A bursa is a fluid-filled sac that serves as a cushion to the bones, tendons, and muscles that surround your joints. The job of the bursae is to reduce friction between the moving parts of your joints and help prevent damage from developing in the course of everyday activity.
Occasionally, bursae can become inflamed, resulting in discomfort and pain, among other symptoms. This is called bursitis. Bursitis of the hip is when this inflammation occurs in one of the bursae in the hip.
What Are the Types of Hip Bursitis?
Bursitis cases are categorized based on the region of the body and the exact bursa affected. The hip has two major bursae—the trochanteric bursa and ischial bursa. Appropriately, the types of hip bursitis, or bursitis of the hip, are named after these two:
1. Trochanteric Bursitis
If you have ever looked at a femur, you will notice a sort of “hump” near the ball-like part that connects to the pelvis. This hump is the greater trochanter and the trochanteric bursa lies next to it. Trochanteric bursitis is when this bursa gets inflamed. The symptoms of trochanteric bursitis are more likely to feel one-sided and can be provoked by activities involving lifting motions with the legs, such as walking up the stairs or getting out of a car.
2. Ischial Bursitis
The ischial bursa lies between the ischial tuberosity and the hamstring. The ischial tuberosity is easily identified since, when standing, it’s covered by the gluteus maximus. A less medically precise explanation is that the ischial tuberosity is your “butt bone.” Ischial bursitis, due to its location, produces symptoms that can be initially mistaken for a pulled hamstring or are otherwise connected to sitting or standing.
How to Recognize Hip Bursitis Symptoms
Regardless of which type of bursitis of the hip you have, the symptoms will be more or less the same. Bursitis causes pain, stiffness, and inflammation within the affected area along with stiffness or an aching sensation. The main difference between bursitis types is where this pain will be located and what can worsen it. Additionally, there may be an angry redness around the joint in question.
With trochanteric bursitis:
- Pain will be localized on the outer hip, thigh, or within the buttock.
- Pain will manifest when lying down on the relevant side or when you press in on the side of the hip.
- Pain will worsen, as mentioned above, by activities like getting out of the car, walking up stairs, or anything that induces similar leg and hip motions.
With ischial bursitis:
- Pain will appear in the upper buttock or hamstring area.
- Pain may be more noticeable when trying to climb uphill or after prolonged sitting on a hard surface.
- Stretching the hamstring may also aggravate the pain.
What Causes Bursitis of the Hip?
Bursitis of the hip is most commonly caused by repetitive motions or prolonged stresses. This usually means things like regular lifting or running, leaning on the bursa, prolonged sitting on a hard surface, or prolonged standing (for trochanteric bursitis) are the culprits. Although the most common, these are not the only possible causes of bursitis in the hip, and some other sources are more apparent than others.
- Injury: Whether the result of a fall, bumping into a hard object, or simply getting punched in the wrong spot, a direct blow to the bursae can cause bursitis.
- Incorrect posture: Certain problems like scoliosis or arthritis of the lumbar (lower) spine can put enough pressure on the hips to cause bursitis. Alternatively, poorly positioned joints, which can sometimes come from arthritis, tendonitis, or other joint inflammations, can aggravate the bursa.
- Bone spurs or calcium deposits: Bone spurs and calcium deposits in nearby tendons can poke at and aggravate the bursa. Such conditions can also inflame the tendon and cause bursa stress indirectly.
- Surgery: Hip surgery, particularly ones that result in hip prosthetics, can cause bursitis. Since the trochanter is more likely to be involved in such surgeries, trochanter bursitis is the more common result compared to ischial.
- Various diseases: Rheumatoid arthritis, gout, psoriasis, and thyroid diseases can sometimes cause bursitis. More rarely, drug reactions can also trigger the inflammation.
How Bursitis of the Hip Is Diagnosed
In most cases, your doctor can diagnose bursitis of the hip through a medical history and physical exam. Sometimes, however, the inflammation isn’t apparent enough to be conclusive or other causes need to be ruled out. For this, imaging tests such as an X-ray, an ultrasound, or an MRI may be used to either confirm bursitis or to rule out other causes. A blood test may also be used, since there are certain markers that appear during inflammation.
Are There Any Natural Remedies for Hip Bursitis?
Natural hip bursitis treatments take steps to comfort the joint, minimize strain, and ease inflammation.
