Hip bursitis is a condition involving the inflammation of bursae, the small sacs or pockets or fluid between bones and tissue within the hip. Bursae are jelly like sacs present throughout the body including hip, knee, ankle, shoulder and elbow. They contain small amount of fluid and acts like a cushion and absorb the friction. The bursae serve the purpose of reducing the friction during movement of the hip joint. In the hip, there are two main areas that are affected by bursitis. On the end of hip bone, there is one bursa called the greater trochanter. There is another bursa on the inner side of the hip (groin), the iliopsoas, which can also become inflamed.
ANATOMY OF HIP BURSAE
Overuse or repetitive motion injury, or any excess strain on the hip joint, can lead to hip bursitis, the inflammation of the bursae in the hip. Avid runners, especially those who run on unlevel terrain or use stair-climbing exercises regularly, may be at a higher risk for bursitis. Other risk factors include previous hip injury or surgery, spine related problems, difference in leg length, rheumatoid arthritis, and bone spurs or calcium deposits around trochanter.
The first symptom is pain in the hip, both during movement and while idle. It may be uncomfortable or painful to lay or sit on the affected area. The pain may be sharp at the onset of the condition, but often becomes more dull or aching after a while. The pain can become worse with lying down on affected side at night, getting up from chair, getting in and out of car and also can get worse with prolonged sitting, standing and walking.
A physician can diagnosis bursitis by tracking the patient’s descriptions and history of pain and discomfort, and by performing a clinical exam to locate the specific areas of pain and tenderness. Other tests may be used, such as an x-ray and MRI to rule out other possible causes of hip pain.
Treatments include anti-inflammatory medications, cold compresses, and occasionally, the draining of excess bursa fluid. Cortisone injections may also be used. Loss of weight may be suggested, as well as physical therapy to ease use of the hip joint. In more severe cases, surgical removal of the bursa fluid or the affected bursa itself may be necessary. Surgery can be performed open or arthroscopically. Arthroscopic removal bursa is less invasive and recovery is quicker. Both types of operations are same day outpatient procedures.
REHAB AFTER OPERATION
For first few days, crutches or cane are required for ambulation and a hip brace depending on simultaneous other issues in hip addressed during the operation like hip gluteus medius tendon repair, labral repair or IT band release or trimming down of bone spurs which are commonly associated findings in patients with hip bursitis in athletic people. Physical therapy is usually 6 weeks to 3 months depending on severity of condition and associate sd pathologies in the hip.
Hip bursitis can be prevented by avoiding repetitive activities that initiates the stress on hips, weight reduction, stretching exercises of IT band (Iliotibial band) and iliopsoas muscle, strengthening other muscles around hip, shoe lift to equalize leg length difference.
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