Hip Bursitis
Inflammation of a cushioning sac on the outer hip
Quick Facts
- Type: Soft-tissue inflammation
- Main symptom: Pain on the outer side of the hip
- Common cause: Overuse, pressure, or injury
- Treatment: Rest, therapy, anti-inflammatories
Overview
Hip bursitis is inflammation of a bursa in the hip. Bursae are small, fluid-filled sacs that act as cushions between bones and the soft tissues, such as muscles and tendons, that move over them. The most commonly affected bursa sits over the bony point on the outer side of the hip, called the greater trochanter, so the condition is often called trochanteric bursitis or greater trochanteric pain syndrome.
It is a frequent cause of hip pain, particularly pain on the outer side of the hip that can make lying on that side or climbing stairs uncomfortable. Hip bursitis is usually not serious and most cases improve with simple measures, although it can be persistent and may overlap with tendon problems around the hip.
Symptoms
The hallmark of hip bursitis is pain over the outer side of the hip. Typical features include:
- Pain on the outside of the hip and upper thigh
- Pain that is sharp at first and becomes more of an ache over time
- Tenderness when pressing on the bony point of the hip
- Pain when lying on the affected side, often disturbing sleep
- Pain that worsens with walking, climbing stairs, or getting up from sitting
- Pain that may spread down the outside of the thigh
Causes
Hip bursitis develops when a bursa becomes irritated and inflamed. Common contributors include:
- Overuse and repetitive activity: such as running, cycling, or standing for long periods.
- Injury: a fall onto the hip or a direct blow.
- Prolonged pressure: for example from lying on one side.
- Muscle and tendon problems: tightness or weakness in the hip and gluteal muscles, often linked to tendon irritation.
- Differences in leg length or gait: which change how the hip is loaded.
- Other conditions: such as arthritis or previous hip surgery.
Risk Factors
- Female sex and middle to older age
- Repetitive activities such as running or cycling
- Hip or knee arthritis
- Differences in leg length
- Weak or tight hip and gluteal muscles
- Previous hip injury or surgery
- Being overweight
Diagnosis
Hip bursitis is usually diagnosed from the symptoms and a physical examination, with tests used mainly to rule out other causes.
- Examination: pressing on the bony point of the hip typically reproduces the pain, and movements may be tested.
- Imaging: X-rays do not show the bursa but help exclude arthritis or other bone problems; ultrasound or MRI can show inflammation and assess nearby tendons if the diagnosis is unclear.
Because outer hip pain can also come from tendon problems, the back, or the hip joint itself, the examination focuses on pinpointing the source.
Treatment
Most cases of hip bursitis improve with simple, non-surgical treatment, although it can take time.
- Rest and activity changes: avoiding or modifying activities that aggravate the hip.
- Ice: applying a cold pack to the painful area.
- Anti-inflammatory medicines: to reduce pain and inflammation when appropriate.
- Physiotherapy: stretching and strengthening the hip and gluteal muscles, which is often key to lasting recovery.
- Corticosteroid injection: into the area around the bursa for persistent pain.
- Surgery: rarely needed, and only for cases that do not respond to other treatments.
Prevention
Several measures can reduce the chance of hip bursitis or stop it returning:
- Strengthen and stretch the hip and gluteal muscles
- Increase exercise intensity gradually rather than suddenly
- Warm up before activity and use proper technique
- Maintain a healthy weight
- Avoid prolonged pressure on one side, such as lying on the same hip
- Address leg-length differences or gait problems if present
When to See a Doctor
See a doctor if outer hip pain lasts more than a couple of weeks, keeps you awake at night, or limits your daily activities. Seek prompt medical attention if you have:
- Severe pain after a fall or injury, or inability to bear weight
- A hip area that is hot, red, and swollen, especially with fever, which could indicate infection
- Sudden severe pain or deformity of the hip
- Pain that is rapidly worsening despite rest
Frequently Asked Questions
What does hip bursitis feel like?
It typically causes pain on the outer side of the hip and upper thigh. The pain is often sharp at first and becomes an ache, is tender to press, and tends to worsen when lying on that side, climbing stairs, or getting up from a chair.
How long does hip bursitis take to heal?
Many cases settle within a few weeks with rest, ice, anti-inflammatory medicine, and physiotherapy, but it can be persistent and sometimes takes several months. Strengthening the hip and gluteal muscles is often important for lasting recovery.
Is hip bursitis the same as a hip joint problem?
No. Bursitis affects a cushioning sac on the outer side of the hip, while problems such as arthritis or a labral tear affect the hip joint itself, usually causing groin pain. Because the symptoms can overlap, an examination helps identify the true source.
Should I keep exercising with hip bursitis?
Gentle movement is encouraged, but activities that clearly aggravate the pain should be modified or reduced for a time. A physiotherapist can guide you on safe stretches and strengthening exercises and on how to return to activity gradually.
When is hip pain a sign of something serious?
Seek prompt care if hip pain follows a fall and you cannot bear weight, if the hip is hot, red, and swollen with fever, or if pain is severe and rapidly worsening. These can indicate a fracture or infection rather than simple bursitis.
References
- American Academy of Orthopaedic Surgeons (OrthoInfo). Hip bursitis.
- Mayo Clinic. Bursitis.
- MedlinePlus, U.S. National Library of Medicine.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).