Hip bursitis

Symptoms of hip bursitis may include:

• Pain
• Swelling
• Heat
• Redness

Pain

This is the most common symptom of hip bursitis. In trochanteric bursitis, pain is felt on the outer side of the hip, and usually radiates down the outside of the thigh. It may start as a sharp or intense pain, changing over time to a dull ache that may affect a larger area of your hip. Pain may be worse at night, especially when sleeping on the affected side. It can also occur after walking, prolonged sitting, squatting, or climbing stairs. Iliopsoas bursitis pain is felt more in the inside of the hip, groin, or upper buttock.

Swelling, warmth, and redness

Swelling is a less common symptom but may happen in severe cases and can indicate infection. This is known as septic bursitis and needs immediate treatment. Swelling may be accompanied by redness and the affected area may feel warm to the touch. See a doctor straight away if you have swelling, warmth, redness, feel unwell or have a fever (a temperature above 38C).

Anyone can develop hip bursitis, but the condition is more common in women, and middle-aged or older people. It is also common among athletes and people who run, or cycle regularly.

Common causes of hip bursitis include:

• Overuse of the hip joint
• Hip injuries
• Muscle tears
• Poor posture
• Hip surgery
• Infection
• Medical conditions such as gout, rheumatoid arthritis, diabetes, psoriasis, and thyroid disease
• Conditions affecting the spine like scoliosis and arthritis of the lower spine
• Abnormal bone growths on top of bone (bone spurs)
• Unequal leg length

Treatment for infected (septic) hip bursitis is with antibiotics. There are a range of treatments for non-infected bursitis. These may be non-surgical, meaning you do not need to have an operation, or surgical, where an operation is necessary. Your consultant will probably recommend a combination of non-surgical treatments before considering surgery.

Non-surgical treatments for hip bursitis.

Activity modification

The first treatment for hip bursitis is to rest and restrict or avoid the activities that trigger it.

Assistive devices

Using crutches or a walking cane, can be beneficial until the inflammation has reduced.

Medication

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen help to relieve pain and reduce inflammation. Your consultant can prescribe a suitable NSAID. Always take any medication exactly as your doctor tells you to and read the patient information leaflet before taking your medication. Ask your doctor or pharmacist if you have any questions.

Heat and cold therapy

Your consultant may recommend applying heat or cold packs to your hip to reduce pain and swelling.

Physiotherapy

Physiotherapy is a highly effective treatment for hip bursitis. Our team of expert physiotherapists can create a tailor-made treatment plan based on your individual needs. Physiotherapy treatment involves exercises you can do at home to build strength and improve your mobility. Your physiotherapist may also use other techniques, such as ice and heat therapy, massage, and ultrasound.

Steroid injections

Corticosteroid injections are a powerful anti-inflammatory that is injected directly into the bursa. They can provide several months of pain relief. Your consultant may recommend steroid injections when other treatments, such as oral anti-inflammatories, haven’t worked.

Surgical treatments for hip bursitis

Most hip bursitis can be treated non-surgically, and you will rarely need to have an operation. If your hip bursitis keeps coming back, or if non-surgical treatments haven’t worked, your consultant may recommend surgery.

Drainage of the bursa

If the fluid is infected (septic bursitis), it may need to be drained with a needle. This may need to be done more than once.

Surgical removal of the bursa

In rare cases, when non-surgical treatments haven’t worked, your consultant may recommend an operation to remove the bursa. This is called a bursectomy. A bursectomy is a relatively minor outpatient procedure and is normally performed as keyhole surgery (arthroscopically). This is where a tiny, flexible camera is inserted through tiny incisions (cuts) and the surgery is performed using specially designed instruments. A bursectomy does not affect the hip joint and your hips will function normally after your surgery.

Hip replacement

In some cases, your consultant may suggest hip replacement surgery for recurrent or severe bursitis. During this surgery, the hip joint is removed and replaced with an artificial one called a prosthesis.

At your first consultation, your consultant will ask you about your symptoms; what they are, when they started and if they are triggered or made worse by certain activities. They will also ask about any medical conditions, previous surgeries, and regular medications you are taking. Your consultant will perform a physical examination of your hips and look for signs of infection such as swelling, redness, and tenderness. They will check your range of movement (how well you can move your hip joints).

Will they need tests or scans?

Your consultant will probably order an X-ray to check for visible injuries or abnormalities. Other possible tests include an MRI, ultrasound, and a blood test to confirm your diagnosis or rule out an alternative cause. If your consultant suspects your bursitis may be infective, they may remove a small amount of fluid from the bursa with a needle. This fluid is then sent to the laboratory to check for infection.

How is a diagnosis made?

Your consultant will make a diagnosis based on a combination of your symptoms, physical examination, and the results of any tests or scans.

Why is this first consultation so important?

Your initial consultation is important because it’s where you first meet your consultant, the doctor who will be responsible for your care. It’s also where we get to know you, assess your symptoms, and test results and plan an individualised treatment plan best suited to meet your needs.

At Circle Health Group we want you to be as well-informed and comfortable as possible during your time with us, so please ask any questions, and discuss any concerns you may have with your consultant during your appointment. It’s a good idea to write down any questions you have before your consultation.

Hip bursitis isn’t always preventable, but there are a few things you can do to lower your risk. These include:

• Lose weight if needed and maintain a healthy weight
• Warm up properly before exercise
• Start new sports or activities slowly to allow your body time to adjust
• Learn the proper technique and posture when participating in sports or exercise
• Avoid repetitive activities that put pressure on your hips
• If you have one leg shorter than the other, wear the correct orthotics or inserts
• Exercise regularly to build strength and flexibility in your hips

What does bursitis in the hip feel like?

Hip bursitis pain often feels like a sharp intense pain at first, but it may change to a dull ache over time. It can be difficult to distinguish hip bursitis from other types of hip pain, such as arthritis, as the symptoms can be similar. A consultation with a specialist early on will ensure you get the correct diagnosis and treatment.

How do you heal hip bursitis quickly?

You can help your hip bursitis heal quickly by seeking an expert medical opinion early. Your consultant will create an individualised treatment plan to ensure your hip bursitis heals in the shortest possible time.

What aggravates hip bursitis?

Hip bursitis is commonly aggravated by repetitive stress on the hip joint. This includes activities such as running, cycling, and climbing stairs. Sleeping on the affected side can also make your symptoms worse.

How long does hip bursitis last?

How long hip bursitis lasts varies depending on the severity of your bursitis, whether or not it is infected, how soon you receive treatment, and your general health. Hip bursitis can last from a few days to several months or even years.

Is walking good for hip bursitis?

Frequent walking is beneficial in the treatment and prevention of hip bursitis, as it helps to strengthen your hip muscles and improve your overall fitness.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care, including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about hip bursitis treatment, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in January 2024. Next review due January 2027.

• Hip Bursitis OrthoInfo
• Bursitis NHS
• Bursitis John Hopkins Medicine