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Hip tendinitis is also known as 'trochanteric bursitis'. Bursitis is an inflammation of the fluid sacs that lubricate the area between bones and tendons. Trochanteric bursitis generally affects the trochanter of hip and muscles of buttock and thigh.

Hip tendinitis is mostly common in middle aged women than men.

Causes of Hip Tendinitis

Hip tendinitis can be caused due to prolonged pressure on bursa, injury, jogging, extensive cycling, joint movements and repetitive twisting. These rigorous activities can lead to inflammation in bursa and cause trochanteric bursitis.

Hip tendinitis can also be caused in the lower back resulting in arthritis of hip and iliotibial band syndrome.

Hip bursitis can affect anyone, but is more common in women and middle-aged or elderly people. It is less common in younger people and in men.

The following risk factors have been associated with the development of hip bursitis.

  • Repetitive stress (overuse) injury. This can occur when running, stair climbing, bicycling, or standing for long periods of time.
  • Hip injury. An injury to the point of your hip can occur when you fall onto your hip, bump your hip, or lie on one side of your body for an extended period of time.
  • Spine disease. This includes scoliosis, arthritis of the lumbar (lower) spine, and other spine problems.
  • Leg-length inequality. When one leg is significantly shorter than the other, it affects the way you walk, and can lead to irritation of a hip bursa.
  • Rheumatoid arthritis. This makes the bursa more likely to become inflamed.
  • Previous surgery. Surgery around the hip or prosthetic implants in the hip can irritate the bursa and cause bursitis.

Symptoms of Hip Tendinitis

Common symptoms of hip tendinitis (trochanteric bursitis) include:

  • Warmth and redness in the affected area due to inflammation
  • Feeling of tenderness in the area affected
  • Hip and buttock pain that further extended to thigh and knee
  • Pain while walking, running or sitting cross legged

Diagnosis of Hip Tendinitis

To diagnose hip bursitis, the doctor will perform a comprehensive physical examination, looking for tenderness in the area of the point of the hip. He or she may also perform additional tests to rule out other possible injuries or conditions. These tests can include imaging studies, such as x-rays, bone scanning, and magnetic resonance imaging (MRI).

Treatment

Nonsurgical Treatment

The initial treatment for hip bursitis does not involve surgery. Many people with hip bursitis can experience relief with simple lifestyle changes, including:

  • Activity modification. Avoid the activities that worsen symptoms.
  • Non-steroidal anti-inflammatory drugs (NSAIDs).
  • Assistive devices. Use of a walking cane or crutches for a week or more when needed.
  • Physical therapy. Your doctor may prescribe exercises to increase hip strength and flexibility. Treatments such as rolling therapy (massage), ice, heat, or ultrasound may help.
  • Steroid injection. Injection of a corticosteroid along with a local anesthetic may also be helpful in relieving symptoms of hip bursitis. This is a simple and effective treatment that can be done in the doctor's office. It involves a single injection into the bursa. The injection may provide temporary (months) or permanent relief. If pain and inflammation return, another injection or two, given a few months apart, may be needed. It is important to limit the number of injections, as prolonged corticosteroid injections may damage the surrounding tissues.

Surgical Treatment

Surgery is rarely needed for hip bursitis. If the bursa remains inflamed and painful after all nonsurgical treatments have been tried, your doctor may recommend surgical removal of the bursa. Removal of the bursa does not hurt the hip, and the hip can function normally without it.

A newer technique that is gaining popularity is arthroscopic removal of the bursa. In this technique, the bursa is removed through a small (1/4-inch) incision over the hip. A small camera, or arthroscope, is placed in a second incision so the doctor can guide miniature surgical instruments and cut out the bursa. This surgery is less invasive, and recovery is quicker and less painful.

Both types of surgeries are done on an outpatient (same-day) basis, so an overnight stay in the hospital is not usually necessary. Early studies show arthroscopic removal of the bursa to be quite effective, but this is still being studied.

Prevention

Although hip bursitis cannot always be prevented, there are things you can do to prevent the inflammation from getting worse.

  • Avoid repetitive activities that put stress on the hips.
  • Lose weight if you need to.
  • Get a properly fitting shoe insert for leg-length differences.
  • Maintain strength and flexibility of the hip muscles.
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