential to reducing stress placed on the hip joints. Adopt healthy habits, such as eating regular meals and avoiding snacks between meals.
Wear appropriate footwear: Shoes with adequate arch support and comfort can reduce strain on the bursae and the risk of hip bursitis over the long term.
Remove fall hazards: Declutter your home, especially if there are items on the floor, as these can increase the risk of falls.

Our Orthopaedic Doctor and Surgeon in Singapore

Dr. McGraw

M.B.Ch.B. | M.R.C.S. (Lon) | F.R.C.S. (Tr & Orth)

Dr. McGraw is a practising orthopaedic and trauma surgeon at Mount Elizabeth Novena Hospital and Parkway East Hospital.

His special interests and expertise include the management of all aspects of hip and knee conditions, in addition to general orthopaedic and trauma surgery.

Born and bred a Yorkshireman, Dr. McGraw studied Dental Surgery at Newcastle-Upon-Tyne in the United Kingdom. Upon qualifying, he worked as a Maxillofacial surgical trainee before undertaking his dental fellowship at The Royal College of Surgeons London and then commencing his studies in Medicine at Manchester University. He subsequently decided to change tack and completed his training as an Orthopaedic Surgeon in the northwest region of England. Dr. McGraw completed his training by undertaking two fellowships in hip and knee surgery at Wrightington Hospital in the UK. He was appointed as Consultant Orthopaedic Surgeon at Bury & North Manchester General Hospitals in 2012. Whilst at these hospitals, he kept up with the waiting list issues by dedicating his weekends to work in waiting list initiative lists at Wrightington Orthopaedic Hospital.

Frequently Asked Questions About Hip Bursitis

How soon should I see a doctor?

If you are frequently experiencing any hip bursitis symptoms or if they are preventing you from performing activities of daily living or work, seek medical attention immediately. Prompt treatment can ensure symptoms are managed before they worsen.

Are hip bursitis and trochanteric bursitis the same thing?

Yes, they are. Hip bursitis is an umbrella term for inflammation or infection of the hip bursae. Meanwhile, trochanteric bursitis is a specific type of hip bursitis which affects the trochanteric bursa. Doctors may describe your condition as hip bursitis regardless of whether it impacts the trochanteric or iliopsoas bursa.

How long does recovery from hip bursitis take?

Your recovery may vary depending on your current health, the extent of injury to the bursae, and your treatment plan. Most mild cases may only take a few weeks to recover, while severe cases might require up to several months for you to make a complete recovery. Your doctor will provide advice to facilitate your recovery and minimise risks.

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