DIET AND FITNESS:

Hip Bursitis --Causes and Cures
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February 20, 2010

By Muireann Prendergast, Contributing Columnist, and
Susan Callahan, Health Editor


Do you suffer from hip pain when lying down at night? Do
you feel a sharp twinge in the hip region when getting up
from a chair? Is this sharp twinge gradually becoming a
constant painful ache throughout your hip area?

If so, chances are that you are suffering from hip bursitis
and it is time to consult your family doctor for advice on how
to treat it.

According to the American Academy of Orthopedic Surgeons
(AAOS), bursitis is the inflammation and irritation of the
"bursae". Bursae are small fluid-filled jelly-like sacs that
cushion the points of contact between muscles and your
bones. Think of them as tiny pillows around your joints.

The hip area is the site of one of the most important bursa
sacs because the hip bone, called the Great Trochanter, is
the meeting points of a number of muscles. The AAOS sets
out that there is a second bursa on the groin side of the hip
which, when it becomes inflamed, is sometimes referred to
as hip bursitis although the pain is felt more in the groin area.

SEPTIC AND NON-SEPTIC BURSITIS

A 2008 study carried out by a researcher at New Jersey
Medical School explains two different forms of Bursitis--
septic and aseptic. Septic bursitis is the more serious form as
it involves the bacterial infection of the bursa. Non-Septic
Bursitis refers to an inflammation of the bursa.

The 2008 New Jersey Medical School study found that septic
bursitis is often accompanied by fever due to the fact that
the body is fighting infection when it occurs. It is also
accompanied by swelling in the lymphatic channel and it is
the more painful of the two forms. However apart from this,
it can de difficult for doctors to tell the two apart as they
both present similar symptoms and it is sometimes necessary
that laboratory tests be carried out on the inflamed bursa’s
fluid to tell the difference. A 1998 study published in the
British Medical Journal found that these tests are not widely
available and often not sensitive enough. The 2008 New
Jersey Medical School study concluded that generally no
fatalities are associated with the condition. However,
underlying causes of the condition can cause fatalities, such
as a virus in the autoimmune system.

WHAT CAUSES  HIP BURSITIS?

A 2004 study published in the Journal for Accident and
Emergency Medicine explains that non-septic hip bursitis can
be caused by sudden impact on the area caused by a fall or
accident. It can also result from any kind of habitual stress
on the region such as that caused by cycling, climbing or
walking or even repeatedly lying too long on one side when
in bed. The AAOS also that the condition can result from
inflammatory conditions such as rheumatoid arthritis, various
spine diseases and leg length inequality when one leg is
shorter than the other by at least an inch. It is a condition
more common in older people.

The 2004 study published in the Journal for Accident and
Emergency Medicine suggests that the bacteria causing
Septic Bursitis can be triggered by direct trauma,
inflammatory diseases and the entry of bodily micro-
organisms into the bursa which then become infected. The
2008 New Jersey Medical School study explains that it can
also be caused by diabetes. A 1989 study published in the
Journal of Rheumatology sets out that it can also be
triggered by diseases affecting the auto-immune system such
as AIDS.


TREATMENT OF HIP BURSITIS --Top 10 Tips




























TREATMENT OF NON SEPTIC HIP BURSITIS

1. REST
Once hip bursitis is diagnosed it is vital that the hip region be
rested. This can involve a break in activities such as walking
running and cycling and even lying on one’s back instead of
on one’s side in bed.

2. NSAIDs
Taking non-steroidal anti-inflammatory drugs such as
naproxen or ibuprofen for a short period of time can bring
short term pain relief in the affected region. The AAOS
suggests that these be taken for limited periods and
cautiously.

3. STRETCHING AND PHYSICAL THERAPY
A 1997 study published in the Journal of the American
Family Physician concludes that a set of exercises developed
in conjunction with a physiotherapist can help strengthen
the area and cause pain relief in cases of non-septic bursitis.

4. ULTRASOUND
A 2005 study published in the Journal of Ultrasound in
Medicine and Biology suggests that an ultrasonic, heat-
giving, device on the affected region is an effective pain
reliever in cases of Bursitis.

5. SOFT TISSUE INJECTIONS
A soft tissue injection administered by a doctor can give
quick relief to hip pain and inflammation. As the anti-
inflammatory used might be a Corticosteroid, it is important
to let your doctor know if you are allergic to steroids before
going ahead with the treatment.  A 1989 study published by
the American Medical Association concluded that this is the
most effective short term pain relief solution.   


TREATMENT OF SEPTIC HIP BURSITIS

1. ANTIBIOTICS
Antibiotics such as penicillin are effective in the treatment of
septic bursitis as suggested by a 1988 study published in the
Western Journal of Medicine. This study sets out that a
penicillinase-resistant penicillin such as flucloxacillin can be
administered or alternatively a cefalosporin such as
cefuroxime in incidences of penicillin-allergy.


2. ASPIRATION OF THE BURSA/BURSECTOMY
The AAOS explains that there is a new treatment for hip
pursitis which involves the removal of the bursa through a
small hip incision with the help of a tiny camera. A
bursectomy is a quick, minimally-invasive procedure and
patients can generally go home within a few hours following
the procedure though the use of crutches is recommended
for some days afterwards so as to minimize pressure on the
hip region.

3. SURGERY
In more extreme cases surgery is required. This is carried to
remove the infected bursa as well as to fix other shoulder or
back conditions, perhaps underlying the bursitis. The AAOS
suggests that this is a rare option and should only be
explored after all other options are explored.

HOW TO PREVENT HIP BURSITIS


1. DO NOT OVERUSE THE HIP REGION

If you engage in regular activities like walking, cycling etc, it
is a good idea to allow for periods of rest so as not to over-
work the hip region. In bed, it is useful to switch positions
regularly so as not to put constant pressure on one hip
alone. This is supported by studies carried out by The
American Academy of Orthopedic Surgeons (AAOS)
suggesting that resting the affected area is the first step to
pain relief. After engaging in sports, ice the area for 30 to 40
minutes to help reduce inflammation.

2. WATCH YOUR WEIGHT

A 2005 study published in the British Journal of Anesthesia
states that
weight control can be one of the most effective
ways to reduce and prevent hip bursitis. Extra weight puts
extra pressure on the hip region and could lead to
inflammation of the hip bursa over time.  Keep your weight
as close to
your ideal weight as possible.

3. WARM UP

Sports physiotherapists recommend a warm up period
before a sporting activity that puts pressure on the hip
region such as cycling or climbing. This avoids putting
sudden pressure on the hip.

4. WEAR THE RIGHT SHOES

The American Orthopedic Foot and Ankle Society (AOFAS)
recommends the use of comfortable shoes with shoe inserts
and lifts to align feet with hips when necessary. It is
important to change shoes regularly and not to use shoes
with worn soles as this increases pressure on the hip region.
If you exercise regularly, it is crucial to wear the sports
shoes that suit your size, shape and the sport you practice.
Consulting a specialist on the issue before a purchase is a
good idea.

5. BUMP UP MAGNESIUM AND
CHECK BLOOD SUGAR

The American Diabetes Association suggests that added
Magnesium in the diet can help prevent diabetes, a condition
which can trigger bursitis.  Add pumpkin seeds and other
foods high in magnesium to your diet. The Diabetes
Association also recommends that blood sugar levels be
checked regularly to prevent and/or detect the condition.

6. REGULAR CHECK –UPS

Of course, you should have regular, complete physical check-
ups to monitor the progress of bursitis and to ensure that
the condition does not become septic.



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