What is Hip Bursitis and what is the treatment?

Bursae are small pouches filled with synovial fluid that lubricate those spaces between a joint and other bodily tissue such as muscles and ligaments. One of these bursae is the bursa of the greater trochanter, which is found at the top of the femur, which connects to the pelvis. The greater trochanter can be felt at the side of the hip. When the bursa there is inflamed, it is called trochanteric bursitis, or hip bursitis.

What Causes Hip Bursitis?
The condition is caused when there’s repetitive friction between the trochanter and the muscles of the buttock, or gluteus maximus. It’s common in people who engage in sports where they must bear weight, run or change direction quickly. Some people get trochanteric bursitis because they have gout, a type of arthritis, because their legs are not the same length or they have other skeletal abnormalities. Other causes are muscle strain, injuries to the hip, complications of hip surgery and bad posture.

Trochanteric bursitis is also caused when the iliotibial band, a band of fibers that stretches from the person’s hip to their knee, tightens up and irritates the bursa of the trochanter.

Symptoms
The person with trochanteric bursitis feels tenderness over the bony upper part of their thigh. The pain can run across the hip or down the outer part of the thigh. The area around the bursa may also be swollen and bending or extending the hip when running, walking or playing sports causes pain at the top of the thigh.

Treatment
The good news about trochanteric bursitis is that it is easy to treat, and people with all but the most severe types make a full recovery after a week or two of treatment. If a person thinks they have hip bursitis, they should stop their activity, apply an ice compress to their hip and see their doctor.

In most cases, the doctor will simply recommend that the patient continue to rest and avoid those activities that make the bursitis worse. The doctor may also prescribe pain killers and recommend physical therapy if the person plays sports or works out. A physical therapist may treat the bursitis with electrotherapy to ease the inflammation, and use soft tissue massage to relieve the pain and other symptoms of the bursitis.

The therapist can teach the patient to use a hard foam roller to massage and loosen up their iliotibial band, even if it’s a bit uncomfortable. During this exercise, the patient lies on their side with a roller beneath them. They push their body over the roller so that it slides back and forth across the thigh. After some reps, they turn to their other side and repeat.

Exercises to strengthen the patient’s buttocks include clams, hip hitchers and single leg bridges.

If the bursitis doesn’t clear up after a week or so, the doctor may give the patient a local anesthetic and inject the hip with a corticosteroid. They may recommend EST treatment which helps to heal the area using sound waves.

If the bursa turns out to be not just inflamed but infected, surgery may be needed to remove it. However, this is a last resort.