Bursae, are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction.
Hip bursitis most often involves the bursa that covers the greater trochanter of the femur, although the iliopsoas bursa can also become inflamed.
Bursitis is inflammation of the bursa. There are two major bursae in the hip that typically become irritated and inflamed. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis.
Another bursa — the iliopsoas bursa — is located on the inside (groin side) of the hip. When this bursa becomes inflamed, the condition is also sometimes referred to as hip bursitis, but the pain is located in the groin area. This condition is not as common as trochanteric bursitis, but is treated in a similar manner.
What are the symptoms of hip bursitis?
The main symptom of bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may become more of an ache and spread across a larger area of the hip. The pain is usually worse at night, when lying on the affected hip, and when getting up from a chair after being seated for a while. It also may get worse with prolonged walking, stair climbing, or squatting.
What causes hip bursitis?
Hip bursitis can affect anyone, but is more common in women and middle-aged or elderly people. It is less common in younger people and in men.
The following risk factors have been associated with the development of hip bursitis.
- Repetitive stress (overuse) injury. This can occur when running, stair climbing, bicycling, or standing for long periods of time.
- Hip injury. An injury to the point of your hip can occur when you fall onto your hip, bump your hip, or lie on one side of your body for an extended period of time.
- Spine disease. This includes scoliosis, arthritis of the lumbar (lower) spine, and other spine problems.
- Leg-length inequality. When one leg is significantly shorter than the other, it affects the way you walk, and can lead to irritation of a hip bursa.
- Rheumatoid arthritis. This makes the bursa more likely to become inflamed.
- Previous surgery. Surgery around the hip or prosthetic implants in the hip can irritate the bursa and cause bursitis. Bone spurs or calcium deposits. These can develop within the tendons that attach muscles to the trochanter. They can irritate the bursa and cause inflammation.
How can hip bursitis be prevented?
Although hip bursitis cannot always be prevented, there are things you can do to prevent the inflammation from getting worse.
- Avoid repetitive activities that put stress on the hips.
- Lose weight if you need to.
- Get a properly fitting shoe insert for leg-length differences.
- Maintain strength and flexibility of the hip muscles.
To diagnose hip bursitis, your provider will perform a comprehensive physical exam, looking for pain in the area of the point of the hip. He or she may also perform additional tests to rule out other possible conditions. These tests can include imaging studies, such as x-rays, bone scanning, and magnetic resonance imaging (MRI).