What is hip bursitis?

Bursitis is a condition that occurs when the bursa (fluid-filled sacs near the joints) become irritated and swollen. The bursa is responsible for cushioning the pressure points between the bones, tendons, muscles and skin near the joints.

Hip bursitis occurs when the bursa (iliopsoas bursa) on the groin side of the hip becomes inflamed. The pain is localized to the groin but called hip bursitis.

Causes of hip (trochanteric) bursitis

  • Falling on the hip
  • Repetitive pressure or stress on the hip
  • Rheumatoid arthritis or gout
  • Previous hip surgery

Risk factors for hip (trochanteric) bursitis

  • Arthritis — patients who have arthritis are more likely to develop hip bursitis.
  • Repetitive stress — repetitive stress on the hip from activities such as running, bicycling or standing for long periods can increase your risk of developing hip bursitis.
  • Hip injury — injury to the bony point of the hip that occurs from a fall or bump to this area.
  • Spine disease — people who have arthritis or scoliosis are at higher risk for developing hip bursitis.
  • Leg length inequality — when the legs are different lengths, it can impact the way you walk and aggravate the hip.

Symptoms of hip (trochanteric) bursitis

  • Mass that resembles a hernia
  • Numbness or tingling (when nerves are compressed by inflamed bursa)
  • Tenderness in groin area
  • Pain walking when the leg is extended
  • Pain that radiates down the front and middle of the thigh
  • Difficulty sleeping on the side

Diagnosis of hip (trochanteric) bursitis

Hip bursitis (iliopsoas bursa) is diagnosed in a complete medical examination with your primary care, orthopedist or sports medicine doctor. He or she will try to determine the area of tenderness in the hip. Your doctor may also order an x-ray, bone scan or MRI to rule out other hip conditions.

Treatments for hip (trochanteric) bursitis

Treatments for hip bursitis are aimed at relieving the symptoms while the condition heals. Depending on the cause of hip bursitis, your physician may recommend any of the following treatments:

Medication

Antibiotics or anti-inflammatory medication can be prescribed depending on cause of hip bursitis.

Orthotics

Orthotics can help correct the motion of your foot by providing a cushioning for the body. They can also prevent the lower leg from turning inward, which causes the hip to twist when walking or running.

Physical therapy and rehabilitation

Exercises may be prescribed to improve knee or hip strength and flexibility. Core strength and core stability exercises can help you improve your muscle function across your midsection and pelvis. By strengthening the core, you can reduce the risk of overuse.

Steroid injection

A corticosteroid injection may be helpful to relieve the symptom of hip bursitis. The injection can provide temporary relief (weeks or months), but if the pain comes back, another injection can be given. Too many injections can damage the surrounding tissues, so it is important to use only as doctor prescribes.

Platelet rich plasma (PRP) injection

PRP therapy uses your platelets, which are more concentrated after being put through a centrifuge process, and injects them back into the hip to accelerate the healing process.

Ultrasound-guided percutaneous needle tenotomy (PNT)

Percutaneous needle tenotomy is a minimally invasive intervention that is used to treat tendonitis-related conditions. A small needle is inserted into the skin, guided by an ultrasound, and small incisions are performed on the damaged tendon. This procedure enhances the healing response.

Other non-surgical treatment options

  • Splint/brace
  • Tendon transfer
  • Ultrasound-guided nerve hydro dissection

Although surgery is not typically required for hip bursitis, if nonsurgical options have failed, the physician can remove the bursa. Your physician can remove the bursa arthroscopically through small incisions. Arthroscopic surgery is less invasive, and recovery is quicker.

Recovery from hip (trochanteric) bursitis

Recovery from bursitis typically improves within a few weeks if you stop doing what caused the pain. It is important to follow your physician’s instructions to fully recover and resume your day-to-day activities as quickly as possible.

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