Bursitis of the hip joint is also known as trochanteric bursitis (ICD M70.7). It causes hip pain when walking, but also at rest. It is often caused by overuse or improper loading of the joint. The condition can often be treated with conservative measures. However, surgery is sometimes necessary.
Here you will find further information as well as a selection of doctors and centers specializing in hip bursitis.
Definition: Bursae – The Hip’s Shock Absorbers
Just like in all joints, the hip also has bursae that perform a variety of functions. Think of bursae as small, flat cushions of tissue filled with a gel-like fluid. They act as a kind of springy buffer that compensates for the friction between ligaments or muscles and bones and tendons, and absorbs the pressure on them.
There are several of these small shock absorbers in the hip:
- at the ischial tuberosity,
- on the hip joint capsule
- on the inner and outer sides of the thigh bone near the hip (greater trochanter).
The area around the greater trochanter is particularly important. This is where trochanteric bursitis occurs most frequently. Less commonly, iliopectineal bursitis occurs deeper in the groin.
When the bursae become inflamed, excess tissue fluid accumulates inside them. This causes the bursa to swell. The swelling then presses on the surrounding tissue, resulting in pain that is usually accompanied by limited range of motion.
Causes and Risk Factors for Bursitis in the Hip
The causes and risk factors for trochanteric bursitis are often related to mechanically induced overuse. Athletes and people who run unusually long distances
- running,
- walk,
- cycle, or
- trying new sports.
Improper weight-bearing, misalignment, or uneven stress on the hip also contribute to the development of bursitis. People whose occupation or sport places sustained increased stress on the hip are frequently affected.
Sometimes viruses or bacteria are also responsible for hip bursitis. The pathogens enter the bursa from the bloodstream through its encapsulated membrane, where they then trigger an infection. In this case, it is known as septic bursitis.
In older adults, hip bursitis is often associated with rheumatic diseases or gout.
Other risk factors for hip bursitis include obesity, previous injuries, and repeated pressure on the hip or, less commonly, in the groin. Iliopectineal bursitis is more likely to cause pain in the groin.
Typical symptoms: What symptoms does trochanteric bursitis cause?
The pain experienced depends on the location of the affected bursa. Pain may be diffuse or localized on the outer side of the hip, the outer hip, the lateral hip, or, less commonly, in the groin.
Hip pain associated with trochanteric bursitis is not movement-dependent. This means it often occurs even at rest. However, the symptoms worsen significantly with weight-bearing and leg movement. If the bursa in the outer hip area is inflamed, lying on the affected side is often nearly impossible. Pressure on the bursa can trigger severe pain.
Unlike with other types of bursitis, there are no visible signs typical of inflammation. The source of the inflammation is hidden too deep beneath the muscles and tissue for swelling, warmth, or redness to be apparent.
Signs of bursitis include tenderness, an compensatory posture, limited mobility, and pain that may radiate to the buttocks and thigh.
Key signs of bursitis include lateral tenderness, pain at night, discomfort when climbing stairs, and a pain-avoidance posture. The most common symptoms sometimes resemble those of other hip conditions, which is why symptoms and diagnosis should be evaluated by a doctor. Symptoms and treatment are closely related.
What You Can Do Yourself
For self-care,
- cooling gels and ointments or
- applied cold packs
to be effective in relieving pain. In the acute stage, it’s helpful to rest the joint for a few days to counteract the inflammation. Limit your movements during this rest period to only what’s absolutely necessary. Bend your hip as little as possible and avoid unnecessary walking.
To support the healing process, taping with special Y-tapes is also a helpful complementary measure. These tapes relieve pressure on the joint.
If there is no improvement after a few days despite resting the joint, it is best to consult a doctor.
Diagnosis of Bursitis in the Hip
If you have hip pain, an orthopedic doctor is the right person to see. Diagnosis is often difficult. The symptoms of hip bursitis are similar to those of hip osteoarthritis or other signs of wear and tear. Often, diffuse pain in the hip area does not initially point clearly to bursitis.
