Managing Hip Bursitis Pain: Treatment Options and Physical Therapy

Hip pain is a common problem with various factors affecting its occurrence and treatment. However, if you feel discomfort when moving or while sleeping on your side, it may be a sign of bursitis. Hip bursitis is a prevalent condition that can impact your daily activities and significantly reduce your quality of life due to severe pain.

If left untreated, hip bursitis can negatively affect all aspects of your life and make it difficult to perform even simple tasks. Therefore, seeking prompt medical attention when you notice any symptoms is crucial to prevent the condition from limiting your capabilities. Read on to discover the comprehensive treatment plan for effective hip bursitis management.

Hip Bursitis: Causes and Symptoms

Your hip joint is the largest and most complex joint, with a ball and socket structure, giving you the stability and strength to walk. Bursitis happens due to the inflammation of the bursa, a thin fluid-filled sac that aids in reducing friction and rubbing between bones, ligaments, and tendons. Several studies have revealed about 160 bursae in the human body, with the major ones in the hip, shoulder, elbow, and knee. 

There are two bursae in the hip. The greater trochanter covers the bony points to the hip, while this bursae’s inflammation is termed trochanteric bursitis. 

The other one is the iliopsoas bursa on the inside of the hip. It is known as trochanteric bursitis when it gets inflamed.

  • Common Causes of Hip Bursitis

Hip bursitis primarily happens due to excess stress or overuse of the bursa. Various possible causes and risk factors affect the extent of hip bursitis. Some of them include the following:

Injury or Trauma: A sudden injury or trauma to the hip region when the individual falls onto their hips, bumps on the object’s edge, or lies on one side for a prolonged period.

Repetitive Stress or Pressure: Excess pressure or stress on hip joints happens due to high-impact activities like running, climbing stairs, bicycling, or standing.

Bone Spurs: Bone spurs will develop within the tendons attached to the trochanter bursa. Such calcium deposition will irritate the bursa sac and cause swelling.

Spine Disease: Spine disorders such as scoliosis, arthritis of the lower spine, and other related conditions induce the onset of bursitis.

Rheumatoid Arthritis and Gout – Individuals with rheumatoid arthritis and gout are more likely to develop bursitis.

Irregular Leg Length – When your legs are different lengths by an inch or so, it will impact the way of your walk and result in hip bursa irritation or inflammation.

Age and Gender – According to various studies, hip bursitis is more common in women and the elderly than in younger individuals and men. 

  • Symptoms of Hip Bursitis

The most common symptoms of hip bursitis appear on the side or around the front of your hips. Some of them are listed below:

  1. Dull and burning ache or pain in the side or front of the hip region.
  2. Tender, red, or swelling reaction in the hip joints.
  3. Worsening pain due to low and high-impact activities like walking and running.
  4. The dull ache will become severe pain, especially while sleeping at night while lying on the affected side of the hip area.
  5. Pain can often radiate to the legs and lower back due to its association with muscle tightness and poor mobility. 

Diagnosis of Hip Bursitis

Hip bursitis may present symptoms similar to other conditions, which can lead to misdiagnosis. Therefore, to eliminate other potential conditions, a healthcare provider may employ one or a combination of the following diagnostic methods.

  • Medical History and Physical Examination

A healthcare professional will ask the individual about their medical history, pain pattern, and other symptoms. They will use it to examine their hip joints, swelling, tenderness, and pain spots to understand the root cause. 

  • Imaging Tests

When the physical examination is unclear about the symptoms, the doctor might request to undergo imaging tests like X-rays and MRI scans to get a detailed view of the abnormalities in the soft tissues, such as inflamed bursae.

  • Ultrasound-Guided Aspiration of Bursa Fluid

Ultrasound-guided aspiration of bursa fluid refers to removing excess synovial fluid in the inflamed bursa. Testing the fluid sample will help determine whether or not an infection develops the condition.

Now, let’s look at the non-surgical treatment options for hip bursitis pain, which are discussed in detail below.

Non-Surgical Treatment Options for Hip Bursitis Pain

The ultimate aim of the treatment for bursitis in the hip joint is to relieve pain while reducing inflammation. Based on the underlying cause of bursitis, your healthcare professional might recommend any of the following treatments.  

  • Rest and Activity Modification

Resting your affected hip area is essential to healing the soft tissues properly. You should stop doing activities that might induce inflammation and aggravate the conditions, like sports and standing for a long time. 

Instead, you can switch to low-impact activities that exert less pressure on the hip region. Besides, you must also use assistive devices like a cane or crutches to take off the pressure. 

  • Ice and Heat Therapy

Applying ice/cold packs to the injured area of your hip every few hours for at least 30 to 40 minutes will effectively reduce inflammation and pain. Similarly, heat therapy induces blood circulation to the damaged hip tendons and decreases swelling and stiffness.

  • Medications

NSAIDs like Aleve, Naprosyn, and Motrin help you control hip bursitis inflammation. Even though these medications are extremely effective in diminishing pain, you should take them cautiously and under the direction of a healthcare provider. 

  • Injection Therapy

Opting for injection therapy to treat bursitis will give you a prompt result in decreasing pain and swelling. 

That said, let’s look at some of the effective surgical treatment options for hip bursitis pain, discussed in detail below.

Surgical Treatment Options for Hip Bursitis Pain

Surgical procedures are rarely required to heal hip bursitis. Physicians only recommend it for extreme or severe cases when the bursa tends to remain thick and swollen, resulting in chronic pain. If the bursa is still inflamed after the non-invasive treatment approaches, you must undergo surgery to restore your normal functionality. 

Bursectomy: It is a surgical process involving the removal of the bursa when it becomes severely inflamed.

Trochanteric bursectomy: It is a minimally invasive procedure to remove the inflamed bursa and is a painful condition to restore the hip to its optimal function. 

Endoscopic bursectomy: Endoscopic bursectomy is an efficient and time-saving surgical procedure that uses a small camera to remove the inflamed bursa, accompanied by fast healing results. 

Besides surgical procedures, physical therapy for hip bursitis is also an effective treatment option for hip bursitis pain.

Conclusion

When you are experiencing pain or limited mobility because of hip bursitis, your first line of defense should consult an orthopedic specialist to examine your symptoms and craft a treatment plan that fits your needs. 

Even though hip bursitis is not a life-threatening condition and rarely causes complications, managing hip bursitis pain before it becomes chronic gives you the best results. In addition, if you have developed chronic bursitis, performing daily exercises and consuming a well-balanced diet will aid in maintaining the range of motion and leading an active life.

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