What is bursitis of the hip?

Bursitis is an inflammation of one of these bursae. Bursitis is more common in women and older people, but it can affect anyone.

Hip bursitis is a common condition that can lead to discomfort along the outside of the hip joint. People with hip bursitis often complain of symptoms of discomfort with physical activity and walking, as well as pain when trying to lie on the affected side at night.

Two major bursae are located in your hip and most cases of hip bursitis will heal with rest and at-home care. But medications, steroid injections, physical therapy, fluid removal, and surgery are additional options for treatment and relief.

Decreasing the inflammation of the bursa is the primary treatment goal for hip bursitis. The best way to decrease inflammation will depend on the underlying cause and severity of the inflammation.

In cases of septic bursitis, in which the bursa is infected, antibiotics also must be used to prevent the spread of infection. Most cases of hip bursitis are successfully treated with nonsurgical treatments and do not re-occur.

Surgery to correct trochanteric bursitis is rare.

Non-surgical treatments for hip bursitis

Recommended treatments may include:

Rest and activity modification- When hip bursitis stems from injury or overuse, rest and other remedies to relieve inflammation are usually successful. People with hip bursitis should avoid activities that will aggravate and inflame the bursa.

Ice- Applying ice or a cold pack to the sore hip can help reduce local pain and swelling. This treatment is recommended after any exercise or activity that may inflame the hip bursa.

Non-steroidal anti-inflammatory drugs, or NSAIDs- Anti-inflammatory medications can reduce swelling and inflammation and relieve any pain associated with hip bursitis.

Aspiration to drain the hip bursa- If the hip bursa is significantly swollen, the physician may recommend aspirating, or draining, the bursa using a needle. A cortisone injection may be given following the aspiration.

Corticosteroid injection- If symptoms are not successfully treated with rest, NSAIDs, and/or physical therapy, a corticosteroid injection may be recommended. Because the affected bursa lies deep beneath the skin, the doctor may use ultrasound to accurately place the injection into the bursa.

Physical therapy- To help treat current bursitis and prevent future flare-ups a doctor may prescribe physical therapy. The goals of physical therapy may include strengthening the quadriceps and gluteal muscles and stretching the iliotibial band. Athletes may learn proper running and jumping form.

Weight loss- If excess weight is a possible underlying cause of hip bursitis, then losing weight can be part of a successful treatment plan.

Surgical Treatment for Hip Bursitis

Challenging cases of chronic hip bursitis may warrant surgery, they include:

Bursectomy: In a traditional bursectomy an incision is made at the hip and the affected bursa is removed. Arthroscopic bursectomy may be performed through a small incision, with the intention of lowering the risk of complications and shortening the healing period.

Tendon repair and iliotibial band release: When a tendon is injured or the iliotibial band is too tight it can result in friction and irritation of the trochanteric bursa.
Surgery can be done to lengthen the iliotibial band, called IT band release, or repair the injured tendon. These soft tissue corrections and repairs can reduce unwanted friction.

Osteotomy of the greater trochanter: Osteotomy is defined as the surgical cutting of bone. During this osteotomy procedure, a surgeon will shave off a small portion of the protruding greater trochanter bone. This adjustment can reduce the friction and stress that caused the hip pain.

Prevention of hip bursitis

Regardless of which treatment option works for you, here are some ways to prevent hip bursitis from recurring: