Posted on September 30 2017
Hip Pain/Hip Injuries are a rapidly growing epidemic amongst aging baby boomers. Fact is, individuals are living longer, playing harder, and participating in sports or related activities year round. As a result, more wear and tear are being exposed to their hip joints resulting in hip pain or injury. According to the CDC, in 2010 over 310,000 people in the U.S. had a total hip replacement (THR) surgery. This was near double the amount of THR's performed in 2000 just 10 years prior. Improved surgical techniques coupled with shorter hospital stays also contributed to the linear trend. However, not all hip conditions resulting in pain end up in a surgical fix or even a new artificial hip.
One of the most common causes of hip pain is termed Hip Bursitis. This condition shows up often in running athletes, soccer players and football players. Hip Bursitis often acts like more severe hip pain conditions but can be treated non surgically if caught early and not ignored.
What is hip bursitis?
First, we must understand what a bursa is and its role in the hip joint. The bursa is essentially what we like to refer to as the WD-40 or joint lubricator. It is a thin fluid filled sack on the outside of the joint that protects and is key in creating a smooth mechanism for the ball and socket set-up that is the hip joint.
The most common location of hip bursitis is in the trochanteric bursa. This bursa is located on the outside of the hip. It is susceptible to injury through a fall or other form of direct impact, causing the bursa to become irritated and inflamed The hip bursa may also become swollen through repeated friction on the bursa (such as running and high impact activities over prolonged time) that leads to inflammation and swelling of the synovial lining in the bursa. Other contributors include but are not limited to:
- Posture, poor body mechanics, a leg length inequality or a limp over time all can overstress the tissues in the region of the greater trochanter leading to inflammation and pain.
- Scoliosis, lumbar and sacroiliac joint arthritis, as well as other spinal conditions.
- Hip bone spurs
Some of the most common complaints include experiencing hip pain when:
- Pressing on the outside of the hip
- Walking or step-ups
- Lying on the side of the painful hip
- ADL's, including something like standing from a seated position, especially after sitting for a long period of time
Treatment for Hip Bursitis
Many people with hip bursitis can experience relief with adjusting daily activities in a non-surgical manner.
• Activity modification. Avoid the activities that worsen symptoms. These may include limiting high impact movements or squatting. If you are a runner or high
impact athlete, consider taking your workout to the pool or an Alter G treadmill to reduce impact and weight bearing. Losing weight will also have a significant impact on improving hip pain.
• Non-steroidal anti-inflammatory drugs (NSAIDs) may relieve pain and control inflammation. Talk with your doctor about the NSAIDs you use. NSAIDs may have adverse side effects if you have certain medical conditions or take certain medications.
• Assistive devices. Use of a walking cane (on the opposite side of involved hip) or crutches for a week or more when needed.
• Physical therapy to increase hip strength and flexibility. You may do these exercises on your own, or a physical therapist may teach you how to stretch your hip muscles and use other treatments such as aquatic therapy, soft tissue massage, ice/heat with a compress (such as the ActiveWrap Hip Ice Wrap), and ultrasound.
• Steroid injection. Injection of a corticosteroid along with a local anesthetic may also be helpful in relieving symptoms of hip bursitis. This is a simple and effective treatment that can be done in the doctor's office. It involves a single injection into the bursa. The injection may provide temporary (months) or permanent relief. If pain and inflammation return, another injection or two, given a few months apart, may be needed. It is important to limit the number of injections, as prolonged corticosteroid injections may damage the surrounding tissues.
Surgery is rarely needed for hip bursitis. However, todays arthroscopic surgery techniques are far less invasive, and recovery is quicker and less painful. Typical procedures are done on an outpatient (same-day) basis with the patient up and walking same day as surgery.