Hip pain can be a complicated issue. Common causes include hip arthritis, hip tendinitis, sacroiliac joint related pain, lower back referred pain from facet joint arthritis or a pinched nerve, or neuropathic pain related to chronically irritated peripheral nerves. Unfortunately many folks who have pain along the side of their hip get labelled with the diagnosis of trochanteric bursitis. This diagnosis suggests that the normal fluid sac along the bony prominence on the side of the hip has become inflamed. In reality very rarely is bursitis truly present when visualized under ultrasound.
More commonly weakness and irritation of the tendons around the hip are the true culprit. The difference in diagnosis of hip tendinopathy/tendinitis and hip bursitis leads to dramatically different approaches to treatment. A diagnosis of hip bursitis leads to recommendations of using strong anti-inflammatory medications, steroid injections for inflammation which can actually further weaken tissue, and rest. These treatments may help in the short term, but are in fact short sighted since they do not address the core nature of the problem.
A correct diagnosis of hip tendinopathy leads to recommendations including hip strengthening and treatments such as platelet rich plasma and prolotherapy. This approach is meant to strengthen muscles/tendons and focus on long term improvement of the problem. Platelet rich plasma and prolotherapy injections are safe for your muscles and tendons long term. They have the potential to heal damaged soft tissue, and are more effective long term than steroid injections. In fact a study presented at the American Academy Orthopedic Surgeons annual conference showed that platelet rich plasma gives significantly more and longer pain relief and functional improvement compared to steroid injections.
If you’ve been diagnosed with hip bursitis, make sure your problem has been appropriately evaluated. Choose treatments that aim to heal your problem and improve the long term outlook.