1. Rest and Immobilization
Hip bursitis affects joints related to walking and standing, so resting them means a good deal of lying down. However, since hip bursitis can be aggravated by prolonged contact with a solid surface, you may need to get creative. Try to lie down on your stomach or make sure you are sitting on a cushion or mattress. When moving, especially if getting up or sitting down, take care not to place pressure on the bursa in question—this may require assistance or at least something else to support your weight (an armrest or a banister, for example).
Cold temperatures can help reduce the swelling. Make sure to never put the ice directly on your skin. Wrapping ice cubes in a cloth or thin towel should be enough to protect yourself while still letting the cold do its work.
If the swelling has gone down but the joint is still giving you trouble, a hot compress may be able to soothe it or at least help take your mind off the bursitis. Getting heat therapy is as simple as filing a hot water bottle to your personal preferred temperature and getting comfortable. You can also alternate between hot and cold.
It’s important to keep weight off the affected bursa while recovering. For trochanter bursitis, this means you may need a walking stick or crutches for a week or so while the inflammation dies down.
5. Exercise and Stretches
As a form of physiotherapy, you can try certain stretches and exercises that work on the area around the bursa and can help restore mobility in the face of hip bursitis. Your doctor may be able to recommend some, but you can also check the section below.
What Exercises and Stretches Help to Relieve Bursitis of the Hip?
When performing any of the following hip bursitis stretches, each stretch should be held for about 20 to 30 seconds and then gently released. If you ever feel a sharp pain during these exercises, stop and wait an hour before trying again.
1. Abductor Stretch
The abductors are the muscles that run along the outer thigh from the hip joints. Begin this exercise for hip bursitis in a standing position, then cross the unaffected leg in front of the affected one and begin leaning away from the bursitic side of your body. Continue leaning until you feel a stretch along the outer hip, then hold and release.
2. Adductor Stretch
The adductor muscles are in the same area as the abductors but are responsible for inward leg motions. Begin this stretch in a standing position with your legs more than shoulder-width apart. Slowly bend the non-bursitic knee out to the side until you feel a stretch on the inner thigh of the bursitic side. Hold, then release.
3. Rotator Stretch
This targets the muscles that help rotate the leg at the hip. Begin in a sitting position and rest the ankle of the bursitic-side foot on the thigh of the non-bursitic leg. Gently press down on the knee of the bursitic side until you feel a stretch in your buttocks.
4. Flexor Stretch
The flexors are the muscles that help raise the leg towards the front of your body. Begin in a standing position and bend the knee of the bursitic side so that your heel is being brought towards the buttocks. Continue until you can grab your ankle with your hand, then hold and release. Note: you do not necessarily have to be standing to perform this stretch; it can also be done on your side or stomach.
What Is the Average Recovery Time for Hip Bursitis?
It takes about six weeks to fully recover from a case of hip bursitis. Fortunately, your activities will only see major restrictions during the initial period when the symptoms are at their worst. Once the symptoms die down, you can carefully increase the amount of activity you undertake so long as you avoid movements that will aggravate the bursitis.
What Are the Risk Factors for Developing Hip Bursitis? Who Is at Risk of Hip Bursitis?
- Age. Like arthritis and similar joint conditions, bursitis becomes more likely the older you are.
- Repetitive motions. Any occupation or hobby that involves repetitive motions or repeatedly sitting down and getting up (setting tile, laying carpet, etc.) puts you at a higher risk for developing bursitis.
- Diseases. Certain systemic conditions such as rheumatoid arthritis, gout, or diabetes can also increase the risk.
- Weight. Being overweight increases pressure on the joints.
How to Prevent Bursitis of the Hip
- Try not to sit in one position for too long, particularly on hard surfaces.
- Use some of the above hip bursitis exercises to strengthen the joints around the hips.
- Warm up and stretch before any strenuous activity.
- Maintain a healthy weight.
- When lifting large or heavy objects, make sure to bend at your knees to avoid putting unnecessary stress on the hip’s bursae.
When Should You Seek Medical Help?
A doctor’s visit is always helpful when you want to be certain of the diagnosis, but most cases of bursitis of the hip will resolve without medical attention. There are certain conditions, however, where you should definitely arrange to speak to your medical provider, such as:
- You experience repeated cases of bursitis;
- The affected area appears red and feels warm;
- You have a fever;
- The pain doesn’t improve despite treatment measures; and
- The pain is enough that it interferes with day-to-day activity.
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