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.

Where is hip bursa pain located?

Hip bursa pain is located along the outer aspect of the hip. A bony prominence can be felt on the outer aspect of the hip and in case of inflammation of this bursa, the pain is usually present over it and can be felt while rubbing it or lying over it.

Is bursitis curable?

Bursitis means inflammation of the bursa. It is usually caused due to excessive rubbing of the bursa and the structures around it. Bursitis is usually cured by use of RICE (rest, elevation, ice and compression) along with anti-inflammatory medications. Occasionally if the pain is not relieved with these measures, a cortisone injection can be helpful.

Is bursitis painful?

Bursitis, as any other inflammation in the body, is a reaction of the body against some persistent injury. They are usually painful and a way of body to inform that something unusual is going on. It is usually treatable with RICE (rest, ice, compression and elevation) along with anti-inflammatory medications, with or without steroid injection.

How do you treat bursitis of the shoulder?

The bursitis of the shoulder is usually treated with RICE (rest, elevation, compression and ice) along with anti-inflammatory medications. If the patient does not get improvement with this, then a cortisone injection can be given in the shoulder joint which may help recover from the bursitis. The patient may also be asked to start physical therapy and avoid movements which cause persistent bursitis.

Is bursitis a form of arthritis?

Bursitis may be present even in the absence of arthritis and may be caused due to mechanical overuse or rubbing of the surfaces along the bursa. It may occasionally also be associated with arthritis and may be a presentation of that due to mechanical reasons.

What are the symptoms of septic bursitis?

Sepsis bursitis means infection in a bursia. It is caused due to organisms like bacteria which may cause inflammation along with collection of pus formation. These patients may present with worsening pain, fever with or without chills, swelling, redness, discharge and inability to move the joint. These patients may need urgent medical supervision and management and should be treated by a physician.

What is the best over-the-counter medication for bursitis?

Patients who have pain due to bursitis, may take anti-inflammatory medications like Tylenol, Aleve or Advil. They may also use some local ointment in the area apart from using ice and rest.

What does a cortisone shot due to a bursitis?

Cortisone shot helps in decreasing the inflammation and, hence, decreasing the pain caused by the bursitis. It may give a long enough effect which may be helped with physical therapy or modification in activities to be lasting long enough to not require another form of treatment.

How do they test for hip bursitis?

The physicians usually do a physical examination with a special test to find out if the patient has hip arthritis or bursitis. Then they also do x-rays of the hip to rule out hip arthritis. In rare cases, an MRI may be needed to confirm the diagnosis of hip arthritis or bursitis.

What can you do for bursitis in the hip?

Bursitis in the hip should be initially treated with over-the-counter pain medications and possible physical therapy. If the pain is not relieved, a cortisone injection into the bursa of the hip can help resolve the condition. Also, the precipitating conditions of the bursitis should be avoided to prevent future development of bursitis of the hip.

These questions have been personally answered by:

Dr. Vedant Vaksha

I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

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