Is Hip Bursitis
Causing Your Hip Pain?

Hip bursitis is a common hip joint pain condition. When the bursa becomes inflamed, it can mean pain day and night. What is bursitis? And what can you do at home to reduce the pain and keep it from coming back?




What is Hip Bursitis?

Hip Bursitis, often called trochanteric bursitis, is hip pain secondary to inflammation of the trochanteric bursa. The bursa is a fluid filled sac that functions to cushion and reduce friction around the greater trochanter of the lateral hip. Because of the nerves associated with bursa, this condition can be quite painful.



How does this happen? The cause of trochanteric bursitis can be varied. Often the iliotibial band (or IT band) that runs along the outside of the leg can become tight, rubbing against the bursa. This can occur because of a weakness of the lateral hip muscles, thus causing the IT band to become tight to compensate. Trauma can also cause bursitis such as a fall landing on the outside of the hip.


it band


Symptoms of Trochanteric Bursitis

Bursitis of the hip will create pain in the lateral aspect of the hip. The trochanteric bursa will be point tender, thus direct pressure on the lateral hip will recreate pain.

Because of the location of the bursa of the hip, one of the most common complaints is pain when lying on the effected side when trying to sleep. Compression of the bursa causes the pain. In addition, because muscles lie on top of the bursa, contraction of the lateral hip muscles can also compress the bursa causing pain. This most often occurs when walking or climbing stairs.

The area of trochanteric bursitis symptoms can also be associated with pain originating from the lower back. As a physical therapist I have frequently evaluated patients with the diagnosis of hip bursitis, only to determine the pain was coming from their lower back. It is important that if you have a history of low back pain that you see your physician in order to determine the exact cause of the symptoms.


Typical Bursitis Treatment

Because inflammation of the bursa is the cause of the pain, reducing the inflammation is the main initial focus of treatment. As with any inflammatory condition, anti-inflammatory medication or cortisone injections can be helpful (consult your doctor regarding medications).

Utilizing ice therapy (don’t use heat!) can be greatly helpful in reducing the pain and inflammation.

Bursitis of the hip responds specifically well to ice massage. Ice massage is performed by filling a Styrofoam cup with water and freezing it. Then, peel off the rim off the top of the cup, exposing the ice, and leaving the bottom for you to hold. Massage the ice directly over the painful area of the lateral hip for 5 minutes.

An often overlooked way of minimizing pain and inflammation is to simply avoid those activities that recreate your pain. Limit your walking and stair climbing on those days when pain is elevated. When pain is significant, consider using a cane to help decrease hip stress. Make sure to use the cane on the opposite side the leg feeling the pain.

Sleeping position is also very important in helping to minimize irritation of the bursa. Avoid sleeping on the effected side. At times, even the position of sleeping on the uninjured side will create pain. If this occurs, sleep with a pillow between the knees. Using a larger body pillow (called a body pillow) can help maintain a comfortable sleeping position throughout the night.


hip bursitis sleeping position


Physical Therapy Exercise

Physical therapy can be very effective in treating bursitis of the hip. Ultrasound, phonophoresis, and iontophoresis are all effective in helping reduce inflammation of the bursa. Manual stretching and soft tissue massage of the IT band helps to reduce pressure on the bursa.

The focus of physical therapy exercises for trochanteric bursitis is to reduce the friction over the bursa. Because the IT band is generally the cause of this friction, stretching of the IT band is the main focus.

To stretch the IT band, stand with the leg to be stretched next to a wall. Place your hand on the wall to support your body. Shift the hip toward the wall, keeping your back in an upright position. Hold the stretch for 30 seconds and repeat a few times.

IT band Stretch


In addition, the use of a foam roll can be used to help improve IT band flexibility. To use the foam roll lie with the involved leg down on the foam roll. Use your arms to support your upper body. Roll over the mid aspect of the lateral leg over the foam roll for a minute and repeat.

IT Band Foam Roll


Summary

• Bursitis is a common source of hip joint pain.

• Bursitis of the hip is inflammation of the trochanteric bursa.

• IT band tightness and lateral hip muscle weakness are often causative factors.

• Anti-inflammatory medication and ice (no heat!) can help minimize the inflammation.

• Adjust sleeping position to avoid bursa pressure at night.

• Perform IT band stretching and use the foam roll to improve IT band flexibility. to improve hip flexibility and strength of surrounding tissues.


Hip bursitis can be painful both with activity and at rest. There is no need to let your bursitis get you down. Stay consistent with the recommendations and your hip bursitis pain will improve.




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