Pain on the outside of the hip is a very common complaint in adults, and can often be caused by hip bursitis, also known as trochanteric bursitis. The greater trochanter is the large, bony bump on the upper end of the femur. Tendons pass over or attach to this part of the femur. A bursa, or fluid-filled cushion, sits between the trochanter and tendons reducing friction between the soft tissue and bone.
The bursa and tendons can become irritated and inflamed resulting in hip bursitis. This condition can occur in anyone, but it is more common in middle-aged females and the elderly.
Another sources of inflammation is around the iliopsoas muscle in the front of the hip. As this muscle passes over the front part of the hip joint, it can rub and become irritated. This presents as hip pain in the front of the hip that can be worsened with flexion of the hip. This condition can also be treated without surgery in the majority of cases.
Symptoms of hip bursitis:
- Tenderness over the bump on the side of the hip
- Pain radiating down side of leg
- Trouble sleeping on the affected side
- Swelling on the side of the hip
- Pain that is worse with walking up stairs or with activity
- Walking with a limp due to pain
What treatment to expect:
- Injections are the mainstay of treatment for bursitis around the hip. An injection into the region of the greater trochanter (outside of the hip) can provide good relief. An ultrasound guided injection into the iliopsoas can also improve function and return patients to their previous level of activity.
- In conjunction with an injection, physical therapy can help the patient improve their function and provide guidance as to how to prevent the inflammation from returning.
- Arthroscopic surgical intervention can be effective, but only in very rare and selective cases.
- Surgery is rarely needed to treat hip bursitis, and is only considered after failure of conservative treatment. During this procedure, the surgeon will remove the unhealthy bursa either with an open incision over your hip, or using 2-3 half-inch incisions and a camera to guide instrumentation (arthroscopically).