This usually means a period of time not participating in sports or activities that aggravate your symptoms. As a general rule of thumb, any activity that causes hip bursitis pain should be avoided--this only contributes to inflammation of the bursa.
- Anti-inflammatory Medications
Anti-inflammatory medications (e.g. Motrin, Aleve, Naprosyn, etc.) will help control the inflammation associated with hip bursitis. These medications are helpful for the pain as well as diminishing inflammation.
- Ice the Injury
Icing the area of hip bursitis often helps to alleviate the symptoms of hip bursitis. Especially after exercise, ice can control inflammation, and stimulate blood flow to the injured area.
- Aspiration/Drainage of the Bursa
In some patients who have a significant amount of fluid that has collected within the bursa, a needle can be placed into the bursa to remove the fluid. This is rarely needed in cases of hip bursitis, but when it is done it may be combined with a cortisone injection (see below).
- Cortisone Injection
A cortisone injection may also be given into the bursa in patients with pain. The cortisone injection is helpful because it can be both diagnostic and therapeutic. In cases where hip bursitis may be one of several diagnoses being considered, cortisone can be given to see if the shot helps to alleviate symptoms.
Most patients find relief with stretching of the muscles and tendons that are found over the outside of the hip, specifically the iliotibial band. The idea is that a better conditioned muscle and tendon will glide more easily and not cause hip bursitis. Special attention to proper stretching technique is important.
- Physical Therapy
Working with a physical therapist is a useful treatment adjunct for patients with hip bursitis. Not only can the therapist help develop a proper stretching and exercise program, but they can use modalities such as ultrasound which may be helpful as well.
Surgical treatment for hip bursitis is rarely needed, and most patients who are faithful about treatment get better within about six weeks. Patients who do not rest from their activities until the inflammation subsides often have a return of hip bursitis symptoms. Also, patients who return too aggressively (i.e. not a gradual build-up), may also find that their symptoms return.
In those few cases where surgery is needed, this can be done through a small incision, or sometimes it can be performed arthroscopically. Either way, the bursa is simply removed (called a bursectomy), and the patient can resume their activities. The surgery is done as an outpatient, and most often crutches are only used for a few days. Patient's do not need a bursa, and therefore there are few complications from this type of surgery. The most common complications are anesthetic-related complications, and infection.
Paluska SA. "An overview of hip injuries in running. " Sports Med. 2005;35(11):991-1014.
Fox JL. "The role of arthroscopic bursectomy in the treatment of trochanteric bursitis." Arthroscopy. 2002 Sep;18(7):E34.