Hip Bursitis
By
By: Niki Heeter, PT, DPT, ATC and Dr. William Pujadas
Hip bursitis is inflammation in the bursa on the outer portion of the hip. A bursa is a fluid filled pouch which lies between some bony surfaces and tendons to allow a smoother glide between the surfaces. With hip anatomy, there is a large bursa at the large prominent bony surface which is call the Greater Trochanter. The IT band glides over this area and the bursa helps to reduce the friction.
When there is too much pressure on the area over time, the bursa can become inflamed and painful. This condition is called Hip Bursitis or Trochanteric Bursitis.
Hip bursitis may also come from imbalances in muscle strength. Scoliosis or abnormal curvature in the spine can lead to an imbalance which may increase pressure on the hip bursa. Bursitis may also be more likely with people with rheumatoid arthritis or pseudoarthritis.
Symptoms of Trochanteric Bursitis or Hip Bursitis
The main symptom of trochanteric bursitis is pain on the outside of the hip. The pain can extend into the thigh region and sometimes even refer to the back and down the side of the leg. The pain can be sharp and intense, especially at the beginning of onset. The longer the symptoms are present the pain may progress to an ache and become more widespread throughout the hip region. The area of the bursa will be tender to touch or lay on. Pain is usually increased with sleeping on involved side, prolonged walking and standing tasks, stairs, transfers in and out of the chair or car and squatting.
Risk Factors for Hip Bursitis
There are many factors that could predispose you to developing hip bursitis including:
- Being a female
- Middle age or elderly
- Repetitive stress or over-use injuries
- Previous hip or back injuries
- Leg length discrepancy
- Previous surgeries
Medical Treatment of Trochanteric Bursitis
Injections for Hip Bursitis
According to Dr. William Pujadas of the Jacksonville Orthopaedic Institute, injections frequently help with trochanteric bursitis, especially when patients have functional limitations with stairs and getting up from a chair. He usually offers this injection at your first doctors’ appointment if he finds your diagnosis to be trochanteric bursitis. He generally will offer to do a cortisone injection in the lateral hip as well as prescribe an anti-inflammatory and physical therapy. Dr. Pujadas recommends that patients try physical therapy prior to an injection if they are hesitant. With the combination of the injection and proper physical therapy, He sees about a 95% success rate in decreasing patient’s hip pain and restoring function.
Surgery for Hip Bursitis
Dr. Pujadas states that he rarely uses surgery to treat trochanteric bursitis as the majority of patient’s get better with an injection and physical therapy. Occasionally patients will need a second injection.
Conservative Treatment
Physical therapy can help with trochanteric bursitis by helping decrease pain, swelling and stiffness as well as improve any weakness or imbalances within the body. Physical therapists evaluate strength and muscle length, as well as observe walking and movement patterns. The therapists will also screen for serious issues in the hip and confer with the physician or orthopedist as needed.
A typical physical therapy treatment plan will include exercises and treatments to be performed at home. A typical recovery ranges from 2-8 weeks. Treatment will include ways to reduce pain and swelling such as ice, heat, or modalities. Treatment will also include manual techniques and exercises to improve motion, flexibility, strength, balance, and guidance on return to activities. Learning a home exercise program is imperative for recovery.
Soft tissue mobilization and massage may be helpful as well as Graston Technique.
Prevention of Hip Bursitis
Keeping the muscles around the hip, knee and abdomen strong and stretched can help prevent further injury or recurrence of hip bursitis. Following a consistent workout program and warming up properly can help keep symptoms resolved. It is also important to gradually increase activity when returning to prevent acute overuse stress in hip.
Related Links:
Dr. William Pujadas is a renowned Orthopedist specializing in hip bursitis, sports medicine, and joint replacement surgery. If you have hip pain, he can help! To schedule an appointment with Dr. Pujadas and the team at the Jacksonville Orthopaedic Institute, call (904)JOI-2000, schedule online, or click the link below. To see a JOI Rehab Therapist in 1 of our convenient locations, call (904)858-7045.