Many of our patients come to us with hip pain on the side of their hip. Most commonly they tell us they can’t sleep on that side, or worse can’t sleep on either side. Belly sleepers won’t understand but when you’re a side sleeper and the side of your hip hurts, you often wake up with a mowhawk from turning on one side to the other.
Trochanteric Bursitis is by far the most common cause of Lateral hip pain or pain on the side of the hip. The Trochanter is that boney bump that you feel when you push on the side of your hip. The large Gluteal (Butt and side of the hip) muscles attach here and hold your pelvis upright when you step by pulling on this bone. A small sack of lubricating fluid, resembling the look and feel a sandwich bag full of vegetable oil, helps the muscle glide over the bone when you walk.
Injury, overuse, or even small tears in the muscle attachments called tendons can inflame the bursa. An inflamed bursa becomes thick and feels more like a rubber heating bottle. This thickness leads to swelling, tightness and pain.
Causes of Hip Bursitis
Hip bursitis is commonly seen in runners and other athletes
Hip bursitis is sometimes associated with patients who fall onto their upper thigh, causing traumatic bursitis.
Diagnosis of Hip Bursitis
The diagnosis of hip bursitis is made most reliably on physical examination. The most common symptoms of hip bursitis include:
- Tenderness over the bony prominence of the upper/outer thigh.
- Swelling over the bursa.
- An x-ray is often obtained to ensure there are no bone spurs or calcifications that could be contributing to the problem.
- An MRI if the diagnosis is unclear or if the problem does not resolve with treatment. Also if a muscle tear is suspected.
What else can cause symptoms similar to hip bursitis?
Treatment of hip burisitis is aimed at controlling the inflammation caused by this condition and stretching out the tight tendons near the bursa.
Rest: Any activity that causes hip bursitis pain should be avoided.
Anti-inflammatory Medications Anti-inflammatory medications (e.g. Motrin, Aleve, Naprosyn, etc.) will help control the swelling associated with hip bursitis.
Ice the Injury Icing the area of hip bursitis often helps to alleviate the symptoms of hip bursitis.
Cortisone injections are helpful because they can be both diagnostic and therapeutic. In cases where hip bursitis may be one of several diagnoses being considered, cortisone can be given to see if the shot helps to alleviate symptoms.
Stretching A better conditioned muscle and tendon will glide more easily and not cause hip bursitis. Special attention to proper stretching technique is important.
Physical Therapy Working with a physical therapist is useful. They can use modalities such as ultrasound and iontophoresis.
Surgical treatment for hip bursitis is rare
In those few cases where surgery is needed, it can be done arthroscopically. Dr. Wierks is specially trained in this surgery, in which the bursa is simply removed (called a bursectomy). It will regrow smooth and thin.