Hip bursitis is usually manageable and not inherently serious, often resolving with rest and conservative care, but it can become a chronic, debilitating pain issue if ignored, potentially leading to gait problems, muscle weakness, or, rarely, infection (septic bursitis), which requires immediate medical attention. While most cases improve, persistent or severe pain warrants a doctor visit to rule out other serious conditions like muscle tears, say experts from Johns Hopkins Medicine, Aurora Health Care, Brown University Health, Cleveland Clinic, Orthopaedics SA, Healthscope Orthopaedics Services, and Hoag Orthopedic Institute.
Outlook / Prognosis
Trochanteric bursitis usually gets better after a few weeks to a few months of rest and treatment. You might have an increased risk of it coming back (recurring) if a repetitive motion or activity caused bursitis. Talk to your healthcare provider about ways to reduce stress on your hips.
The affected area may be somewhat tender and warm but not to an excessive degree. The swelling may also be accompanied by bruising.
Overuse/repeated pressure on the hip: Hip bursitis usually occurs after long periods of repeated activity like standing, walking, stair climbing, gardening, running or painting. If you have a bone spur (a small outgrowth on the hip or thigh bone), you are more likely to develop bursitis as well.
Chronic bursitis
The same kind of irritation that caused the original inflammation can trigger a new episode. Repeated flare-ups may damage the bursa and reduce your mobility in that joint.
See a GP if:
your bursitis symptoms have not improved or are getting worse after treating it yourself for 1 to 2 weeks. you have a high temperature, or you feel hot, cold or shivery. you cannot move the affected joint. you have very severe, sharp or shooting pains in the joint.
Mild cases typically resolve in 2–4 weeks with proper rest and treatment, while moderate cases may take 2–3 months. Severe or chronic bursitis can last 6+ months. Knee and elbow bursitis often heal faster (2–4 weeks), while shoulder and hip bursitis may require 6 weeks to 6 months for full recovery.
Surgery is rarely needed for hip bursitis. If the bursa remains inflamed and painful after you have tried all nonsurgical treatments, your doctor may recommend surgical removal of the bursa. Removal of the bursa does not hurt the hip, and the hip can function normally without it.
The most common causes of bursitis are injury or overuse. But it can also be caused by infection. Pain, swelling, and tenderness near a joint are the most common signs of bursitis. Bursitis can be treated with rest and medicines to help with the inflammation.
Activities or positions that put pressure on the hip bursa, such as lying down, sitting in one position for a long time, or walking distances can irritate the bursa and cause more pain.
Ultrasound or MRI might be used if your bursitis can't easily be diagnosed by a physical exam alone. Lab tests. Your doctor might order blood tests or an analysis of fluid from the inflamed bursa to pinpoint the cause of your joint inflammation and pain.
At its worst, septic bursitis can lead to overt sepsis or septic shock, a life-threatening illness that can cause decreased blood pressure, organ failure, stroke, altered mental status, and death.
Tendonitis and rotator cuff injuries are often confused with bursitis. Shoulder impingement and arthritis can mimic bursitis symptoms. Accurate diagnosis is key to effective treatment. Understanding the differences between musculoskeletal conditions is important.
Bursa Drainage and Removal
If the bursa is severely damaged, the surgeon may remove the entire inflamed sac. The incision is closed with stitches. Removal of a bursa does not affect the way the muscles or joints work and can permanently relieve the pain and swelling caused by bursitis.
If left untreated, trochanteric bursitis can lead to chronic hip pain, mobility limitations, and compensatory movement patterns that contribute to further joint strain.
The steroid injection eases symptoms of hip bursitis, shoulder bursitis and other types of bursitis. If injections don't relieve symptoms, you may need surgery.
The condition can also affect bursae, which are small sacs containing a slippery fluid that lubricates the muscles, bones, and tendons that move your joints. Specifically, lupus can cause inflammation of your tendons and bursae to cause tendonitis and bursitis, which can result in joint pain and stiffness.
Surgical Treatment for Bursitis
If you're experiencing intractable hip pain, your orthopedic specialist will usually recommend surgery to remove or drain the affected bursa.
Bursitis pain may start out sharp and quite pronounced, then gradually change into a more widespread and persistent ache. Hip bursitis is often worse at night, when lying down puts added pressure on the pelvic area.
Most of the time, patients with substantial hip arthritis have pain deep in the groin.
Potentially, yes. If your hip bursitis becomes chronic and prevents you from working even after treatment, you may be eligible for Social Security Disability Insurance (SSDI) in addition to workers' compensation benefits. Veterans may also qualify for VA disability ratings.
“Sleeping on your back with a pillow under your knees, or on your side with a pillow between your knees, can help align your hips and reduce pain,” says Dr. Shekhman. Adjusting your position is one of the easiest ways to sleep with hip pain and minimize pressure on the joint overnight.
Common Symptoms of Hip Bursitis
Let's talk about three of the most common conditions that are confused with hip bursitis.
3) Fever or Illness Signs
If hip pain is paired with fever, chills, or feeling unwell, infection of the bursa (septic bursitis) must be ruled out. Infection requires medical care and should not be managed at home.