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Hip Bursitis : Diagnosis and Treatment

By May 29, 2024May 30th, 2024Hip Bursitis

What is Bursitis?

Hip Bursitis is a painful condition that affects the bursae. Bursae are small, fluid-filled sacs that cushion the bones, tendons, and muscles near the joints. Bursitis occurs when the bursae become inflamed. It often occurs near joints that perform frequent repetitive motions.

Treatment involves resting the affected joint and protecting it from further damage. With proper treatment, bursitis pain goes away within a few weeks, but recurrent bursitis flare-ups are also common.

The Differences of Hip Bursitis and Arthritis

Hip bursitis and arthritis are anatomically and pathologically different. Arthritis is a condition that damages bone, cartilage, and joints beyond repair. Treatments for hip arthritis can help relieve pain and prevent the damage from getting worse, but arthritis can’t be cured.

Hip bursitis is temporary, and the bursae sacs only swell for a while. When treated appropriately, bursitis can be cured. One can have hip bursitis and osteoarthritis simultaneously or connected to other issues, such as lower back arthritis or a hip labral tear.

Both have distinct outlooks on the conditions and different treatment plans to help with the pain and progression. For bursitis, the pain originates on the outside of the hip in the lower region. Tenderness increases when pressure is applied, and the pain worsens at night.

The pain associated with hip arthritis comes from the inside of the hip joint. It can also come from the groin, thigh, or buttocks. The pain develops slowly and worsens in the morning. It can spread to the knee or back. Genetic factors can also contribute to arthritis, but hip bursitis is not genetically transmitted.

Signs Your Hip Pain Stems from Bursitis

Hip pain that stems from bursitis can be sharp, dull, achy, constant, or sporadic. It usually occurs when you’ve been sitting for a prolonged period, lying on the side of the inflamed bursae, or after prolonged walking or climbing the stairs.

Sometimes, people experience hip bursitis for a short period, and then it goes away; others can experience it as pain that comes and goes or chronic pain.

Hip pain from bursitis may worsen when lying on that side or pressing on the outside of your hip. You may even feel pain when you get out of a car, and the pain usually radiates to the thigh or buttock on the affected side. See a professional if you have persistent or recurrent hip pain.

What causes bursitis of the hip?

The common causes of bursitis include:

Direct injury

A trauma in the hip region can cause the bursa to fill with blood and cause irritation and inflammation.

Hip joint friction

Repeated friction of the hip joint can irritate the bursa and cause bursitis. Friction in the iliotibial band during knee and hip movement over the hip’s trochanteric bursa can cause bursitis.

Excess pressure on your hip

Too much pressure on the outside of your hip, either from sleeping on your side on a hard surface or from lifting your hip too high, can cause problems.

Irritation or damage of the bursa

Anything irritating or damaging the bursa near your great trochanter can cause hip bursitis.

How is bursitis of the hip diagnosed?

Healthcare providers diagnose bursitis through medical history and physical examination. Tests used to diagnose bursitis include:

  • Ultrasound or MRI—Ultrasound or MRI is used to diagnose bursitis that can’t be easily diagnosed by a physical exam alone.
  • X-ray – X-ray images can be used to exclude other causes of discomfort.
  • Blood test—Your doctor can request blood tests or an analysis of fluid obtained from the inflamed bursa to determine the cause of your bursitis.

Which Joints Are Most Susceptible to Bursitis?

Every joint has bursae. This means that all joints are susceptible to bursitis. However, bursitis is more common in the major joints of your arms and legs, such as shoulders, elbows, hips, knees, and heels.

Stretches and Exercises to Decrease Hip Bursitis Pain

Hip External Rotator Stretch

This is one of the best stretches to minimize bursitis pain. To perform a correct hip external rotator stretch:

  • Lie on your back with both knees bent while your feet are flat on the floor.
  • Put the ankle of the affected leg on your opposite thigh near the knee.
  • Use your opposite hand to pull your knee across your body toward your shoulder gently.
  • Hold the stretch for 15 to 30 seconds.
  • Repeat twice or more.

Clamshell

This is also a good exercise to reduce hip bursitis pain.

  • Lie on your side, with the affected hip on top and your head propped on a pillow.
  • Keep the feet and knees together with the knees bent.
  • Raise the top of your knee while keeping your feet together.
  • Your legs should open like a clamshell, and avoid rolling your hips back.
  • Hold for 6 seconds.
  • Lower your knee back down gently and rest for 10 seconds.
  • Repeat 8 to 12 times

Physical Therapy for Hip Bursitis

Effective therapy for hip bursitis includes:

Hip Bridges

Hip bridges can be used to treat both iliopsoas and trochanteric hip bursitis. To perform this exercise:

  • Lie on your back with both knees bent and your feet flat on the floor.
  • Gently pull your belly button toward your spine.
  • Lift your buttocks 15 inches off the floor, making a bridge with your body.
  • Release slowly and bring yourself back down to the starting position.
  • Repeat 10 times.

Side Lying straight leg raise.

The side lying straight leg raise exercise is great for improving the strength of your gluteus medius.

To perform the exercise:

  • Lie on your side with your painful hip up.
  • Slowly lift your leg and keep it straight.
  • When you have lifted your leg about 12 inches, hold it at the top for three seconds.
  • Slowly release back to the starting position.
  • Repeat the exercise 10 times.

How Can Joint Injections Treat Hip Bursitis Pain?

Bursa injections are administered to treat bursitis pain. The shot contains a steroid like triamcinolone, an anti-inflammatory agent that reduces swelling and pain. The injection is usually combined with an anaesthetic to reach a larger area and provide initial pain relief before the steroid starts to work.

Steroid Injection for Hip Bursa Inflammation

Steroids are anti-inflammatory medicines that minimize swelling and pain. It’s mostly combined with an anaesthetic agent for treating hip bursa inflammation.

Trochanteric Bursal Injection Procedure

The trochanteric bursal injection is the process of injecting anaesthetic in combination with corticosteroids into the trochanteric bursal sac to help treat greater trochanteric pain syndrome.

During the procedure, you will be asked to change into a gown depending on the area being injected. You will then be asked to lie down on a scanning bed or sit in a chair.

The area to be injected will be imaged to locate the bursa. The doctor will then place a mark on the skin to help guide the needle.

The skin will be cleaned, and a fine needle will be passed into the bursa using ultrasound images to guide its positioning. The needle can also be inserted at the point of maximum tenderness for a lateral hip injection without using ultrasound guidance.

A small amount of corticosteroid and a local anaesthetic will be injected into the bursa. The needle will be removed after the medication is injected.

How long does hip bursitis take to heal?

With proper care, hip bursitis can take about 8 to 10 weeks to heal, but you start feeling better as soon as you start the treatment. Physical activities should be resumed gradually so the pain doesn’t recur.

Can you fully recover from hip bursitis?

Yes, it’s possible to recover from hip bursitis, although it can take time. However, hip bursitis can return if care isn’t taken and the triggering factors aren’t avoided.

What activities should be avoided with hip bursitis?

Weight-bearing exercises, activities, or positions that pressure the hip bursa should be avoided. These include lying down, running, jumping, or sitting in one position for a long time or walking long distances. All these activities can irritate the bursa and cause more pain.

Bursal Injections May Bring You Pain Relief from Dr. Rozier, MD, in Mansfield, TX

Dr. Rozier, MD, is an expert in administering bursa injections to treat hip bursitis in Mansfield, TX. After a proper evaluation of your condition, he will create a treatment plan tailored to meet your specific needs and goals.

If you are suffering from hip bursitis, contact Dr Rozier today to schedule a consultation.

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