Bursae are small sacks filled with a jelly like fluid that are located around several joints in the body including the hip. The purpose of bursae are to provide additional cushioning around the joint. Two main bursae exist around the hip – one located over the bony point on top of the thigh bone (femur) known as the Greater Tronchanteric Bursa, and the other located on the inner side (groin side) of the hip joint known as the Iliopsoas Bursa. Bursitis occurs where the bursa becomes inflamed.
Pain is the most common symptom. Pain caused by inflammation of the Greater Tronchanteric Bursa is generally felt over the outside of the hip and thigh. Pain caused by inflammation of the Iliopsoas Bursa is usually felt in the groin.
The pain can be worse at night particularly when lying on the affected hip, and after standing or sitting for long periods of time. The pain can also worsen with walking, stair climbing or squatting.
Although bursitis can affect anyone the following risk factors have been linked with development of the condition:
- Middle-aged or elderly
- Repetitive stress injury caused by repetitive activities such as running, climbing stars or cycling
- Rheumatoid arthritis
- Hip injury caused by falling on or bumping your hip or lying on your hip for an extended period of time
- Previous surgery around your hip or a hip replacement
- Bone spurs or calcium deposits that can develop within the tendons around the hip joint can irritate the bursa
- Spinale diseaseproblems
If you are experiencing ongoing pain or stiffness in or around your hip joint that affects your mobility, you should consult your doctor. Your doctor will ask questions to get a comprehensive history and perform a physical examination.
Your doctor may also refer you for an x-ray of your hip joint and on occasions a MRI and/or CT scan is also required.
Initially, bursitis is managed with non-surgical options.
- Avoiding repetitive activities that aggravate your pain
- Assistive devises such as walking cane or crutches for use when pain is worse
- Anti-inflammatory medication
- Steroid injections into the affected bursa
When your pain can no longer be effectively managed with non-surgical options, your doctor may recommend surgery. The Inflamed bursa may be removed surgically either with arthroscopic or open surgery. The type of surgery is determined by several factors including the size and location of the bursa, the patient’s body habitus and the presence of other injuries in the area which needs to be addressed such as torn tendons.