Hip bursitis, more accurately known as greater trochanteric bursitis, involves the inflammation of the bursa located on the outer side of the hip joint. These small, fluid-filled sacs act as cushions between the bone and soft tissues, reducing friction during movement. When the bursa becomes irritated or inflamed, it causes a distinctive pain on the side of the hip that can spread down the thigh. Successfully managing this common condition requires a coordinated team of medical professionals specializing in musculoskeletal health and pain.
Understanding the Condition and Initial Assessment
Treatment typically begins with a Primary Care Physician (PCP) or General Practitioner. This initial consultation is important for a preliminary diagnosis and to rule out other possible sources of hip pain, such as arthritis, tendon tears, or a stress fracture. The physician conducts a physical examination, checking for tenderness at the bony prominence on the side of the hip, known as the greater trochanter.
If symptoms are new or mild, the initial management plan includes activity modification, rest, and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). These conservative steps are designed to reduce acute inflammation and pain. If the patient’s symptoms do not resolve within a few weeks, the primary care provider determines the next step, which is usually a referral to a specialist for further evaluation and targeted treatment.
The Primary Specialists for Conservative Treatment
The non-surgical management of hip bursitis involves orthopedic specialists, sports medicine physicians, and physiatrists. These professionals work together to provide comprehensive care, focusing on diagnosis, rehabilitation, and prevention of recurrence.
Orthopedic Specialists
These specialists focus on musculoskeletal disorders, providing expert diagnosis and comprehensive treatment plans. They use imaging like X-rays or ultrasound to confirm the diagnosis and ensure no other structural issues are present.
Sports Medicine Physicians
These physicians often treat bursitis stemming from repetitive motion or activity-related overuse. Their expertise lies in helping patients modify activities and focusing on movement mechanics to prevent the recurrence of inflammation.
Physiatrists (PM&R)
A physiatrist specializes in Physical Medicine and Rehabilitation (PM&R). They focus on functional recovery and non-surgical pain management, often coordinating the full scope of a patient’s rehabilitation. They view the patient’s condition holistically, focusing on improving overall mobility and function.
Advanced Procedures and Pain Management
If conservative treatments fail to provide adequate relief, advanced procedures are considered. Corticosteroid injections are a common next step, typically administered by an orthopedic specialist or a pain management physician. This involves injecting a strong anti-inflammatory steroid medication directly into the inflamed bursa, often using imaging guidance for precise placement.
The steroid reduces inflammation and can provide significant pain relief lasting several months or longer. In rare cases, when chronic bursitis resists non-surgical intervention, an orthopedic surgeon may be consulted. This surgeon can perform a bursectomy, which is the surgical removal of the inflamed bursa, often through a minimally invasive arthroscopic technique.
The Critical Role of Physical Therapy
The Physical Therapist (PT) is a vital member of the team for long-term recovery and prevention. The PT performs a detailed assessment of muscle strength, flexibility, and gait to identify biomechanical factors contributing to the bursitis. Their main goal is to restore the normal function of the hip joint and surrounding structures.
Therapy focuses on strengthening the gluteal muscles, such as the gluteus medius and minimus, which support the hip and pelvis. The therapist also uses specific stretching exercises to improve flexibility in the iliotibial band and hip flexors, reducing the friction that irritates the bursa. This targeted rehabilitation is designed to correct movement patterns and reduce the chances of the condition returning.