Hip Bursitis

Inflammation of the bursa surrounding either of the big knobs of bone (trochanters) at the top of the femur (thigh bone). Bursitis may vary in degree from mild irritation to an abscess formation that causes excruciating pain.

BODY PARTS INVOLVED

• One of two bursas in the hip joint where the trochanters fit into their socket. A bursa is a soft sac filled with lubricating fluid that facilitates motion in the hip and protects it from injury.
• Soft tissue surrounding the hip joint, including nerves, tendons, ligaments, blood vessels (both large vessels and capillaries), periosteum (the outside lining of bone) and muscles.

Causes

• Injury to the hip.
• Acute or chronic Infection.
• Arthritis.
• Gout.
• Unknown (frequently).

Signs & Symptoms

• Pain in the hip.
• A "crackling" feeling when moving the hip.
• Tenderness.
• Swelling.
• Pain which radiates down the thigh at night
• Redness (sometimes) over the affected bursa.
• A "snapping" noise with stepping or other hip motion.
• Fever if infection is present.
• Limitation of motion in the hip.

How is hip bursitis diagnosed?

The diagnosis of hip bursitis is made most reliably on physical examination. The most common symptoms of hip bursitis include:

• Tenderness over the bony prominence of the upper/outer thigh
• Swelling over the bursa

An x-ray is often obtained to ensure there are no bone spurs or calcifications that could be contributing to the problem. Occasionally, your doctor may obtain an MRI if the diagnosis is unclear or if the problem does not resolve with treatment.

Treatment

Follow your doctor's instructions. Instructions are supplemental.

• Use frequent ice massage. Fill a large styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area about in a circle the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition. After 72 hours, apply heat instead of ice, if it feels better.Use heat lamps, hot soaks, hot showers ,heating pads, or heat liniments or ointments.
• Take whirlpool treatments, if available.
• Use crutches to prevent weight-bearing on the hip joint,if needed.
• Elevate the hips above the level of the heart to reduce swelling and prevent accumulation of fluid. Use pillows for propping.
• Gentle massage will frequently provide comfort and decrease swelling.

MEDICATION

Your doctor may prescribe:

• Non-steroidal anti-inflammatory drugs.
• Antibiotics if the bursa is infected.
• You may use ibuprofen (i-bew-pro-fin) and acetaminophen (uh-c-tuh-min-o-fin) for your pain. These may be bought as over-the-counter medicine. Do not take ibuprofen if you are allergic to aspirin.
• Prescription pain relievers for severe pain. Use, non-prescription aspirin, acetaminophen or ibuprofen (available under many trade names) for mild pain.
• Injections with a long-lasting local anesthetic mixed with a corticosteroid drug, such as triamcinolone.

Home Diet

Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.Your doctor may suggest vitamin and mineral supplements to promote healing.

Prevention Tips

• Always warm up your muscles and stretch gently before exercising. Do cool-down and stretching exercises when you are finished. This will loosen your muscles and decrease stress on your hips. Rest between exercise sessions.
• Use protective gear such as hip pads for contact sports.
• Start exercising when caregivers say that it is OK. Do not run if you have pain.
• Warm up adequately before athletic practice or competition.
• Wear warm clothing in cold weather.
• To prevent recurrence, continue to wear extra protection over the hips until healing is complete.
• Do cool-down exercises after working out.
• Rest your hip, use ice treatments and take NSAIDs as directed by your caregiver.