People experience many different types of hip pain. They feel pain and discomfort and tend to want to diagnose it for themselves; they moved wrong, overexercised, or perhaps it’s just part of the aging process. Often, they just try to ignore it. Ignoring the pain may end up making the injury worse. Addressing the injury early through non-invasive methods may save you from surgery. The knowledgeable and highly trained orthopedic specialists at Advanced Orthopedics in Denver, Parker, and Aurora, Colorado, can determine the source of your pain and create a treatment plan to treat it.
HIP BURSITIS OVERVIEW
Hip bursitis is a painful condition that can affect anyone. It affects 15% of women and 8.5% of men of all ages in the United States. Yet most people couldn’t tell you what it is. If someone is diagnosed with hip bursitis, they usually have a list of questions besides “What is it?” They want to know if it’s serious, if it could be permanent, what makes it worse, and whether or not it will keep them from their daily activities and the things they love to do. Because it is the hip, they even question whether or not they’ll be able to walk long-term.
ABOUT THE HIP
The hip joint functions as one of the most important joints in the human body It is a complex ball-and-socket joint that supports the body’s weight and is responsible for the movement of the upper leg. It consists of two main parts: a ball (femoral head) at the top of the thighbone (femur) that fits into a rounded socket (acetabulum), sometimes referred to as the cup, in the pelvis. Bands of tissue, called ligaments, hold the joint together and provide stability. Designed for both mobility and stability, the hip allows the entire lower extremity to move in three planes of motion while providing an important shock absorption function to the torso and upper body.
The hip joint structure enables the large range of motion needed for daily activities like walking, squatting, and climbing stairs. Changes, damages, or wear to any of the parts of the hip may lead to physical limitations.
WHAT IS BURSITIS?
Bursae (bur-SEE) are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid and are positioned between bones and soft tissues, acting as cushions to help reduce friction. Bursitis is inflammation of the bursa. When bursae swell, over time, fluid builds up in the sacs, and there’s less room for joints and connective tissue to move. This creates friction and pain in the joint.
There are two major bursae in the hip that typically become irritated and inflamed. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis. Another bursa — the iliopsoas bursa — is located on the inside (groin side) of the hip. When this bursa becomes inflamed, the condition is also sometimes referred to as hip bursitis, but the pain is located in the groin area. This condition is not as common as trochanteric bursitis but is treated similarly. The pain from inflamed hip bursae may be sudden or build up over time.
WHAT CAUSES HIP BURSITIS?
The following risk factors have been associated with the development of hip bursitis:
- Repetitive stress (overuse) injury. This can occur when running, stair climbing, bicycling, or standing for long periods. It can even happen from carpet laying, gardening, raking, painting, or shoveling.
- Hip injury. An injury to the point of your hip can occur when you fall onto your hip, bump your hip, or lie on one side of your body for an extended period.
- Leg length difference.
- Incorrect posture.
- Bone spurs or calcium deposits.
- Diseases or conditions like rheumatoid arthritis, gout, psoriasis, or thyroid disease.
The main symptom of trochanteric bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may become more of an ache and spread across a larger area of the hip. There may be swelling and a warm feeling around the affected area. Pain can radiate down the outside of the thigh or to other points in the body, such as the lower back, buttock, or groin, and may extend down the outside of the thigh towards the knee. The pain is often noticeable when getting out of a chair or bed, when sitting for a long time or when sleeping on the affected side. Acute bursitis usually flares over hours or days. Chronic hip bursitis can last from a few days to several weeks. Over time, the bursae may become thick, which makes the swelling worse. This can lead to limited movement and weakened muscles (atrophy) in the area.
HIP BURSITIS VS HIP ARTHRITIS
Arthritis and bursitis are different conditions that are similar in various ways. The conditions have overlapping symptoms and affect the same locations in the body—which sometimes makes it difficult to differentiate them. The key difference between the two conditions is the exact location of the inflammation. In arthritis, it is in the joint, whereas bursitis is in the bursae. Arthritis and bursitis also differ in pathology, onset, and how long they last. With arthritis, the damage can be permanent. In most cases, hip bursitis is short-term inflammation that won’t create long-lasting damage unless left untreated.
Conservative measures such as rest, ice, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, naproxen, and others, may relieve pain and control inflammation. If conservative measures don’t work, a doctor may suggest temporarily using a walking cane or another device, physical therapy, antibiotics, or a corticosteroid drug injected into the bursae, which generally works quickly. In many cases, one injection is all that is needed.
WHEN IS SURGERY INDICATED?
Surgery is rarely needed to treat trochanteric bursitis. However, when all else fails, and the pain is disabling, the doctor may recommend it. Several types of surgical procedures are available to treat trochanteric bursitis. The primary goal is to remove the thickened bursae, remove any bone spurs that may have formed on the greater trochanter, and relax the large tendon of the gluteus maximus. Some surgeons prefer to lengthen the tendon slightly, and some prefer to remove a section of the tendon that rubs directly on the greater trochanter. Both procedures result in taking pressure off the bursae. Physical therapy will ease recovery and help avoid future problems.
GETTING THE RIGHT DIAGNOSIS
Hip bursitis can often be diagnosed based on a detailed medical history and comprehensive medical exam. But not every doctor is trained to identify the condition and how it progresses in each individual patient. A true diagnosis takes specialists with extensive orthopedic training like those at the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado. They know the questions to ask and what to look for as identifying factors. They may also perform tests to rule out other possible injuries or conditions. These tests can include imaging studies, such as X-rays, bone scanning, and magnetic resonance imaging (MRI) scans. The doctors at CCOE aren’t just capable; they care. Not just about relieving your pain, but about getting you back to everything you need to do and love to do.