Bursitis

What is it?

A bursa is a fluid-filled sac that acts as a cushion between tendons, bone, and skin and helps your joints move with ease. There are over 150 bursae in your body and several are found around the outer area of the hip. The two bursae in the hip that are more commonly irritated and inflamed are the greater trochanteric bursa (covers the bony point of the hip bone) and iliopsoas bursa (found on the inside of the hip). Bursitis occurs when a bursa becomes inflamed, and it is a common cause of pain that can affect your hip to your knee.

Inflammation of a bursa can be caused by repetitive-use injuries, prolonged pressure, direct trauma, lumbar spine diseases, rheumatoid arthritis, and sometimes infection. It can affect anyone at any age, but is most common in middle-aged women. The main symptom is aching pain over the part of the outer hip. The pain worsens with movement or pressure and may travel down the outside of the thigh toward the knee. Pain caused by pressure at night can make sleeping very difficult.

In order to properly diagnose your doctor will carry out a physical examination on the specific area that is causing pain and tenderness. They may order and x-ray to rule out other possible other causes. Lab tests may also be ordered to analyze fluid from the inflamed bursa to pinpoint the cause of the joint inflammation and pain.

What are the treatment options?

Treatment for bursitis tends to be conservative, imploring rest, ice and pain medications. If these do not work then your doctor may take any of the following measures:

• If due to an infection, provide an antibiotic 
• Recommend physical therapy to strengthen and/or stretch the muscles surrounding the affected area 
• Corticosteroid injection 
• Assistive device such as a walking cane to relieve pressure from the affected area 
• If necessary, surgery to drain the inflamed bursa

Risk Factors

Bursitis can develop in anyone, but it is more likely in individuals with any of the following:

• Increased age 
• Work or hobby that requires repetitive motion or pressure on a particular bursae 
• Medical conditions such as rheumatoid arthritis, gout and diabetes

Rehabilitation Plan - Exercises

If rehab has been prescribed for your bursitis, the therapist will perform a comprehensive evaluation to determine the underlying cause of your bursitis and address any weakness and/or soft-tissue restrictions that may be present through instruction in a home strengthening and/or stretching program, as well as possible manual techniques to relieve pressure to the bursae and modalities to decrease pain and inflammation.