Are you suffering from painful hips? Wondering how to relieve pain/make it better? You could very well be suffering from bursitis. While there can be many causes of hip pain, today we’re going to look at trochanteric bursitis or commonly known as hip bursitis.
The main symptoms of hip bursitis is pain at the point of the hip [1]. It usually extends to the outside of the thigh area. The pain is usually sharp and intense in the early stages which then can transition into more of a dull ache and spread across a larger area of the hip later on. The pain is usually worse at night, especially when lying on the affected hip. It also may get worse when getting up from a chair after being seated for a while or with prolonged walking, stair climbing or squatting.
Risk factors for hip bursitis include:
· It is more common in women and middle-aged or elderly people
· Repetitive stress (overuse) injury: running, stair climbing, bike riding, or standing for long periods of time
· Hip injury: falling or bumping your hip, or lying on one side of your body for long periods of time
· Problems with the spine: this includes spine problems that may affect the way you walk such as scoliosis or arthritis of the lumbar spine
· Leg-length inequality: this is a big factor in developing hip bursitis and can be caused by a scoliosis. This is when one leg is significantly shorter than the other, this affects the way you walk and can cause irritation of a hip bursa.
· Rheumatoid arthritis which increases the risk of a bursa becoming inflamed.
· Previous surgery around the hip or prosthetic implants in the hip can irritate the bursa.
· Bone spurs or calcium deposits: these can develop within the tendons that attach the muscles to the trochanter. These can irritate the bursa and cause inflammation.
A physiotherapist, chiropractor or osteopath can diagnose hip bursitis. A comprehensive physical examination will be performed on the hip joint. This will include physical palpation to see the tenderness of the hip area as well as a variety of tests to rule out other possible injuries or conditions. In addition, referrals for imagining studies might be utilised as well to get a definitive diagnosis such as X-rays or magnetic resonance imaging (MRI) scans.
TREATMENT
Nonsurgical Treatment
People with hip bursitis can experience relief of pain with simple lifestyle changes, these can include:
· Avoiding the activities that worsen symptoms
· Assistive devices such as a walking stick or crutches for a week if needed
· Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen etc. may relieve pain and reduce inflammation. Always talk to a health expert about this as they may have adverse effects if you have a medical condition or take other medications.
· Physical therapy is one of the most important aspects in relieving symptoms of hip bursitis. Your physio can prescribe exercises to stretch out the IT band and increase hip strength and flexibility. These can be done under supervision at the clinic to enable you to do them on your own at home. These treatments may also include heat therapy, massage performed by a remedial massage therapist and rolling therapy using a foam roller to loosen tight muscles.
· If these treatments have all been attempted and you are still suffering pain or the pain is severe and more relief is needed then your health practitioner may recommend a steroid injection. A corticosteroid injection is an effective treatment in which a single injection is placed into the bursa. This can provide temporary relief (months) or permanent relief. A second injection can be done if pain and inflammation return but it is important to determine the cause of the bursitis and not rely on injections all the time. Prolonged corticosteroid injections can damage the surrounding tissues and is not a good long-term solution.
Surgical Treatment
Surgery is rarely needed for hip bursitis. If the bursa is still inflamed and painful after all nonsurgical treatments, your doctor may recommend surgical removal of the bursa. This does not hurt the hip and the hip can function normally without it, however, this is a last result and is rarely needed.
PREVENTION
The key to managing hip bursitis is identifying the causes of it and in doing so, prevent the inflammation from getting worse. To do this it is important to see a physio, osteo or chiro so that they can identify what is causing your hip bursitis and how best to manage it. These can include:
· Avoiding repetitive activities that put stress on the hips
· Losing weight if you need to
· Getting a properly fitting shoe insert (orthotic) for leg-length differences
· Maintain strength and flexibility of the hip muscles
To get to the bottom of your hip pain, book in a consultation with a health practitioner at Back in Motion Cranbourne today.
References
[1] Armstrong, AD & Hubbard, MC. AAOS Essentials of Musculoskeletal Care. American Academy of Orthopaedic Surgeons. 2018; 5(1): 663-700.