Bursitis is often caused by overuse of the hip joint. Therefore, the doctor will first ask you about any changes in your habits or activities.
Next, they will check whether pressing on the affected area causes pain. They may also order a blood test to measure inflammation markers. This helps distinguish between bursitis caused by overuse and that caused by pathogens.
The doctor may also use imaging techniques, such as
- an ultrasound,
- X-rays, or
- magnetic resonance imaging (MRI)
to make a definitive diagnosis.
Treatment of Bursitis: Medication, Rest, and Exercise
Medical treatment is primarily based on the specific type of trochanteric bursitis. Septic bursitis (caused by pathogens) is treated differently than stress-related bursitis.
However, other factors also influence treatment. For example, the stage of the condition must be considered:
- early-stage hip bursitis,
- acute bursitis, or
- chronic hip bursitis.
The patient’s age and any other underlying conditions, such as
- rheumatism,
- osteoarthritis, or
- gout,
which could influence treatment, also play a role here.
If the condition is septic bursitis, the patient is prescribed antibiotics or antiviral medications, depending on the causative pathogen. Surgical treatment is often necessary for these forms of the condition.
In cases of bursitis caused by overuse, the doctor will initially prescribe
- rest for the hip as well as
- anti-inflammatory and pain-relieving medications.
The goal of conservative treatments is to sustainably reduce the inflammatory process and alleviate symptoms. After the rest period, the doctor will recommend specific exercises to slowly and gently restore mobility to the hip. Physical therapy and rehabilitation can help strengthen the muscles and correct improper alignment.
Another treatment option: surgery
In rare cases, treatment with anti-inflammatory medications is unsuccessful. In such cases, surgery is the only option. During the procedure, the surgeon removes parts of the inflamed bursa. This stops the inflammatory process and prevents permanent loss of mobility.
How can I prevent bursitis?
The duration of the healing process depends on the cause, stage, age, and any underlying medical conditions. Recovery is fastest in cases of acute bursitis caused by physical strain. In these cases, improvement can often be expected within a few days to weeks.
In chronic cases, treatment takes longer. If misalignments, training errors, or uneven strain are not addressed, the symptoms may recur. To prevent chronic bursitis, the underlying cause must be corrected over the long term.
What is the best way to treat bursitis? Early rest, medical evaluation, appropriate therapy, and a gradual return to activity are crucial. To prevent bursitis, you should increase your training volume slowly and wear appropriate footwear.
Specialists
If you experience persistent hip pain, unexplained symptoms, or recurrent bursitis, specialists in orthopedics and trauma surgery are the right people to consult. They will determine whether bursitis is actually present or whether other conditions—such as hip osteoarthritis, tendon insertion irritation, spinal problems, or rheumatic causes—might be to blame.
Specialists can coordinate diagnosis and treatment, pinpoint the cause, and select the appropriate therapy.
Frequently Asked Questions
What provides quick relief for bursitis of the hip?
For acute, painful bursitis, rest, cooling, anti-inflammatory pain relievers (after consulting a doctor), and taking it easy can help.
How long does bursitis of the hip last?
Mild hip bursitis often improves within a few days to weeks. In cases of chronically irritated structures, healing may take longer.
Where does pain occur with trochanteric bursitis?
Pain is typically felt on the outer side of the hip, often directly above the greater trochanter. It can radiate into the buttocks and thigh and be particularly painful when walking or lying down.
Can hip bursitis go away on its own?
Mild bursitis may improve on its own. If the symptoms persist or are very severe, you should see a doctor to rule out other conditions.
What exercises help with hip bursitis?
In the early stages, the focus is on reducing strain. Later on, targeted physical therapy exercises may be beneficial.
What is the difference between trochanteric bursitis and iliopectineal bursitis?
They affect different bursae. Trochanteric bursitis is located on the outer side of the hip, while iliopectineal bursitis is found in the groin area.
What are common causes of bursitis?
Major causes include overuse, pressure, improper weight-bearing, injuries, infections, and rheumatic diseases. A bursa in the hip is particularly sensitive to repeated mechanical stress.
Share this article
