Causes and risk factors
The most common cause of bursitis is a repetitive or constant motion which causes pressure on the bursae. Hip bursitis is more commonly seen in bicycle riders. Standing for prolonged period, continuous running predisposes one to hip bursitis. Trauma is another common cause of bursitis. A strong blow on hip or fall on a hard surface on sideways can injure the bursa of the hip leading to inflammation. Certain diseases like rheumatoid arthritis, gout, systemic lupus erythematosus, discrepancy in leg, HIV, and diabetes can also cause hip bursitis. Hip bursitis can also occur due to infection and some unknown causes. Deposition of excess calcium in the muscles and tendons of hip or prosthetic implants in the hip or even after surgery the irritation of bursa can occur causing hip bursitis.
Clinical presentation:
Symptoms develop gradually. Pain in hip joint, swelling, and stiffness are the prominent features. Pain may vary from person to person. Pain varies as per the bursa involved. In case of trochanteric bursa involvement, there occurs tenderness on the outer hip, while pain in upper buttocks is seen in case of ischial bursitis. It can be mild or severe. Sharp shooting pain or dull aching and throbbing pain can be experienced by the patient. Difficulty in movement like walking, standing, sitting is experienced by the patient. Pain is aggravated at night. Swelling, rash, and redness on the affected joint can occur. Muscle weakness, malaise, and tenderness are also present.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and the physical examination carried out by the doctor. Fluid analysis of the bursae are the diagnostic investigations. Certain investigations which can be done are x-ray, MRI, or CT scan of the hip joint. Routine blood test and a profile of specialized blood tests are done to rule out other causes.
Treatment:
The treatment consist of administration of pain relieving medications, nonsteroidal anti-inflammatory drugs (NSAIDs), or steroids for allying the pain are given. In severe cases, corticosteroid injections and topical pain relieving gels and lubricants are advised. Use of walking canes and crutches are advised. Wearing of braces and supports to hold the joint in alignment during movement, cold and hot compressions are advised. Surgical draining is sometimes required in some cases. Change in lifestyles is necessary to correct the pain. Weight reduction in obese, adequate rest, correction of wrong postures, and regular exercises need to be adopted.
Other Modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints. Acupuncture which is the science of insertion of fine needles on certain stimulating spots on the body has been proven to be effective. Certain yoga exercises can also be helpful in relieving the pain and strengthening the muscles.
Recent updates:
American Academy of Orthopedic Surgeons has revealed that according to the new researches carried out, platelet-rich plasma injections are significantly more effective and durable than cortisone injections for the treatment of severe chronic hip bursitis.
