What is hip bursitis?
Hip bursitis is a soft-tissue condition that causes pain around the outside of the hip. Other names are lateral hip pain syndrome and trochanteric bursitis.
It often happens after sitting for a long time, repeatedly getting up and down from a chair, side sleeping, or climbing stairs. In some cases, bursitis is from falling onto the hip (known as traumatic bursitis).
What does bursitis in the hip feel like?
Give yourself a hip check. Press down on the outside of your hip bone. If it triggers the hip pain you've been feeling, then it probably is bursitis. —Dr. Benjamin Schwartz
The pain is typically a dull ache. And is centered around the outside of the hip. You may notice it after sleeping on your side.
Often it's in just one hip. Though it can happen in both hips.
Your iliotibial band (ITB) may also be tight or painful. The ITB is a long, thick muscle that runs along the outside of the leg to the outer knee area.
- Dull, aching pain on the outside of the hip.
- Pain when sleeping on your side.
- Pain on the outside of the hip. Most often from sitting too long, when getting up from a sitting position, or climbing stairs.
Other symptoms of hip bursitis
- Giving way (buckling) of the leg.
- The outside of the hip or along the ITB is sore when touched.
- Unable to find a comfortable sleep position.
What causes hip bursitis to flare up?
The key to success is to be patient. Limiting activities can be frustrating, but will lead to a quicker recovery. Commit to physical therapy. And to regular anti-inflammatory use. People often give up on the medications before they have a chance to work. Please don't! —Dr. Schwartz
Hip bursitis is more common in women. Though men develop it too.
- Repetitive motions like ladder or stair climbing, kneeling/crouching, getting up and down from a sitting position.
- Walking or running on hills or uneven ground.
- Sleeping on your side, which puts pressure on the hip bursa. The bursa is a small, fluid-filled sac.
- Having a stiff back or tight hip/leg muscles, particularly the ITB.
- Falling on the side of the hip (traumatic bursitis).
A stiff back—possibly from arthritis or surgery—can lead to tight ITBs. It then puts pressure on the outside of the hip.
Hip bursitis can be intense. It can make walking painful. Still, it's rarely an emergency.
You can try to treat it yourself. But see a doctor if it's still painful after 4 to 6 weeks. If pain shoots below the knee and into the foot. Or you notice numbness or weakness in the leg.
Try NSAIDs, heat/ice, activity modification, and physical therapy exercises. See your doctor or an orthopedic surgeon if these home treatments are not working.
You may also want to see a physical therapist (PT) for exercises.
I often tell my patients that they are better off having bursitis instead of arthritis. Bursitis is a soft tissue disorder and is curable. Arthritis is a disease of joint cartilage and isn't reversible. The endgame of arthritis treatment often involves hip replacement surgery. Only rarely does hip bursitis require surgery. —Dr. Schwartz
Treatments for bursitis
Minimize climbing stairs, repetitive bending/crouching, sitting for too long, walking/running on uneven or hilly surfaces. And especially, sleeping on your side.
Simple stretching exercises can lessen symptoms. You can download hip rehabilitation exercises from the American Academy of Orthopedic Surgeons.
- If you are not improving after exercising on your own, you may need PT. PT will probably involve stretching of the muscles (particularly the ITB), massage, foam rolling, electrical stimulation, and strengthening.
- NSAIDs like ibuprofen and naproxen are one of the most effective treatments. Take NSAIDs as directed for at least 2 to 3 weeks. Often, people stop taking before they have a chance to work.
- Ice is best for numbing pain and reducing swelling. Heat loosens and soothes tight muscles. Experiment with both to figure out which is most effective for you.
- Corticosteroid ("cortisone") injections act as a targeted anti-inflammatory. Cortisone is injected directly into the hip bursal area.
- Bursitis rarely requires surgery. Though, sometimes, removal of the bursa (bursectomy) is an option.
If after a year or more of trying other treatments without success, your doctor may want to discuss surgery.
Surgery for bursitis involves excising (cutting out) the bursa and lengthening the ITB to relieve tension. This may be through a full incision (open bursectomy) or smaller incisions (arthroscopic bursectomy). With some exceptions, it's outpatient—no overnight hospital stay.
The success rate of bursectomy varies. It is not always successful. And the bursa can grow back.
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