Hip Bursitis

Does this sound like you?

Most people have several of these, not all of them.

• Pain over the bony point at the outside of the hip, which you can point to
• Pain lying on that side, often the thing that brings people in
• Pain standing up after sitting, easing over the first few steps
• Discomfort on stairs, hills and getting out of a car
• Ache spreading down the outside of the thigh, rarely past the knee
• Tenderness to press on the bone itself

Why it happens

• Compression of the tendons over the bony point \u2014 sitting cross-legged, standing hanging on one hip, lying on that side
• A rapid increase in walking, hills or running
• Weakness through the deep hip muscles
• Most common in women between forty and sixty
• A direct fall onto the side of the hip
• Altered walking after a knee or back problem on the same side

What we would do about it

Roughly in this order — each step waits for the one before it.

1. Working out whether the tendon, the bursa or the joint is the source, because the plans differ
2. Taking the compression off first \u2014 how you sit, stand and sleep
3. A pillow between the knees at night, and off the painful side
4. Graded loading of the gluteal tendons rather than rest
5. Deep hip and pelvic strengthening built up in stages
6. Walking and hill load managed rather than stopped
7. Referral for a corticosteroid injection only where pain blocks all loading, and paired with rehabilitation rather than used instead of it