Hip bursitis is a hip pain condition secondary to inflammation of a bursa or bursae in the region of the lateral hip where the bony prominence of the greater trochanter. Bursitis occurs when a bursa becomes inflamed. A bursa is a small sac of lubricating fluid, often placed between different types of tissue such as muscles, tendons, skin and bone. This allows reduced friction and rubbing where parts of the body have to move past other parts regularly.
Repetitive small actions can bring on bursitis but it can also be generated by a larger incident, with increasing age making it more likely to occur and so it tends to present in adults over forty years old. Higher risk activities include sports such as tennis and golf and activities such as gardening and house painting. Hip arthritis may cause the hip mechanics to become abnormal and this can increase the likelihood of hip bursitis. If hip replacement has been performed this can restore the hip area to normality and help relieve the symptoms.
Pain over the site of the inflamed bursa is the main symptom people complain of with limitation of movement in the affected area. It usually comes on slowly but can occur more quickly if a lot of repeated work is done when the person is not used to it. Bursitis can occur in many areas but most common are around the Achilles tendon, the knee (housemaid's knee for example), the hip and the shoulder.
In the hip, lateral hip pain is often diagnosed as bursitis and also called trochanteric bursitis, but this diagnosis has been challenged by research which suggests that no inflammation is involved and the pain is likely to be due to degenerative changes in the hip tendons. People complaining of hip pain running may have this kind of pain and injections and stretches can give hip pain relief.
To make bursitis less likely to occur it is useful to start at a low level and build up activities slowly to avoid over stressing the soft tissues. Treatment of bursitis included reducing or avoiding the activity which brings on the pain, resting, using ice to reduce inflammation and pain and using anti-inflammatory drugs.
If lower back pain is present then the physiotherapist may check the lumbar spine as back pain problems can refer pain to the outside of the hip and thigh area.
Corticosteroid injections for this kind of thigh pain can be given directly into the hip bursa and are a very safe treatment which strongly reduce the pain and inflammation. Treatment is not always curative with around a third of patients not being helped much and steroids cannot be given more frequently than once every three months for a limited number of times.
Physiotherapy assessment and management is a common option, with treatment including splinting, ice, ultrasound, frictions, stretches and exercises.