Tendons link muscles to bones. Inflammation of these strong tissue cords in your hip causes pain, swelling, and discomfort. Hip tendonitis is usually caused by injury, strain, or overuse—including overexercising. Hip tendonitis may indicate diabetes, infection, or rheumatoid arthritis. Joint bursae are small, fluid-filled pads. Bursitis is pain caused by bursae inflammation. Bursitis predominantly occurs in joints subjected to repetitive motion, such as the hip, shoulder, and elbow.
Hip Bursitis Types
Hip bursitis can affect outside or inside bursae. The site and infection of the bursa dictate the classification of hip bursitis. The primary types of hip bursitis are:
- Trochanteric bursitis: The trochanter is the osseous prominence located on the lateral aspect of the hip at the superior end of the femur. Pain in the outer hip and outer thigh may be attributed to trochanteric bursitis.
- Ischial or iliopsoas bursitis: Inflamed bursae on the groin side of the hip can cause groin or upper buttock pain.
- Septic hip bursitis: Infected hip bursae are called septic hip bursitis. Septic hip bursitis may be accompanied by fever, fatigue, and malaise.
What are Hip Bursitis and Tendinitis?
Hip abductor tendinopathy and trochanteric bursitis can both cause pain on the side of the hip. Bursas are sacs filled with fluid that are found between soft tissues and bony protrusions. Bursitis is an inflammation that can be caused by a number of things (see below). When you have trochanteric bursitis, the bursa between the trochanter of the femur and the gluteus medius and minimus (hip abductor) tendons gets swollen and hurt. On the other hand, tendinitis is the first word for damage or inflammation of a tendon.
The inflammatory response goes away after a few weeks, but tendinosis is still there because of long-term changes in the tendon. Tendinopathy is made up of tendinitis and tendinosis. By attaching to the trochanter, the gluteus medius and minimus tendons pull the hips back. Hip abductor tendinopathy can happen when these tendons become inflamed, hurt, or wear down. When trochanteric bursitis and hip abductor tendinopathy happen at the same time, they make trochanteric pain syndrome worse.
What Makes Hip Bursitis and Tendinitis Happen?
Hip bursitis and tendinitis are more likely to happen if you have a focal lateral hip injury, overuse injuries (like from walking or running for long periods of time), had hip surgery in the past, or have changed biomechanics and/or gait because of bad posture, scoliosis, spine or hip problems, or leg length differences.
Bursitis and Hip Tendonitis Symptoms
Hip tendonitis/bursitis symptoms include:
- Hip joint grating—a grinding sensation while moving.
- Hip pain or throbbing when moving hip tendons.
- Stiffness—at rest and while moving.
- Joint/tendon swelling—fluid and inflammation.
- Hip tenderness.
Diagnose Hip Tendonitis and Bursitis
Your doctor reviews your health history and examines you.
If more tests are needed to diagnose hip pain, your doctor may recommend:
- MRI uses a magnet, radio waves, and a computer to create hip images.
- Invisible electromagnetic energy beams called X-rays image the hop and its soft tissues. Your doctor will recommend this arthritis test. X-rays can show damage to bones from arthritis but not to tendons.
Hip Bursitis and Tendonitis Treatment
Your hip pain doctor in Dallas may prescribe any of the following to treat tendonitis and get you back to your best. Treatment for hip tendonitis may ease pain and swelling:
- Cortisone injections into the hip joint reduce pain and swelling.
- Physical therapy—muscle-building and range-of-motion exercises.
- Rest, ice, compression, and elevation (RICE)
- Surgery (rare)
- Atopic anti-inflammatory gels
- Hip bursitis treatments include:
- Antibiotics—Dallas pain clinic doctors may prescribe antibiotics for infectious bursitis.
- Putting cortisone into the bursae lowers the pain and inflammation.
- Physical therapy—muscle-building and range-of-motion exercises.
- Surgery to drain bursae.
- Therapeutic contrasting—using ice packs and heating pads to quickly change tissue temperature.
Surgical Intervention
Hip bursitis rarely requires surgery. If the bursa is still painful and inflamed after all nonsurgical treatments, your doctor may suggest removing it. Taking out the bursa doesn’t hurt the hip, and it can work normally without it. Arthroscopy for bursa removal is becoming more popular. This method removes the bursa through a 1/4-inch hip incision. During bursa excision, the physician employs an arthroscope to navigate minuscule surgical instruments through an additional incision.
This less invasive surgery recovers faster and is less painful than open surgery.Both surgeries are outpatient (same-day), so hospitalization is rarely needed. Recent studies indicate that arthroscopic bursa excision is efficacious; however, further investigation is required.
Rehabilitation and Prevention
After surgery, rehabilitation is brief. Walking the night after surgery is fine. Most patients find a cane or crutches helpful for a few days. Pain from surgery diminishes after several days. Although hip bursitis and tendonitis may not be entirely preventable, inflammation can be mitigated:
- Avoid repetitive hip-stressing activity.
- Lose weight if needed.
- Make sure your shoe insert fits leg-length differences.
- Keep hips strong and flexible.
Conclusion
Doctors can diagnose hip bursitis or assist you in identifying the origin of your hip pain. The orthopedic team can diagnose your tendonitis and bursitis and provide customized treatment. After hip tendonitis Integrative therapies like acupuncture, physical therapy, and minimally invasive surgery may help you move comfortably again.