Who has had hip bursitis?
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Hip bursitis is a common problem seen in runners or athletes who participate in running-oriented sports (e.g. soccer, football, etc.). However, it can also occur in the average person as well.
And, it may also occur in people who are overweight and sedentary, typically middle-aged women.
A bursa is a fluid filled sac that allows smooth motion between two uneven surfaces. There are multiple bursae that surround the hip. For example, in the hip, one bursa rests between the bony prominence over the outside of the hip (the greater trochanter) and the tendon that passes over this bone. The bursal sac becomes inflamed from repetitive movement of the tendon passing over the bone.
The diagnosis of hip bursitis is made by a combination of history and physical examination. In the example of trochanteric bursitis mentioned above, bursitis is made worse by walking and by lying on the affected side. On physical examination, a patient has pain directly over the location of the trochanteric bursa.
Another type of hip bursitis is iliopsoas bursitis. The pain from this disorder is felt in the front of the hip. Walking, running, and stair climbing aggravate this.
The other type of bursitis that is relatively common is ischiogluteal bursitis ("weaver's bottom"), the pain of which is felt in the buttocks. This is aggravated by sitting.
An x-ray is sometimes ordered to better delineate the problem. The presence of osteoarthritis is common in older patients and may confuse the diagnosis. Occasionally, the doctor may obtain an MRI if the diagnosis is unclear or if the problem does not resolve with treatment.
The best treatment for hip bursitis is to rest the affected area. This usually means a period of time not participating in sports or activities that aggravate symptoms.
Oral anti-inflammatory medications may help control the inflammation. Icing the area of hip bursitis may help alleviate symptoms. Once the initial symptoms are controlled, some physical therapy strengthening and stretching exercises may be helpful. Special attention to proper stretching technique is important. A cortisone injection may also be given to help control the inflammation around the bursa. I'm not a fan of cortisone since it tends to weaken soft tissue. However, as a short term fix used one time, it's OK.
A newer treatment for bursitis may be very effective and prevent the need for surgery. Percutaneous needle tenotomy is a technique where a small gauge needle is introduced using local anesthetic and ultrasound guidance. The needle is used to poke several small holes in the soft tissue of the bursa. This procedure is called "tenotomy." Tenotomy induces an acute inflammatory response. Then, platelet rich plasma, obtained from a sample of the patient's whole blood is injected into the area where tenotomy has been performed. Platelets are cells that contain multiple healing and growth factors. The result? Normal good quality tissue is stimulated to grow with natural healing.
For more information about this procedure, visit our sister site:
Tendonitis TendonitisandPRP.com provides reliable, accurate, and useful information on tendonitis treatment written by a board-certified rheumatologist. Learn more about how to get tendonitis relief using the most up-to-date methods.
Surgical treatment to remove the bursa is rarely needed, and most patients get better within about six weeks. Patients who do not rest from their activities until the inflammation subsides often have a return of hip bursitis symptoms. Also, patients who return too aggressively (i.e. not a gradual build-up), may also find that their symptoms return.
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