The recommended treatment for hip bursitis, or bursitis at any joint location, is usually aimed at controlling the inflammation of the bursa.
If hip bursitis stems from injury or overuse, rest and other remedies to relieve inflammation are usually successful. In cases of septic bursitis, in which the bursa is infected, antibiotics also must be used to prevent the spread of infection.
It is important to wait until all hip bursitis symptoms are gone before resuming regular activities. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause hip bursitis symptoms to flare up again.
Rest and activity modification. People with hip bursitis should avoid activities that will aggravate and inflame the bursa, which may include sports and/or standing for long periods of time.
Ice. Applying ice or a cold pack to the sore hip can help reduce local pain and swelling. This treatment is recommended after any exercise or activity that may inflame the hip bursa.
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Non-steroidal anti-inflammatory drugs, or NSAIDs. Anti-inflammatory medications, such as aspirin, ibuprofen (e.g. Advil), naproxen (e.g. Aleve), and cox-2 inhibitors (e.g. Celebrex) can reduce swelling and inflammation and relieve any pain associated with hip bursitis.
Aspiration to drain the bursa. If the hip bursa is significantly swollen, the physician may recommend aspirating, or draining, the bursa using a needle. In the rare cases that this is recommended, a cortisone injection will usually be done at the same time.
Corticosteroid injections. Symptoms that are not successfully treated with rest, NSAIDs, and/or physical therapy may be relieved with corticosteroid injections. Because the affected bursa lies well beneath the skin, the doctor may use ultrasound to help guide the injection.
Physical therapy. A doctor may prescribe physical therapy to stretch or strengthen hip muscles, which may help treat the current bursitis and ward off future cases of bursitis.
Antibiotics. Septic trochanteric bursitis requires treatment with antibiotics. The choice of antibiotic may be influenced by what microorganism is causing the infection. Most people with septic bursitis are effectively treated with oral antibiotics. More challenging cases may require hospitalization and antibiotics delivered intravenously.
Surgery. While rarely needed, certain particularly challenging cases of chronic hip bursitis may warrant surgery. Below are the typical surgeries for alleviating hip bursitis. The type of surgery recommended depends on symptoms and other factors.
Bursectomy. In a traditional bursectomy an incision is made at the hip and the affected bursa is removed. Some doctors perform arthroscopic bursectomies, with the intention of lowering the risk of complications and shortening the healing period.
Tendon repair and iliotibial band release. When hip bursitis is caused by problems with the iliotibial band or other tendons, a surgical correction may be made. A tendon(s) may be repaired and reattached to the greater trochanter, if necessary. The iliotibial band is a particular tendon that is associated with Greater Trochanteric Pain Syndrome. Iliotibial band release involves lengthening the band to reduce friction. These types of surgeries may be done in conjunction with a bursectomy.
Osteotomy of the greater trochanter. During an osteotomy, defined as the surgical cutting of bone, a surgeon will shave off 5-10 mm of the protruding greater trochanter bone. This adjustment can reduce the friction and stress that caused the hip pain.
A primary care provider may treat hip bursitis, as well as certain joint pain specialists, including physiatrists (physical medicine and rehabilitation specialists), sports medicine doctors, and orthopedic surgeons.