Hip Bursitis: The Pain is Not What You Think

Hip Pain is a frequent complaint causing patients to seek treatment from their physician. Typically symptoms coming from hip structures will cause pain in the groin, buttock, or outer hip and may even radiate down the leg. Often pain occurring on the outside of the hip will worsen when walking or rising from a chair. There may also be difficulty sleeping as lying on one’s side will create great discomfort; touching the outer hip may cause extreme soreness and pain. Hip bursitis is often blamed for causing this type of hip pain, however research has shown this is not accurate.

While there are many causes of hip pain including degenerative arthritis, cartilage tears, and even pain referred from the lower back, one common diagnosis patients receive is “hip bursitis”. Bursae are tiny flat sacs of fluid, which exist throughout our skeletal system. In the hip, these are located between bone and overlying hip tendons known as the gluteal tendons. They are important in reducing friction created when these structures move against one another and when weight is applied.

Based on research using MRI and ultrasound, pain on the side of the hips is not so much stemming from inflamed bursal sacs, but rather from the overlying gluteal tendons, which become scarred, thickened, and in many cases, torn. These function similarly to the rotator cuff tendons of the shoulder and become worn from either weakness of the hip girdle muscles, scoliosis, leg length discrepancies, or inflexibilities about the lower limb. Women tend to have this condition more frequently than men due to a wider pelvis, creating more stress on the “cuff” tendons.

Various treatments exist but often require a comprehensive treatment strategy for the best possible outcomes. If hip pain persists despite typical RICE strategies, it may be worthwhile to have the “rotator cuff” tendons of the hip examined by your physician. So remember:

• There are many causes of hip pain
• Pain on the side of the hip may be caused by multiple factors
• Hip bursitis is actually an UNCOMMON cause of hip pain
• Treatment often requires a multimodal approach

Paul Lento, MD is a Physical Medicine & Rehabilitation Physician and is triple board certified and a Castle Connolly Top Doc. At SOA we are committed to getting you back on your feet, back to work, back in the game, and back to life.