Hip Bursitis: Symptoms and Diagnosis
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A similar pattern of symptoms can develop with hip bursitis and tendonitis. Common symptoms of both of these conditions are pain a the outside of the hip, pain to cross legs or lie on your side, and pain to walk, run or climb stairs. A difference is the quality of the pain. Bursitis is often described as hot, and can look and feel swollen. Often, it is more painful to touch than tendonitis. Hip bursitis most often affects the greater trochanteric bursa on the outside of the hip. This bursa sits between the boney prominence of the femur, thigh bone, and gluteus maximus muscle. The attachment of the gluteal muscles to the femur at this location is via tendons. Hence why there are such similarities between these two pathologies as they are in a similar location but affecting different structures. The best way to get a diagnosis is to see an experienced physical therapist. You can click the link to read more about Hip Bursitis Symptoms and Diagnosis.
Hip arthritis has more unique symptoms compared to hip bursitis than other pathologies like tendonitis. Arthritis is a painful condition but is usually accompanied by stiffness and a reduced range of movement of the joint, which would not be experienced with bursitis. Arthritis and bursitis, however, both develop gradually over time in most cases. But they can also be triggered or exacerbated by an acute event. Bursitis will generally get worse with activity, while arthritis can feel more painful and stiff at the start, and usually, the joint feels like it “warms up” over the first 20-30 minutes of exercise. Both will feel pain with impact and have similar specific positions that aggravate pain. These positions are internal rotation, adduction and flexion of the hip. A difference that will be seen on assessment is that bursitis may be painful with these positions, but the range of movement will not be restricted. With arthritis, typically, pain and restriction will be seen together.
A gluteal hip bursitis and labral tear can both cause pain in the hip area, but the difference between these two pathologies are the location of pain and some specific symptoms. A hip labral tear will usually present with pain that wraps around the outside of the hip, often in a “C” shape made by putting your index finger and thumb around your hip. In contrast, hip bursitis pain is usually a patch on or just behind the boney prominence of the femur at the side of the hip, rarely felt at the front. Another bursitis at the hip is at the hip flexor and this will only be felt at the front of the hip, rarely anywhere else. A labral tear can also produce sounds when the hip moves, like a click or a sensation of a clunk, both absent with bursitis. You can click the link to read more about Hip Labral Tear.
Following hip replacement, common complications involve the muscles around the hip. This is because these muscles are cut through to access the hip for the surgery. As these muscles recover and repair, they can feel weak and tight, putting more pressure on the bursae around the hip. Typically after hip replacement surgery, you will receive physical therapy, and your therapist will be aware of this likely complication. Recovery will include specific muscle strengthening exercises, pain relief with ice packs, activity modification, and anti-inflammatory medications. In more severe or persistent cases, cortisone injections may be offered to help reduce pain.
Yes. Bursitis can cause IT band pain. The gluteal muscles function to perform movements at the hip and provide stability to the pelvis. The IT band also have functions to assist hip movements and pelvis stability. Gluteal muscle weakness is a common contributing factor or cause of bursitis. Gluteal weakness can also cause the IT band and the TFL (tensor fascia lata muscle) at the top of the band to work more and tighten, causing pain. You can click the link to read more about Iliotibial Band Syndrome.
Hip bursitis can be a mistaken diagnosis for sciatica pain. A common area of pain with sciatica is in the buttocks, where hip bursitis that affects the ischiogluteal bursa is also felt. The ischiogluteal bursa sits over the seat bone to protect the gluteus maximus muscle, and the sciatic nerve is the main nerve from the lower back that supplies the back and outside of the leg. Both can be aggravated or developed after sitting for long periods of time and relieved by standing, so differentiating the diagnosis can be difficult. In a clinical assessment, differentiation tests include palpation of the area, neural tension positions, as well as hip and lower back movements.
Yes. The issues contributing to the development of hip bursitis can also contribute to the development of back pain. Weakness of the gluteal muscle and the resultant poor stability and biomechanics of the pelvis can cause the muscle in the back to work more. This can result in fatigue and pain of these muscles.
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments.