A bursa is a fluid-filled sac that cushions the bone from other moving parts, such as tendons, muscles, and skin. Bursae help your joints work smoothly. They cushion your tendons, bones, and ligaments as they move against each other. Bursitis is when these small bursae become irritated or inflamed, and usually happens with injury or joint overuse.
Greater trochanter [tro-CAN-ter] bursitis, also called hip bursitis, is when the bursa in the hip become inflamed. Repetitive motions or joint stress can cause or worsen hip bursitis. The greater trochanter is the bony point on the outside of your hip. Usually this is painful on the outside of the hip or leg. There is another bursa in the hip, called the iliopsoas [ill-ee-oh-SO-as] bursae. When this bursa becomes inflamed, it causes pain in the groin area.
If the outside of your hip becomes tender and swollen, it may be affected with bursitis. Bursitis can be very painful, and tends to be more severe during joint use, or while resting at night. Hip bursitis can become so painful that it may limit your mobility.
The first sign of trouble with greater trochanter bursitis is pain, as this type of bursitis can be a very painful and uncomfortable condition. The pain for this type of bursitis is usually on the outside of the hip, down the outside of the leg, or in the buttocks. Symptoms of hip bursitis usually begin slowly and get worse over time.
Although the symptoms of hip bursitis vary based on which bursa is affected, hip bursitis often creates the following symptoms in the affected area of your hip:
- Pain when you press on it
- Discomfort while the hip is in use or at rest
If the greater trochanter bursa is also affected, it will cause pain in the outside of the hip.
See your healthcare provider as soon as possible if you have any of the following conditions (in addition to pain and swelling in the hip):
- Sudden inability to move or put weight on the hip
- Disabling pain in the hip
- Excessive redness, swelling, or puffiness in the hip
- A rash or bruising on the hip
- Sharp or shooting pains
- Pain while exercising, moving, or otherwise exerting the hip
Hip bursitis happens when the bursa fills with extra fluid and becomes inflamed. This inflammation puts pressure on the nearby tissue and causes discomfort.
Hip bursitis can be caused by:
- Joint overuse at work or during recreation
- Injury, such as a blow to the hip or a fall
- Repetitive motions such as squatting repeatedly
- Motions that put extended pressure on the joint, such as leaning or laying on a hard surface for an extended period of time
- Muscle imbalances
- Bacterial infection of the bursa in the hip
Hip bursitis can also be caused by other health conditions such as:
- Rheumatoid arthritis
You are also more likely to get bursitis at an older age, or if your occupation or hobbies involve a lot of repetitive motion.
To diagnose bursitis, your healthcare provider will usually perform a physical exam. They may take a sample of the bursa’s fluid to make sure it is not infected.
Your healthcare provider may also perform an ultrasound. An ultrasound creates pictures of the inside of the body using soundwaves. Ultrasound is a noninvasive medical test to help your healthcare provider perform a diagnosis by showing real-time conditions of the body’s internal organs, blood vessels, muscles, tendons, ligaments, joints, and soft tissues. It is very safe and painless.
Hip bursitis will often get better on its own as long as it is not caused by an infection. To heal your hip bursitis, you will need to rest the affected joint and protect it from any further harm. Most patients feel better within a few weeks with proper treatment. However, some people may still experience recurrent flare-ups of bursitis in the affected area.
Typical measures to relieve hip bursitis pain include:
- Resting the hip to avoid overuse.
- Applying heat, such as a heating pad or warm bath.
- Applying ice to help reduce the swelling (this should only be done for the first 48 hours after symptoms occur).
- Taking an over-the-counter pain medicine, such as naproxen sodium (Aleve) or ibuprofen (Motrin IB, Advil), to relieve pain and reduce inflammation. Other options include topical methods, which are applied directly to the skin.
- Cushioning and supporting the hip, especially while sleeping.
- Avoiding resting directly on the side of the body that is affected.
If these measures do not help, your healthcare provider may recommend these treatments:
- Physical therapy, such as exercises designed to help strengthen the hip and prevent recurrence.
- Medicines, such as antibiotics if the inflammation is caused by an infection.
- An assistive device, such as a walking cane, to temporarily reduce the hip joint stress and help heal bursitis.
- Injections, such as a corticosteroid [core-tih-co-STARE-oyd] medicine to quickly relieve joint bursitis when injected directly into the bursa.
- Surgery, but only in rare cases where a bursa may need to be surgically drained or removed.
Some types of bursitis cannot be prevented. There are things you can do to help reduce your risk of bursitis due to overstrain or overuse of a joint, however. These prevention methods include:
- Exercise, warming up, and stretching. Exercise and stretching help keep the muscles conditioned, which makes bursitis less likely.
- If you’re a runner, avoid running on cement, or running down steep hills. Make sure your running shoes have cushioning.
- Avoid excessive squatting. Overuse of the hips, such as excessive bending or squatting, can increase the force and strain on your hip joints.
- Taking breaks. Make sure to alternate repetitive tasks with rest so that the joints do not become over-strained.
- Lifting properly. Bend your knees when you lift. Failing to do so puts extra stress on the bursae in your hips.
- Wheel heavy loads. Avoid carrying heavy loads as carrying heavy loads puts stress on the bursae in your shoulders.
- Maintaining a healthy weight. Additional weight places more stress on the hips.