Two likely causes of hip pain are osteoarthritis and bursitis. They have similar symptoms, but very different reasons for causing pain.
By: Marco Funiciello, DO, Physiatrist
To diagnose hip bursitis, a doctor must rule out other problems that could cause outer hip pain, such as hip osteoarthritis, tendonitis, snapping hip syndrome, iliotibial band syndrome, and conditions affecting the low back.
Sometimes an infection in the bursa or tendon will cause the area to be inflamed. Tendonitis or bursitis may be linked to other conditions. These include rheumatoid arthritis, gout, psoriatic arthritis, thyroid disease and diabetes.
This condition is also generally referred to as hip bursitis. The main difference between iliopsoas bursitis and trochanteric bursitis is that iliopsoas bursitis causes pain in front of the hip and/or groin area, while trochanteric bursitis causes pain in the outer hip.
The most common causes of bursitis are injury or overuse. Infection may also cause it. Bursitis is also associated with other problems. These include arthritis, gout, tendonitis, diabetes, and thyroid disease.
Arthritis, bursitis, and tendonitis are three different conditions, but they share similarities. For many people, these conditions can cause pain and swelling, which makes it harder to perform even basic movements. The source of pain for all three involves inflammation, but the location of the inflammation varies.
Tendinitis and bursitis are inflammation or breakdown of the soft tissue around muscles and bones. They often affect the shoulders, wrist, neck, hips, knees, and ankles. Tendons are cord-like structures where muscles attach to bone. Tendinitis is often very tender to the touch and caused by injury or repetitive use.
The pain is often sharp in the first few days. It may be dull and achy later. You may notice it more when getting out of a chair or bed. You may also notice it when sitting for a long time and when sleeping on the affected side.
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.
The most common causes of bursitis are repetitive motions or positions that put pressure on the bursae around a joint. Examples include: Throwing a baseball or lifting something over your head repeatedly. Leaning on your elbows for long periods.
Rheumatoid arthritis.
Rheumatoid arthritis is an autoimmune disease that attacks the tissues in your joints. Tissue damage weakens the joint, putting extra pressure on the bursa.
The main symptom of trochanteric bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may become more of an ache and spread across a larger area of the hip.
Ultrasound and MRI specifically are used to confirm the diagnosis when the bursae are too deep for regular inspection.
There are two types of hip bursitis: trochanteric bursitis and iliopsoas bursitis.
Pain that doesn't go away
Hip bursitis (trochanteric bursitis) may be a sign of a more serious issue. If you continue to have bursitis pain at the hip that has not improved despite extensive treatment, you may have a tear of a muscle located next to the bursa called the gluteus medius.
Rest and don't overuse the affected area. Apply ice to reduce swelling for the first 48 hours after symptoms occur. Apply dry or moist heat, such as a heating pad or taking a warm bath.
Initially, the pain may be located primarily at the outside of the lower hip. Over time the pain may radiate down the outside of the thigh or to other points in the body, such as the lower back, buttock, or groin, and may extend down the outside of the thigh towards the knee.
Bursitis can be very painful, and tends to be more severe during joint use, or while resting at night.
Try sleeping on your back or, if you're a side sleeper, sleep on the side that doesn't hurt and put a pillow between your knees to keep your hips aligned. Around your hip bone and other joints are small sacs filled with fluid that cushion the joint when it moves. These sacs are called bursae.
Hip injury or trauma.
Falling on the outside of the hip, or banging the hip on any hard surface, can cause the bursa to fill with blood and/or its lining to become inflamed. Even though the blood may be reabsorbed into the body, the bursa lining may stay inflamed, causing bursitis symptoms.
Bursitis is when a joint becomes painful and swollen. It can usually be treated at home and should go away in a few weeks.
Bursitis occurs when the bursae become inflamed. Inflammation of the bursae causes pain from the hip that spreads down the side of the thigh. This sharp, intense pain may worsen at night.
While tendonitis causes pain during movement, bursitis can be painful even during rest. Bursitis is typically caused by repetitive joint movement. It may also be caused by an infection, sudden injury or inflammatory medical condition like rheumatoid arthritis or gout.