Hip bursitis can cause groin pain, not just discomfort on the outer hip. While trochanteric bursitis is commonly associated with pain on the side of the hip, other forms of hip bursitis or related mechanisms can lead to pain in the groin. Understanding this connection helps clarify how hip conditions can manifest.
Understanding Hip Bursitis
Bursitis is the inflammation of a bursa, a small, fluid-filled sac that cushions bones and soft tissues. In the hip, the trochanteric bursa is most frequently inflamed. Located on the outside of the thigh over the bony prominence of the greater trochanter, its inflammation (trochanteric bursitis) typically causes pain on the outer hip, sometimes extending down the outer thigh. Common causes include repetitive stress from activities like running or stair climbing, direct injury, or underlying conditions such as spinal issues or leg-length inequality.
Other bursae exist around the hip, though less commonly inflamed than the trochanteric bursa. These include the iliopsoas bursa, positioned on the inner side of the hip near the groin. When any of these bursae become inflamed due to friction, trauma, or overuse, they can swell and cause localized pain.
How Hip Bursitis Can Cause Groin Pain
Hip bursitis can cause groin pain through several mechanisms. Trochanteric bursitis, the most common type, can lead to groin pain through referred pain. Although the inflamed bursa is on the outer hip, nerve pathways can transmit pain signals to be perceived in areas like the inner thigh or groin. This happens because nerves supplying the outer hip also have branches that supply the groin region.
Iliopsoas bursitis is another direct cause of groin pain. This involves the inflammation of the bursa deep within the hip, between the iliopsoas muscle and the hip joint. This bursa reduces friction as the iliopsoas muscle, a major hip flexor, moves over the front of the hip. When inflamed, iliopsoas bursitis directly causes pain and tenderness in the groin and front of the hip, sometimes radiating down the thigh to the knee. Symptoms often worsen with hip flexion activities like walking, climbing stairs, or rising from a seated position.
Hip bursitis can also indirectly contribute to groin pain through compensatory issues. Individuals experiencing bursitis pain may alter their gait or movement patterns to avoid discomfort. These altered mechanics can strain other muscles and soft tissues around the hip and pelvis, including those near the groin. This secondary strain can then lead to additional discomfort or pain in the groin region.
When to Seek Professional Medical Advice
Seek medical attention if hip pain, especially groin pain, is severe, persistent, or worsens over time. If the pain interferes with daily activities, sleep, or weight-bearing, consult a healthcare professional. Other symptoms requiring medical evaluation include fever, significant swelling, redness, warmth around the hip, or an inability to bear weight on the affected leg. These signs could indicate a more serious condition, such as an infection.
A proper medical diagnosis is important to differentiate hip bursitis from other potential causes of groin pain, including hip joint issues, muscle strains, or conditions affecting the lower back or abdomen. Healthcare providers typically perform a physical examination, checking for tenderness and assessing the hip’s range of motion. Imaging tests like X-rays, MRI scans, or ultrasound may confirm the diagnosis and rule out other conditions. In some instances, fluid may be withdrawn from the bursa for analysis, especially if an infection is suspected.
Treatment and Management for Hip Bursitis
Treatment for hip bursitis often begins with conservative approaches aimed at reducing inflammation and pain. Rest from aggravating activities is generally recommended, along with applying ice to the affected area. Over-the-counter pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage pain and inflammation. Activity modification, which involves adjusting movements to avoid stressing the bursa, is also important in early management.
Physical therapy is a common and effective intervention for hip bursitis. A physical therapist can provide specific exercises to strengthen the muscles surrounding the hip, improve flexibility, and address any biomechanical issues contributing to the bursitis. This may include stretches for the iliotibial band and exercises to improve hip muscle strength and range of motion.
If conservative treatments do not provide sufficient relief, medical interventions such as corticosteroid injections may be considered. These injections deliver anti-inflammatory medication directly into the bursa, which can significantly reduce pain and swelling, often providing relief for several months. While generally effective, the number of injections may be limited to prevent potential tissue damage.
Surgery for hip bursitis is rarely necessary, typically reserved for severe, chronic cases that have not responded to other treatments for at least six months. Surgical options may involve arthroscopic removal of the inflamed bursa through small incisions. The hip can function normally without the bursa. Long-term management often includes continued exercises and lifestyle adjustments to prevent recurrence.