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Overview

Hip bursitis is a common problem that causes pain over the outside of the upper thigh and hip joint. A bursa is a fluid filled sac that allows smooth motion between two surfaces. For example, in the hip, a bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the firm tendon that passed over this bone. When the bursa becomes inflamed, each time the tendon has to move over the bone, pain results. Because patients with hip bursitis move this tendon with each step, symptoms of this condition can be quite painful.

Why it Occurs

Trochanteric bursitis can result from one or more of the following events:

• Injury to the point of the hip. This can include falling onto the hip, bumping the hip into an object, or lying on one side of the body for an extended period.
• Play or work activities that cause overuse or injury to the joint areas. Such activities might include running up stairs,climbing, or standing for long periods of time.
• Incorrect posture. This condition can be caused by scoliosis, arthritis of the lumbar (lower) spine, and other spine problems.
• Stress on the soft tissues as a result of an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint).
• Other diseases or conditions. These may include rheumatoid arthritis, gout, psoriasis, thyroid disease or an unusual drug reaction. In rare cases,bursitis can result from infection.
• Previous surgery around the hip or prosthetic implants in the hip.
• Hip bone spurs or calcium deposits in the tendons that attach to the trochanter.

Bursitis is more common in women and in middle-aged or elderly people. Beyond the situations mentioned above, in many cases, the cause of trochanteric bursitis is unknown.

Symptoms

Trochanteric bursitis typically causes the following symptoms:

• Pain on the outside of the hip and thigh or in the buttock.
• Pain when lying on the affected side.
• Pain when you press in on the outside of the hip.
• Pain that gets worse during activities such as getting up from a deep chair or getting out of a car.
• Pain with walking up stairs.

Treatment

Treatment goals include reducing pain and inflammation, preserving mobility, and preventing disability and recurrence.  Treatment recommendations may include a combination of rest, splints, heat, and cold application. More advanced treatment options include:

• Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen
• Corticosteroid injections given by your health care provider. Injections work quickly to decrease the inflammation and pain.
• Physical therapy that includes range of motion exercises and splinting. This can be very beneficial.
• Surgery, when other treatments are not effective.