Hip (Trochanteric) Bursitis

Bursitis is caused by inflammation of a bursa, a small fluid-filled sac that functions as a gliding surface to reduce friction between muscles, tendons, and joints during movement. There are 160 bursae located throughout the body. The major bursae are adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, knees, and heels.

The bony point of the hip is called the greater trochanter. It is an attachment point for muscles that move the hip joint. The trochanter has a fairly large bursa overlying it that occasionally becomes irritated, resulting in hip bursitis (trochanteric bursitis). Bursitis can also result in pain in the groin area, when the iliopsoas bursa on the inside of the hip is irritated, but this is much less common. The main symptom of hip bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, it may feel achier and spread out.

Typically, the pain is worse at night, when lying on the affected hip, and when getting up from a chair after being seated for a while. It also may get worse with prolonged walking, stair climbing, or squatting.

The following risk factors have been associated with the development of hip bursitis:

  • Repetitive stress (overuse) injury. This can occur when running, stair climbing, bicycling, or standing for long periods of time.
  • Hip injury. An injury to the point of your hip can occur when you fall onto your hip, bump your hip on the edge of a table, or lie on one side of your body for an extended period of time.
  • Spine disease. This includes scoliosis, arthritis of the lumbar (lower) spine, and other spine problems.
  • Leg-length inequality. When one leg is shorter than the other by more than an inch or so, it affects the way you walk and can lead to irritation of a hip bursa.
  • Rheumatoid arthritis. This makes the bursae more likely to become inflamed.
  • Previous surgery. Surgery around the hip or prosthetic implants in the hip can irritate bursae and cause bursitis.
  • Bone spurs or calcium deposits. These can develop within the tendons that attach to the trochanter. They can irritate the bursa and cause inflammation.