Hip Bursitis FAQs
What is Bursitis of the Hip?
Bursitis around the hip occurs when the normal collection of fluid that exists around the greater trochanter of the femur directly adjacent to the hip becomes inflamed. This results in the small sac of fluid, which is a normal anatomical finding, increasing in size and becoming red and tender.
What causes Hip Bursitis?
Hip bursitis (or as it is more commonly known greater trochanteric bursitis and also known as greater trochanteric pain syndrome) can occur for a number of reasons, but most frequently presents when the patient is suffering from arthritis from within the affected hip. The underlying joint inflammation and inflammatory cascade locally around the hip joint can extend to the bursa where the inflammation continues, even if the hip pain is not actually that severe, the bursa pain can be quite troublesome.
It should also be mentioned that hip bursitis can occur after total hip replacement surgery if the surgeon does not routinely perform a bursectomy as part of the procedure. If the bursa remains then there is a potential for it to become inflamed post surgery, although this is rare. Some patients do suffer from residual symptoms and some even go on to undergo bursectomies to deal with her pain.
What are the symptoms of Greater Trochanteric Bursitis?
The classic presentation of greater trochanteric bursitis is one of hip pain particularly felt on the outside aspects of the hip directly over the bump up under the skin (the greater trochanter). The pain will typically be worse with prolonged standing or weight-bearing and is usually able to be pinpointed directly over the aforementioned anatomical skin landmark. Direct palpation and pressure on the area will cause the patient discomfort and soreness, but other movements of the hip usually do not provoke the pain or cause it to worsen.
How to treat Greater Trochanteric Bursitis?
In most patients, greater trochanteric bursitis is self-limiting and a period of rest from prolonged standing or walking is usually sufficient to resolve these symptoms. However, there are some patients who will require more aggressive treatment – first line treatment should be a trial of anti inflammatory medications over-the-counter – either oral or topical. If neither of these is effective then injection of the greater trochanteric bursa with corticosteroid can be performed and is usually very effective at treating this pain and often effective at eradicating it permanently.
If patients have had total hip replacements and continue to suffer from bursitis then they can undergo surgical bursectomy if this was not completed as part of the total hip replacement, although they should be fully assessed by a specialist orthopedic surgeon with experience and training in hip replacement surgery, as there are often technical aspects of the surgery that can predispose the patient to develop greater trochanteric bursitis such as excessive offset.
How long does Greater Trochanteric Bursitis take to heal?
The vast majority of cases will self limit and heal without any specific medical intervention within 1 – 2 weeks. The cases that do require anti inflammatory medication (whether this is given orally, topically or in form of an injection locally) are usually effective within 2 – 4 weeks for those cases that are persistent in nature. Very, very few patients require further surgery to excise the bursa (as most hip replacement surgeons will remove the bursa routinely, as part of their surgery). However, those patients who do require surgery to correct the bursitis typically respond well to this, or correction of any potential underlying cause in the total hip replacement itself. Surgery takes longer to recover from, but symptoms should not persist beyond 6 weeks post-op.
In summary, hip bursitis is a very common complaint amongst hip osteoarthritis sufferers and typically responds well to conservative management and will often respond very well to having hip replacement surgery also (although clearly this would not be done for hip bursitis alone). If you think you may be suffering from hip bursitis or that it is related to underlying hip osteoarthritis, please arrange a consultation with one of our specialist orthopedic surgeons who will be happy to confirm the diagnosis with you and discuss your treatment options moving forward.