Hip Bursitis (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Hip bursitis facts
- What is bursitis?
- What is hip bursitis?
- What causes hip bursitis?
- What are hip bursitis symptoms?
- How is hip bursitis diagnosed?
- What is the treatment for hip bursitis?
- What is the prognosis for hip bursitis?
- Find a local Rheumatologist in your town
What are hip bursitis symptoms?
Trochanteric bursitis frequently causes tenderness of the outer hip, making it difficult for patients to lie on the involved side, frequently causing difficult sleep. Trochanteric bursitis also causes a dull, burning pain on the outer hip that is often made worse with excessive walking or stair climbing. The ischial bursa is located in the upper buttock area. Ischial bursitis can cause dull pain in this area that is most noticeable when climbing uphill. The pain sometimes occurs after prolonged sitting on hard surfaces, hence the names "weaver's bottom" and "tailor's bottom."
Bursitis of the hip is the most common cause of hip pain.
How is hip bursitis diagnosed?
Hip bursitis is diagnosed based on the history of outer hip pain, specific areas of tenderness of the outside of the hip, and confirmed by relief with local injection of anesthetic in the doctor's office. Patients frequently notice pain in the outer hip with stair climbing or descending and tenderness of the hip when lying on the affected side at night. The doctor can localize the tender areas to the location of the bursae of the hip. Occasionally, X-ray tests of the hip are used to rule out other conditions of the bone and joints, such as arthritis. Sometimes, but not always, X-rays can highlight areas of calcium deposits in an inflamed bursa.
What is the treatment for hip bursitis?
The treatment of any bursitis depends on whether or not it involves infection. Noninfectious or aseptic hip bursitis can be treated with ice compresses, rest, and anti-inflammatory and pain medications. Occasionally, it requires aspiration of the bursa fluid. This procedure involves removal of the fluid with a needle and syringe under sterile conditions. It can be performed in the doctor's office. Sometimes the fluid is sent to the laboratory for further analysis. Frequently, there is inadequate fluid accumulation for aspiration. Noninfectious hip bursitis can be treated with an injection of cortisone medication, often with an anesthetic, into the swollen bursa. This is sometimes done at the same time as the aspiration procedure.
Patients with hip bursitis can often benefit by weight reduction, stretching exercises, and wearing proper footwear for exercise activities. Sometimes physical-therapy programs can be helpful. Generally, patients should avoid hills and stairs and direct pressure on the affected hip (sleep on the other side), when possible, while symptoms are present. Affected people should also avoid exercising on inclined surfaces and stairs, especially running hills, until symptoms have resolved.
Septic bursitis (rare in the hip) requires even further evaluation by a doctor. This is unusual in the hip bursa but does occur. The bursal fluid can be examined in the laboratory to identify the precise bacteria causing the infection. Septic bursitis requires antibiotic therapy, often intravenously. Repeated aspiration of the infected fluid may be required. Surgical drainage and removal of the infected bursa sac (bursectomy) may also be necessary.
Viewers share their comments
Find out what women really need.