DEFINITION--Inflammation of the bursa surrounding either of the big knobs of bone (trochanters) at the top of the femur (thigh bone). Bursitis may vary in degree from mild irritation to an abscess formation that causes excruciating pain.
BODY PARTS INVOLVED
One of two bursas in the hip joint where the trochanters fit into their socket. A bursa is a soft sac filled with lubricating fluid that facilitates motion in the hip and protects it from injury.
Soft tissue surrounding the hip joint, including nerves, tendons, ligaments, blood vessels (both large vessels and capillaries), periosteum (the outside lining of bone) and muscles.
SIGNS & SYMPTOMS
Pain in the hip.
A "crackling" feeling when moving the hip.
Redness (sometimes) over the affected bursa.
A "snapping" noise with stepping or other hip motion.
Fever if infection is present.
Limitation of motion in the hip.
Injury to the hip.
Acute or chronic infection.
RISK INCREASES WITH
Participating in competitive athletics, particularly contact sports.
Running and bouncing activities.
Previous history of bursitis in any joint.
Exposure to cold weather.
Poor conditioning and inadequate warmup.
Inadequate protective equipment in contact sports.
HOW TO PREVENT
Use protective gear such as hip pads for contact sports.
Warm up adequately before athletic practice or competition.
Wear warm clothing in cold weather.
To prevent recurrence, continue to wear extra protection over the hips until healing is complete.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis and treatment.
Surgery (sometimes), particularly for a frozen hip.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the hips.
Permanent limitation of the hip's normal mobility.
Prolonged healing time if activity is resumed too soon.
Proneness to repeated flare-ups.
Unstable or arthritic hip following repeated episodes of bursitis.
Spontaneous rupture of bursa if severe infection is present.
Hip bursitis is a common--but not a serious -- problem. Painful symptoms usually subside in 3 to 4 weeks with treatment, but they frequently recur.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNone. This problem develops slowly.
Use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
After 72 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
Use crutches to prevent weight-bearing on the hip joint, if needed. See Appendix 3 (Safe Use of Crutches).
Elevate the hips above the level of the heart to reduce swelling and prevent accumulation of fluid. Use pillows for propping.
Gentle massage will frequently provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
Non-steroidal anti-inflammatory drugs.
Antibiotics if the bursa is infected.
Prescription pain relievers for severe pain. Use non-prescription aspirin, acetaminophen or ibuprofen (available under many trade names) for mild pain.
Injections with a long-lasting local anesthetic mixed with a corticosteroid drug, such as triamcinolone.
ACTIVITYRest the inflamed area as much as possible. If you must resume normal activity immediately, use crutches until the pain becomes more bearable. To prevent a frozen hip, begin normal, slow joint movement as soon as possible.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.
REHABILITATIONSee section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have symptoms of hip bursitis.
Pain increases despite treatment.
Pain, swelling, tenderness, drainage or bleeding increases in the surgical area.
You develop signs of infection (headache, muscle aches, dizziness or a general ill feeling and fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.