What’s a bursea?
Bursae are small, jelly-like sacs found around the shoulder, elbow, hip, knee, and heel. These sacs contain fluid and are set between bones and joints to help reduce friction. Bursitis is a condition that happens when the bursa becomes inflamed. Hip bursitis most often involves the bursa that covers the greater trochanter of the femur or the iliopsoas bursa. When this bursa becomes irritated or inflamed pain in the hip is the result.
Symptoms of hip bursitis
Initial hip pain involving bursitis is usually described as sharp and intense, and that can evolve into an ache that spread across a larger area of the hip which may worsens at night.
Hip bursitis is reported more often in women and middle-aged or elderly people. Hip bursitis caused by overuse that happens in people who do a lot of running, stair climbing, bicycling, or standing for long periods of time. It can also be the result of a fall or bump to the hip and sometimes happens when people lie on one side of the body too long. It can also be the result of spine disease including scoliosis, arthritis of the lumbar (lower) spine. When one leg is significantly shorter than the other it may lead to irritation of a hip bursa. Other factors include rheumatoid arthritis, previous surgery involving the hip and bone spurs or calcium deposits.
Treatment for hip bursitis
Many people with hip bursitis can experience relief with simple lifestyle changes, activity modification, and anti-inflammatory drugs. There are also assistive devices that can help such as a walking cane or crutches when symptoms are at their worst.
Physical therapy for hip bursitis
Physical therapy is an excellent way to treat bursitis and exercises designed to stretch out the IT band and/or increase hip strength and flexibility are most often prescribed. These exercises can be accomplished at home or with the help of a physical therapist who can offer instruction on how to stretch the hip muscles. A physical therapist can also train the patient how to use other therapies including rolling therapy (massage), ice, heat, or ultrasound.
Injections for pain relief
Some patients benefit from injection of a corticosteroid combined with a local anesthetic. This injection can provide relief that lasts for months, and in some patients the relief is permanent. If pain and inflammation return, another injection a few months after the initial injection may be helpful. When pain persists despites these treatments, determining the exact cause of the bursitis becomes the objective.
As most cases of bursitis is the result of overuse, the best treatment is very often prevention. Avoiding or modifying the activities that cause the problem can be very helpful. Underlying conditions also need to be addressed whether that is improper posture, or poor technique with sporting activities or a difference in leg length. Surgery is rarely needed for hip bursitis.
Surgery for bursitis – rare, but effective
Only if the bursa remains inflamed and painful after exhausting all of the nonsurgical treatments, your doctor may recommend surgical removal of the bursa. Removal of the bursa does not cause injury to the hip which can function normally without it.
Taking care to avoid hip bursitis
Although hip bursitis cannot always be prevented, there are things you can do to prevent the inflammation from getting worse which include; avoiding repetitive activities that put stress on the hips.
Losing weight if necessary, getting orthotic shoe inserts to compensate for leg-length differences. And, exercise with help to maintain strength and flexibility of the hip muscles.
SRO’s orthopaedic doctors offer knowledge and skills to address your hip pain. If you are experiencing hip pain that is not resolved with rest and over-the-counter medications, don’t hesitate to seek orthopaedic care. We offer our patients quality orthopedic care for hip pain through nonsurgical and surgical treatments.