There are three major bursa in the hip region; the greater trochanter, iliopsoas, and ischial bursa. Bursa are small fluid filled sacs that cushion bones from soft tissue structures and help reduce friction. Pain at the site of the bursa is a common symptom. The pain may be worse with activity or worse at night. Treatment is initially nonoperative with anti-inflammatory medications, icing the area, rest from inciting activities, and physical therapy. Injections of steroid medication directly into the bursa can help decrease the inflammation. Surgery is rarely indicated for treatment. Prevention of hip bursitis involves avoiding repetitive activities, losing weight, and doing exercises and stretches for the hip.
Trochanteric Bursitis
The American Academy of Orthopaedic Surgeons article on "Hip Bursitis" states that the most common site of hip bursitis is the bursa overlying the greater trochanter. This bursa is over the bony prominence on the side of the hip. Pain is on the outside of the thigh and often there is point tenderness directly over the greater trochanter.
Iliopsoas Bursitis
The iliopsoas bursa is located inside the groin overlying the front of the hip joint. Patients may have pain in the front of the thigh or pain with bending the hip against resistance.
Ischial Bursitis
The ischial bursa is located between the gluteal muscles and the ischial tuberosity in the buttocks. Pain may be present with walking or after sitting down. The ischial tuberosity becomes a weight bearing surface during sitting and the bursa can become irritated when sitting.
References
- American Academy of Orthopaedic Surgeons: Hip Bursitis
- "AAOS Comprehensive Orthopaedic Review"; Dr. Jay Lieberman (editor); 2008.
- "The Sports Medicine Patient Advisor"; Dr Pierre Rouzier; 2004.
