What causes hip bursitis?
Hip bursitis, also known as trochanteric bursitis, is caused by your iliotibial band rubbing on the outside part of your hip called the greater trochanter. This often causes pain on the side of your hip, and can make it painful to sleep on that side. It can also cause pain after you’ve been walking for a long time. I frequently see hip bursitis as a practicing orthopedic surgeon in Colorado Springs. The good news is that with the proper treatment, you can get rid of your hip bursitis without too much difficulty.
What is hip bursitis?
A bursa is a fluid filled sac, and you have them all over your body. There is one in your shoulder, one on the back of your elbow, and in many other places. The reason you have these bursa is that they help reduce friction in your body between areas that move a lot. Most of the time you don’t even notice them, until they get inflamed. You have a fibrous band that runs down the side of each leg called your iliotibial band (also known as your IT band). There is a bursa between your IT band and your greater trochanter (the bony prominence on the side of your hip). The problem becomes when some of your hip muscles get tired or weak, the IT band can start rubbing much more on your greater trochanter. Too much rubbing causes the bursa to get inflamed, and you get trochanteric bursitis.
How do I know if I have hip bursitis?
You will know if you have hip bursitis if you have a pain on the outside of your hip that gets worse when you press on it. It may also hurt you to lie down on that side, or take a long walk over uneven surfaces. Lifting your legs out to the side may hurt as well. Hip bursitis doesn’t really show up on x-rays or MRIs. The best way to confirm that you have hip bursitis is to see your doctor. I make the diagnosis of hip bursitis fairly often as an orthopedic surgeon in Colorado Springs.
How to get rid of hip bursitis
To treat your hip bursitis you need to treat what is causing it. Most of the time someone will get hip bursitis because their abductors are weak. Your abductors are the muscles that let you move your hip out to the side and stabilize your pelvis. When your abductors are strong, they keep the IT band from touching the greater trochanter. When they are weak and tired, the IT band really starts to rub on the greater trochanter and causes bursitis. Physical therapy is a great first step. Your therapist will focus on abductor and core strengthening, and IT band and gluteal stretching. Doing physical therapy gets at the root cause of why you developed hip bursitis in the first place. It is best for you to see a physical therapist in person, but if you can’t you can always do the exercises on your own at home, which you can find in this video. Strengthening and stretching takes time, and I will often give my patients a steroid injection to their greater trochanteric bursa. Not only can this knock out the pain from the bursitis, it will also help you make more gains in physical therapy. A steroid injection alone can provide relief, but it is not as good as a steroid injection combined with a good course of physical therapy. Rarely, if you are still in pain after PT and a steroid injection, surgery can be done to remove the bursa. The great majority of people never will need surgery for their hip bursitis.
I hope I was able to answer all of your questions about what is hip bursitis. If you still have any questions or want to schedule an in person or virtual consult, please feel free to contact me.
-Written by Dr. Daniel Paull