Hip Bursitis Information

Is hip pain making walking, sleeping or everyday activities increasingly uncomfortable?

Perhaps you're finding it painful to lie on your side at night, climb a flight of stairs or go for your usual walk. Even getting up from a chair after sitting for a while can become surprisingly uncomfortable.

If you've been diagnosed with hip bursitis, you'll know just how frustrating these seemingly simple activities can become.

Hip bursitis occurs when one of the small fluid-filled sacs surrounding the hip becomes inflamed. It can develop following an injury, repetitive strain or changes affecting the tissues around the hip.

Understanding what causes hip bursitis, where the pain comes from and how the condition is diagnosed can help you make more informed decisions about managing your symptoms.

What Is Hip Bursitis?

Your hip is a large, weight-bearing joint that allows you to walk, run, bend and move comfortably throughout the day.

Surrounding the hip are several small, fluid-filled sacs called bursae. Their job is to act as cushions, helping reduce friction between bones, muscles and tendons as they move against each other.

When one of these bursae becomes irritated or inflamed, it can cause pain, tenderness and discomfort. This condition is known as hip bursitis.

Because we rely on our hips for so many everyday movements, even relatively mild inflammation can become surprisingly troublesome.

And unlike bursitis affecting more superficial joints, swelling around the hip may not be visible from the outside.

What Are the Different Types of Hip Bursitis?

Hip bursitis can affect several locations around the hip and pelvis. Two conditions worth understanding are trochanteric bursitis and ischial bursitis, as they can cause pain in quite different areas.

Trochanteric Bursitis

Trochanteric bursitis affects the bursa located over the greater trochanter, the bony prominence on the outside of your upper thigh.

It commonly causes pain along the outer side of the hip, which may extend down the outside of the thigh. You might notice discomfort when lying on the affected side, walking longer distances or climbing stairs.

An important distinction is that not all pain in this area is caused by bursitis alone.

The surrounding gluteal tendons can also contribute to symptoms. Healthcare professionals often use the term greater trochanteric pain syndrome (GTPS) to describe pain arising from these structures. [1]

>> Learn More About Trochanteric Bursitis →

Ischial Bursitis

Ischial bursitis affects a bursa located beneath the pelvis, near the bony areas we sit on, commonly known as the sitting bones.

Unlike trochanteric bursitis, which generally causes pain along the outside of the hip, ischial bursitis typically produces discomfort lower down in the buttock. Pain may become particularly noticeable when sitting for prolonged periods, especially on hard surfaces.

Activities involving repeated pressure or strain around the affected area can also aggravate symptoms.

>> Learn More About Ischial Bursitis →

Other bursae surrounding the hip can also become inflamed, including the iliopsoas bursa towards the front of the hip, which may cause groin pain.

The location of your discomfort can provide useful clues, but it doesn't necessarily confirm which structure is responsible.

What Causes Hip Bursitis?

Hip bursitis can develop for several reasons, and it isn't limited to athletes or people performing strenuous physical activities.

In fact, ordinary activities can contribute to irritation, particularly when they repeatedly place pressure or strain on the tissues surrounding the hip.

Common contributing factors include:

• Repetitive strain: Running, cycling, prolonged walking or regularly climbing stairs can place additional demands on the hip.

• Direct injury: A fall or impact onto the side of the hip may trigger inflammation.

• Age-related changes: Changes affecting the tendons and other soft tissues around the hip can contribute to irritation and discomfort.

• Muscle weakness or altered movement: Weakness around the hip or changes in walking patterns may increase stress on certain structures.

• Underlying medical conditions: Some forms of arthritis and inflammatory conditions can increase susceptibility to bursitis.

Sometimes, several factors contribute rather than one particular injury.

For example, someone who has recently increased their walking distance or returned to exercise after a period of inactivity may begin experiencing discomfort without recalling any specific injury.

What Are the Common Symptoms of Hip Bursitis?

The symptoms of hip bursitis can vary depending on which bursa is affected and whether other surrounding tissues are involved.

Common symptoms include:

• Pain around the hip: Usually felt on the outside of the hip, although some types of bursitis can cause pain towards the buttock or groin.

• Pain when lying down: Particularly when sleeping directly on the affected side.

• Discomfort when walking: Pain that becomes more noticeable during prolonged walking, running or climbing stairs.

• Tenderness around the hip: Increased sensitivity when pressure is applied to the affected area.

• Pain after sitting: Discomfort when getting up from a chair or following periods of inactivity.

• Restricted activities: Difficulty enjoying normal exercise, recreational activities or certain household tasks.

One frustrating aspect of hip bursitis is that symptoms don't always follow a predictable pattern.

You might manage reasonably well during the day, only to experience increased discomfort when trying to find a comfortable sleeping position at night.

Alternatively, a longer walk or unusually active day may leave your hip feeling more uncomfortable afterwards.

Can Hip Bursitis Affect Both Hips?

