Bursitis of the Hip
What is bursitis?
A bursa (bursae, plural for bursa) is a closed fluid-filled
sac that functions as a gliding surface to reduce friction between tissues
of the body. The major bursae are located adjacent to the tendons near the
large joints, such as the shoulders, elbows, hips, and knees. When the bursa
becomes inflamed, the condition is known to as “bursitis.” Most
commonly, this is a non-infectious condition (aseptic bursitis)
caused by inflammation resulting from local soft tissue trauma or strain injury.
On rare occasions, the hip bursa can become infected with bacteria. This condition
is called septic bursitis.
What is hip bursitis?
There are two major bursae of the hip, which can both be associated with stiffness
and pain around the hip joint. The trochanteric bursa is located
on the side of the hip. It is separated significantly from the actual hip joint
by tissue and bone. Trochanteric bursitis frequently causes tenderness of the
outer hip, making it difficult for patients to lie on the involved side. It
also causes a dull, burning pain on the outer hip that is often made worse
with excessive walking or stair climbing. Sufferers often experience excruciating
pain when getting up from a sitting position, but feel better after moving
around a little bit. The ISCHIAL bursa is located in the upper
buttock area. It can cause dull pain in this area that is most noticeable climbing
up hill. The pain sometimes occurs after prolonged sitting on hard surfaces,
hence the names “weaver’s bottom” and “tailor’s
bottom.”
How is bursitis of the hip treated?
The treatment of any bursitis depends on whether or not it involves infection.
Aseptic hip bursitis can be treated with ice compresses, rest, and anti-inflammatory
and pain medications. Occasionally, it requires aspiration of the bursa
fluid. This procedure involves removal of the fluid with a needle
and syringe under sterile conditions. It can be performed in the doctor's office.
Sometimes the fluid is sent to the laboratory for further analysis. Non infectious
hip bursitis can also be treated with an injection of cortisone medication
into the swollen bursa. This is sometimes done at the same time as the aspiration
procedure. Generally, patients should avoid hills and stairs, when possible,
while symptoms are present.
Septic bursitis requires even further evaluation by a doctor. This is unusual
in the hip bursa, but does occur. The bursal fluid can be examined in the laboratory
for the microbes causing the infection. Septic bursitis requires antibiotic
therapy, often intravenously. Repeated aspiration of the inflamed
fluid may be required. Surgical drainage and removal of the infected bursa
sac (bursectomy) may also be necessary.
