Check-up: Hip Bursitis

I developed pain in my hip last week, which has been diagnosed as acute trochanteric bursitis. What is this?

Bursae (singular: bursa) are small, fluid-filled pads that act as cushions among bones, tendons and muscles near the joints.

Bursitis is a painful condition that occurs when the bursa becomes inflamed. The most common locations for bursitis are in the shoulders, elbows or hips. Bursitis can also affect the knee, heel and big toe.

Bursitis often develops in joints involved in frequent repetitive movements. Acute bursitis develops over hours or days. The affected area is usually painful when moved or touched. Acute bursitis caused by an infection or gout may be particularly painful.

Chronic bursitis may result from repeated or persistent bouts of acute bursitis or repeated injuries.

Flare-ups of chronic bursitis may last a few days to several weeks, and frequently recur.

The pain in my hip is so bad at times that it prevents me from walking any distance and disturbs my sleep.

There are two major bursae of the hip, the trochanteric bursa and the ischial bursa. Inflammation of either can be associated with stiffness and pain around the hip joint.

The trochanteric bursa is located on the side of the hip. Trochanteric bursitis can cause tenderness of the outer hip with pain extending from the outer thigh down to the knee. It can make it difficult to lie on the affected side, frequently causing difficulty with sleep. Activities such as walking, climbing stairs and standing can increase pain.

Apart from rest and painkillers, is there any other treatment?

Treatment typically involves resting the affected joint and protecting it from further trauma.

In most cases, bursitis pain goes away within a few weeks, although flare-ups are common. Acute bursitis, if not caused by an infection, is usually treated with rest, ice, and non-steroidal anti- inflammatory drugs. Stronger painkillers may be needed if pain is severe. An injection of local anaesthetic and a corticosteroid directly into the bursa can bring about relief a few days following the injection.

In severe cases of acute bursitis, corticosteroids may be given orally for a few days. Infected bursas are drained and antibiotics prescribed.

Chronic bursitis, if not caused by an infection, is treated in a similar way to acute cases, although rest and immobilisation are less likely to help.

Physiotherapy can help strengthen weakened muscles and re-establish the joint’s full range of motion.