What Causes Hip Bursitis?

What is Hip Bursitis?

What is Hip Bursitis?

A bursa is a fluid filled sac that helps to provide cushioning around bony prominences. Bursitis is simply inflammation of a bursa. Such inflammation can be caused by trauma or chronic pressure or irritation of the bursa.

The specific bursa involved in hip bursitis is called the Trochanteric bursa. It is located over the outside or lateral aspect of the hip and functions to help provide cushioning around the Greater Trochanter of the femur. The most common type of hip bursitis is therefore called Trochanteric bursitis.

Symptoms of hip bursitis most commonly include lateral hip pain, pain with walking and standing, and pain when sleeping on the involved side.

What Can Cause Bursitis?

As indicated above, trauma and chronic pressure are the two main causes of bursitis. Trauma most often comes in the form of a fall, landing on the outside of the hip.

In the case of Trochanteric bursitis, chronic pressure is more likely the cause of inflammation. For some, chronic pressure can come in the form of sleeping position. Lying on the painful side throughout the night can be enough pressure to initiate the inflammatory process. For others, abnormal dynamics of the soft tissue around the bursa is the culprit.

The iliotibial band (also referred to as the IT band) is a frequent source of pressure on the bursa. The IT band attaches to the outside of the pelvis and travels down the outside aspect of the thigh, crossing over the Trochanteric bursa, and connecting just below the knee. Tightness of this IT band is one of the main sources of bursa pressure and over time can lead to inflammation.

Of course, if tightness of the IT band is a main cause of increased pressure on the bursa, it stands to wonder what causes the IT band to become tight. There are a variety of factors that can result in IT band tightness including leg length discrepancies, lateral hip weakness, low back dysfunction, and even shoe wear.

Treatment for Hip Bursitis

Common treatment recommendations for bursitis include anti-inflammatory medication and some times injections. Ice can also be helpful in reducing localized tissue inflammation. Adjusting sleeping position can also be helpful in reducing local tissue pressure.

Although these treatments are very successful in helping to address the inflammation of the bursa, they do not address the overall cause. If the inflammation is reduced by medication or injections and the cause of the inflammation remains, it will only be a matter of time before the inflammation returns.

The best results for both minimizing pain now and reducing the risk of recurrence are a combination of anti-inflammatory treatment and physical therapy. An evaluation by a skilled physical therapist will help determine what structures are weak and tight and help guide you toward improving hip dynamics.

Hip bursitis is a common source of hip joint pain. Work with your doctor in determining the best course of treatment to both reduce pain now and minimize the chance for its return.

by: Janelle Trempe PT, ATC

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