There are many causes of hip pain, but the most common cause is hip bursitis. The hip joint contains several fluid-filled sacs called bursa that cushion bones and reduce friction in the joints and tendons. When these bursae become irritated or inflamed, the result is hip pain. Trochanteric bursitis is hip pain that is felt on the outer areas of the hip, while ischial bursitis can cause pain in the area of the upper buttock.

Doctors diagnose hip bursitis with a combination of tools that include patient interviews, physical exams, and X-rays. An MRI of the affected area may also be necessary if X-rays are unclear and pain is persistent in the area.

Causes of hip bursitis

Aseptic hip bursitis (noninfectious bursitis) is most often caused by trauma, injury, or strain to the area. This can include repetitive motion injuries from common daily tasks or sports, such as:

  • Yard work, such as shoveling or raking
  • Painting
  • Squatting to play catch
  • Skiing
  • Scrubbing
  • Hiking
  • Kicking
  • Throwing

Hip bursitis as a result of the above can be attributed to poor conditioning, not warming up, or completing the activities with improper form that puts undue stress on the bursae.

Another common cause of aseptic hip bursitis is age. This tends to be a wear-and-tear injury. As the tendons get older, they do not stretch as readily, and they tolerate less stress before injury. A tendon in a person over 50 is more likely to tear or suffer a strain.

Septic bursitis is much less common and is caused by bacteria that invades and infects the hip bursae. This bacteria can come from the same crystals that cause gout. Gout is a metabolic disorder that occurs most frequently in men and is characterized by swollen joints caused by an excess of uric acid being deposited there. This is not a common form of hip bursitis but it does cause pain and inflammation.

A final cause of hip bursitis can be simple anatomy.

If a bone is placed improperly, this can cause undue stress and strain on the bursae and can cause inflammation. Having 2 different lengths of femur bone with 1 leg longer than the other can cause stress and inflammation that leads to hip bursitis.

Trochanteric bursitis presents itself as a burning pain on the outside of the hip that becomes especially pronounced after walking, climbing, or other physical exercise. Because it is located on the side of the hip, this frequently causes disrupted sleep.

Ischial bursa are located at the top of the buttocks, so this type of bursitis causes pain in that area of the body. This type of bursitis is often called “weaver’s bottom” or “tailor’s bottom” because the pain tends to worsen with prolonged sitting. People suffering from this type of bursitis will also feel increased pain when climbing up a hill.

Risk factors for hip bursitis

Anyone can get bursitis, but there are several risk factors that increase a person’s chances. Women over the age of 40 are the most likely group to develop hip bursitis, and participation in high-risk activities such as those mentioned above increase that risk.

Certain other conditions of the hip, such as rheumatoid arthritis, increase the chances of developing hip bursitis. People suffering from diabetes are also at increased risk of developing hip bursitis, as are those who develop calcium deposits in that area of their bodies. Infections can sometimes cause an inflammation of the bursa, and thyroid disorders, which are metabolic, can also cause bursitis.

Treatments for hip bursitis

Treatment for hip bursitis depends generally on the severity and the type of bursitis. At a minimum, for aseptic hip bursitis, patients are advised to stop the pain-causing activity and rest. Often ice is called for to decrease inflammation, and doctors may suggest non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen sodium to ease the pain and minimize inflammation.

Patients can also utilize natural anti-inflammatory foods such as tart cherry juice, papaya, and blueberries to help boost immune function and provide anti-oxidant benefits. For severe inflammation and pain, doctors often prescribe corticosteroids to quickly reduce inflammation. For septic bursitis, patients may take antibiotics to fight infection in addition to the above treatments.

Both types of hip bursitis may benefit from alternative therapies such as massage and acupuncture. These treatments can be relaxing to the patient and have benefits beyond simply relieving pain. Ultrasound therapy is another way to relieve inflammation. After the bursae are less inflamed, chiropractic care can also help with alignment of the body, resulting in a general stabilization of the entire hip area.

Tips for avoiding hip bursitis

There are many ways to avoid developing hip bursitis:

  • When starting a new exercise routine, don’t leap right in. Take some time to build up condition and endurance, even if it is just a walking routine. Cross-training or taking a day off in between workouts can also help avoid hip bursitis caused by repetitive motion and stress.
  • Use proper form when going about your day. Practice good posture that supports the natural curves of the spine, and maintain good posture when seated and standing. Similarly, when doing chores or housework, take care to maintain good alignment, and stop if there is pain.
  • Drink lots of water. Water is an essential part of the body. It lubricates joints and keeps the organs hydrated. Drinking water also prevents dehydration, which can be stressful on the joints of the body (in addition to stressful on every other system!).
  • Take time off if pain develops. It’s okay to take a break when the body calls for it. A few days of rest can be good for mind and body.

If you have experienced hip bursitis, tell us what treatments were most effective for you!

Image by Jes via Flickr


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