Bursitis of the hip

Overview

Bursitis of the hip is a condition where the small, fluid-filled sacs (called bursae) that cushion the hip joint become swollen and painful. These sacs help reduce friction between bones, tendons, and muscles. When they get irritated, it can cause pain and make it hard to move your hip comfortably.

Yes, hip bursitis is a common problem, especially in middle-aged and older adults. It is also common in people who are very active or who have jobs that involve a lot of walking, climbing, or sitting on hard surfaces.

Hip bursitis can affect anyone, but it is more common in women, people over 40, and those who do repetitive activities like running, cycling, or standing for long periods. It also affects people who have had a hip injury or surgery.

Symptoms

Common symptoms

• Pain on the outer side of the hip that may spread down the thigh
• Pain when lying on the affected hip
• Pain when getting up from a chair or after sitting for a long time
• Tenderness and swelling over the hip joint
• Pain that gets worse with walking, climbing stairs, or other activity

Symptoms in children

• Hip bursitis is rare in children, but if it occurs, symptoms may include limping or complaining of pain in the hip or groin area.

Symptoms in older adults

• Older adults may notice a dull ache on the outer hip that worsens at night or when lying on that side.
• They might have difficulty walking or a sense of instability in the hip.

Causes

Main causes

• Repeated stress or overuse of the hip joint, such as from running, cycling, or standing for long periods
• Direct injury to the hip, like from a fall or bump
• Poor posture or leg length difference that puts extra pressure on the hip
• Infection (more rare, but can occur if bacteria enter the bursa through a wound)

Risk factors

• Being over 40 years old
• Being female (more common in women)
• Having a job that requires kneeling, squatting, or standing on hard surfaces
• Having a condition like arthritis, gout, or diabetes
• Previous hip surgery or hip replacement

When to see a doctor

See a doctor urgently if:

• If you have signs of infection: fever, chills, redness, or hot skin around the hip
• If you cannot bear any weight on your leg or move your hip at all

Book a routine appointment if:

• If your hip pain does not get better after a week of home care (rest, ice, over-the-counter pain relievers)
• If the pain is severe enough to interfere with your sleep or daily activities

Diagnosis

Your doctor will ask about your symptoms and activities, and then examine your hip. They will press on different areas to find where it hurts and check your range of motion.

Tests that may be done

• X-ray: to rule out other problems like arthritis or bone spurs
• Ultrasound: to see if the bursa is swollen or filled with fluid
• MRI: if the diagnosis is not clear or to look for deeper problems

What to expect at your appointment

Your doctor will likely diagnose hip bursitis based on your symptoms and physical exam. Imaging is not always needed unless there is concern about another condition. The appointment usually takes 15-30 minutes. No special preparation is needed.

Treatment

Treatment for hip bursitis focuses on reducing inflammation and preventing further irritation. Most people get better with simple home care and avoiding activities that cause pain. In some cases, more advanced treatments may be needed.

Self-care at home

• Rest the hip by avoiding activities that cause pain, like running or climbing stairs
• Apply ice packs to the painful area for 15-20 minutes several times a day
• Take over-the-counter pain relievers (such as ibuprofen or naproxen) to reduce swelling and pain. Always follow the instructions on the label and check with a doctor if you have other health conditions
• Do gentle stretches as recommended by a physical therapist
• Use a cushion or pillow when sitting to reduce pressure on the hip

Medical treatments

If self-care is not enough, a doctor may recommend physical therapy to strengthen and stretch the muscles around the hip. They might also suggest a corticosteroid injection (a strong anti-inflammatory medicine) directly into the bursa to reduce swelling. In rare cases, when other treatments fail, a procedure called aspiration (draining fluid) or surgery to remove the bursa may be considered. Your doctor will discuss the risks and benefits with you.

When is surgery considered?

Surgery is rarely needed for hip bursitis. It may be considered if symptoms persist for months despite other treatments. The surgery (bursectomy) removes the inflamed bursa. Recovery usually takes a few weeks.

Living with this condition

Living with hip bursitis means being mindful of your activities. Avoid movements that cause pain, such as crossing your legs or lying directly on the affected hip. Use a supportive chair and sleep on your back with a pillow between your knees if needed.

Lifestyle tips

• Take breaks from sitting or standing for too long
• Wear comfortable, supportive shoes
• Avoid high-impact exercises like running until the pain resolves
• Try low-impact activities such as swimming or cycling on a recumbent bike

Diet and exercise

Eating a balanced diet helps maintain a healthy weight, which reduces stress on your hips. Gentle exercises like stretching, walking, and water aerobics can keep muscles strong without irritating the bursa. Always warm up before exercise and cool down afterward.

Mental health and emotional wellbeing

Living with chronic pain can be frustrating and may affect your mood. It is normal to feel anxious or down at times. If you notice your mood is affecting your daily life, talk to your doctor. Remember, help is available. If you are in crisis, contact your local crisis support line or emergency services.

Prevention

You can reduce your risk of hip bursitis by avoiding repetitive activities that put pressure on your hips. Warm up properly before exercise, strengthen the muscles around your hips (glutes, thighs, and core), and use proper technique in sports. If your job requires prolonged standing or kneeling, take breaks and use padding.

Vaccines

There is no vaccine for hip bursitis.

Screening programmes

There is no routine screening test for hip bursitis. If you have symptoms, see a doctor for evaluation.

Complications

If left untreated

• Chronic pain that lasts for months or longer
• Weakening of the muscles around the hip from disuse
• Thickening of the bursa (fluid-filled sac) which may lead to a permanent lump
• Rarely, if an infection is present, it can spread to the joint or other parts of the body (septic arthritis or sepsis)

Long-term outlook

The outlook for hip bursitis is very good. Most people recover completely with rest and simple treatments. Even when symptoms last longer, modern treatments including physical therapy and injections can help. Hip bursitis rarely leads to long-term problems, and you can usually return to normal activities once the inflammation settles.

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