Yes. Hip bursitis and related conditions can affect either the left or right hip, and occasionally both sides at the same time.

When symptoms occur on both sides, the condition is described as bilateral hip bursitis if inflammation of the bursae has been confirmed.

Sometimes, discomfort on one side can alter the way you walk or distribute your body weight, placing additional demands on the opposite hip.

However, pain affecting both hips doesn't necessarily mean both bursae are inflamed.

Other conditions, including problems involving the hip tendons, joints or lower back, may produce similar symptoms.

If you're experiencing persistent pain in both hips, an appropriate medical assessment can help identify the underlying cause.

How Is Hip Bursitis Diagnosed?

Because several conditions can cause hip pain, obtaining an accurate diagnosis is important before deciding on treatment.

A healthcare professional will generally begin by discussing your symptoms, medical history and any activities that make the pain worse.

They may examine the hip to identify areas of tenderness, assess your range of movement and check whether certain movements reproduce your discomfort.

In many cases, this information is sufficient to make an initial clinical diagnosis.

However, additional investigations may be recommended if the cause remains uncertain or another condition is suspected.

X-rays: X-rays can help identify arthritis, fractures or other bone-related problems that may be contributing to hip pain. However, they don't directly show inflammation within the bursa.

Ultrasound: An ultrasound scan can help assess the bursae and surrounding soft tissues, including signs of fluid accumulation or tendon problems.

MRI Scan: An MRI may be recommended when a more detailed examination of the hip's tendons, bursae and surrounding structures is required.

Not everyone with suspected hip bursitis needs imaging. A clinical examination is often the starting point, with additional tests considered where appropriate. [2]

When Should You Seek Medical Attention?

If hip pain persists, worsens or begins interfering significantly with your sleep, walking or everyday activities, it's worth arranging an assessment with a qualified healthcare professional.

Seek urgent medical advice if you experience severe hip pain following a fall, an inability to bear weight, or a hot, swollen joint accompanied by fever.

Because hip pain can arise from several different conditions, identifying the underlying cause is an important first step towards selecting appropriate treatment.

What Are the Treatment Options for Hip Bursitis?

If you've been struggling with hip bursitis, your first priority is understandably to find some relief.

The good news is that many cases can improve with appropriate conservative management.

Treatment may involve reducing activities that aggravate the affected area, managing discomfort and, where appropriate, introducing rehabilitation to restore strength and movement.

However, the best approach depends on the underlying cause of your symptoms, particularly whether the problem involves an inflamed bursa, surrounding tendons or both.

Some people may also wish to explore drug-free, non-invasive home treatment options to help manage swelling and associated pain.

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>> Learn More About OSMO Patch for Effective Hip Bursitis Relief →

Frequently Asked Questions About Hip Bursitis

Where Is Hip Bursitis Pain Usually Felt?

Hip bursitis commonly causes pain along the outside of the hip, particularly over the bony area of the upper thigh. However, the location depends on which bursa is affected. Some forms of hip bursitis can cause discomfort in the buttock or towards the groin.

Why Does Hip Bursitis Hurt More at Night?

Hip bursitis can become particularly uncomfortable at night, especially when lying on the affected side. The pressure placed on the sensitive tissues around the hip may aggravate the pain, making it difficult to find a comfortable sleeping position and disrupting your sleep.

Can Hip Bursitis Cause Pain Down Your Leg?

Yes. Hip bursitis and related conditions can cause pain that extends from the outside of the hip down the thigh, sometimes towards the knee. However, pain extending below the knee, particularly with numbness or tingling, may indicate another condition requiring medical assessment.

Is Hip Bursitis the Same as Hip Arthritis?

No. Hip bursitis affects the fluid-filled sacs that cushion tissues around the hip, while hip arthritis involves changes within the joint itself. Arthritis often causes pain towards the groin and may restrict hip movement, whereas bursitis commonly causes tenderness around the outside of the hip. Symptoms can overlap, so a proper diagnosis is important.

Can Walking Make Hip Bursitis Worse?

Yes. Walking, particularly over longer distances or on uneven ground, can aggravate symptoms by placing additional stress on the affected tissues. However, complete inactivity isn't generally necessary. Adjusting your walking distance and avoiding activities that significantly increase discomfort may help while the condition is assessed and managed.

Can Hip Bursitis Be Diagnosed Without an MRI?

Yes. A healthcare professional can often make an initial diagnosis based on your symptoms, medical history and a physical examination. Imaging isn't always necessary, although ultrasound or MRI may be recommended when the diagnosis is uncertain or other hip conditions need to be investigated.

Medical References

[1] Healthdirect Australia: Greater Trochanteric Pain Syndrome (GTPS). Read Healthdirect Australia's guidance

[2] American Academy of Orthopaedic Surgeons (AAOS): Hip Bursitis. Read the AAOS medical resource

[3] Cleveland Clinic: Ischial Bursitis – Causes, Symptoms and Treatment. Read Cleveland Clinic's guidance