The Truth About Hip Pain: From Bursitis To Osteoarthritis

When patients are diagnosed with hip bursitis, many are surprised, often exclaiming, “Bursitis? Isn’t that just for old folks?” The reality is, bursitis can affect people of all ages.

Hip pain can stem from a variety of causes, and each one presents its own set of symptoms. One common cause is injury to a lumbar nerve root, which affects the nerves that exit the lumbar spine and travel down into the hip, groin, and legs. Infections in the hip joint or pelvis can also result in hip pain, often accompanied by redness, warmth, and swelling, and must be treated medically. Trauma such as falls, car accidents, or sudden athletic injuries can cause fractures of the femur (thigh bone) or pelvis, leading to significant hip pain.

When trauma occurs, it’s common to notice a thick, boggy swelling around the hip, indicating bleeding from a fractured bone or torn ligament. Muscles and tendons around the hip can also become overused or injured, especially in athletes or “weekend warriors.” Avascular necrosis, where the blood supply to the femoral head is lost, can also cause hip pain. Osteoarthritis, often seen in middle-aged and older adults, may develop due to a previous injury that didn’t heal well, leaving long-term damage. In some cases, osteoarthritis arises from years of overuse or congenital deformities. Gout, caused by uric acid crystals accumulating in the joint, can also contribute to hip pain. Other inflammatory arthritides like rheumatoid arthritis and Reiter’s syndrome are also known causes of hip discomfort.

However, despite all these potential causes, bursitis remains the most common.

What is Hip Bursitis?

A bursa is a small, fluid-filled sac that reduces friction between moving parts, such as between muscles and bones or ligaments. Bursae are found in many areas of the body, particularly near large joints like the shoulders, elbows, knees, and hips. The hip has 13 bursae, with the trochanteric bursae being the most prone to inflammation. Located just above and below the “point” of the hip, these bursae are directly affected if you bump the side of your hip against something.

What Causes Hip Bursitis?

Bursitis occurs when the bursa becomes inflamed. While infections, inflammatory arthritis (like gout or rheumatoid arthritis), and trauma can lead to bursitis, the most common cause is overuse and abnormal motion.

Symptoms of Hip Bursitis

When bursitis occurs in the hip, pain is typically felt when direct pressure is applied to the inflamed bursa. This pain can range from sharp tenderness to a deep, dull ache, often radiating down the thigh and even reaching the knee. Hip bursitis is frequently misdiagnosed as a lumbar spine problem because of the similar pain patterns. In some cases, swelling may appear over the affected area, especially if the trochanteric bursae are involved. One of the most common complaints among sufferers is pain at night. Lying on the affected side can be especially painful and disrupt sleep, and even lying on the unaffected side may cause the affected hip to ache.

Treating Hip Bursitis

Once bursitis is diagnosed, treatment can be highly effective and typically includes:

Rest and Ice: Limiting movement and applying ice to the inflamed area can help reduce pain and swelling.
Physical Therapy: Specific exercises can improve flexibility and strengthen the muscles around the hip to prevent future issues.
Chiropractic Care: Chiropractic adjustments can restore proper movement patterns in the hip and alleviate stress on the affected area, reducing pain.
Medication: Over-the-counter anti-inflammatory drugs (NSAIDs) may help manage inflammation and pain.
Corticosteroid Injections: For more severe cases, injections can provide relief by reducing inflammation in the bursa.

Other Causes of Hip Pain:

While bursitis is the most common cause, other issues can contribute to hip pain:

Arthritis: Osteoarthritis, particularly, can cause pain in the hip joint due to wear and tear on the cartilage.
Fractures: Trauma or accidents can result in fractures to the femur or pelvis, leading to significant pain.
Tendonitis: Overuse or injury can cause inflammation in the tendons surrounding the hip.
Avascular Necrosis: When the blood supply to the femoral head is compromised, it can lead to bone death, causing pain and mobility issues.

Although hip bursitis is the most common cause of hip pain, it is important to consider other potential causes such as arthritis, fractures, tendon injuries, or avascular necrosis. A proper evaluation by a healthcare provider will help determine the cause of your hip pain and guide you toward the most effective treatment plan. Early diagnosis and treatment can lead to quicker recovery and a return to normal, pain-free function.

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(901) 377-2340

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Dr. Richard L. Cole, DC, DACNB, DAIPM, FIACN, FICC
Dr. Jeffrey D. Luebbe, DC, CCRD, CCSP
Dr. W. Steven Vollmer, DC, DAAPM
Dr. Bradford J. Cole, DC, MS, CSCS
Dr. J. Colby Poston, DC
Dr. Daniel Smith, DC
2845 Summer Oaks Dr., Memphis, TN 38134
(901) 377-2340

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