Pain meds, stretching help bursitis

TUESDAY, JUNE 12, 2012

DEAR DOCTOR K: I was just diagnosed with hip bursitis. What will my treatment entail?

DEAR READER: Your hip has several fluid-filled sacs, called bursae. They cushion the hip joint. When one of these sacs becomes irritated or inflamed, the condition is known as bursitis.

My patients use different words to describe the pain they have from bursitis: aching, burning, dull, sharp and radiating. The type and location of your pain depend on which bursa is affected.

Inflammation of the trochanteric bursa is the most common. The greater trochanter is the name of a bony bump on the side of your hip. If you have inflammation of the trochanteric bursa, pushing on that bump will hurt.

The iliopsoas bursa lies between the front of the hip joint and one of the hip flexor muscles, near the groin. The pain it causes goes from the groin down the inner part of the thigh, toward the knee.

Ischial bursitis is, literally, a pain in the butt. It occurs when the bursa under one of the bones you sit on becomes inflamed. A hundred years ago it was called “tailor’s bottom” because people who sit all day are more prone to getting it.

Treatment for any type of hip bursitis includes rest and ice. Pain relievers such as ibuprofen or naproxen also help. You’ll need to reduce your activity until the symptoms subside; this usually takes a few weeks.

Specific stretching and strengthening exercises, under direction from a physical therapist, will also help.

In rare cases, your bursa may remain inflamed and painful even after these treatments. If this is the case, your doctor may surgically remove the bursa. (The hip can function normally without it.) This is a very effective, minimally invasive procedure and can be done on an outpatient basis.

Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.


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