We understand that hip bursitis and lower back pain can be debilitating conditions that impact your daily life. Our team of experts has compiled this comprehensive guide to provide you with the necessary information and resources to manage and alleviate these conditions effectively.
Key Takeaway: Hip bursitis is a painful condition that affects the small, fluid-filled sacs called bursae that cushion the bones, tendons, and muscles near your joints.
The most common locations for bursitis are in the shoulder, elbow, and hip. Trochanteric bursitis is a type of hip bursitis that occurs when the bursa at the outside point of the hip becomes inflamed, causing pain in the hip. The main symptom of trochanteric bursitis is pain at the point of the hip that usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense, and later, the pain may become more of an ache and spread across a larger area of the hip.
Low back dysfunction may also play a role in hip bursitis pain by deactivating and tightening the muscles around the hip and increasing and elongating painful symptoms
Understanding Hip Bursitis and Back Pain
Hip bursitis and lower back pain can be related. Hip bursitis refers to inflammation of the tendons around the hip or the bursa (fluid-filled sac) on the side of the hip. It is one of the most common causes of hip pain, affecting about 2 out of every 1,000 people every year. Hip bursitis can cause pain and stiffness in the hip, but it can also cause referred pain in other parts of the body, including the back.
Hip bursitis can cause back pain because of its close proximity to your lower back muscles and nerve roots. The hip bursae, small fluid-filled sacs near your hip joint, are a cushion between your bones and soft tissue. Excessive pressure over the outside of the hip can cause trochanteric bursitis, such as sleeping on a hard surface while camping. As symptoms progress, pain may radiate down the outside of the thigh and occasionally to the buttock, groin, knee, and low back.
Greater trochanteric bursitis pain syndrome (GTBPS) is a clinical condition that may mimic nerve root pressure syndrome and low back pain. Patients with a long-standing history of low back pain and sciatica should be routinely checked for GTBPS. Peritrochanteric infiltration with glucocorticoids mixed with 2% lidocaine relieves pain in patients with GTBPS.
Physical therapy can target hip bursitis pain and help to strengthen the muscles surrounding the hip joint and improve flexibility, reducing the risk of future episodes of bursitis. Treatment goals for bursitis are focused on resolving the inflammation and pain and strengthening the hip abductor muscle. Anti-inflammatory medications may be prescribed to reduce inflammation and pain. In the majority of cases, conservative treatments provide relief from hip bursitis
Causes of Hip Bursitis
Hip bursitis and back pain can be caused by various factors. Hip bursitis refers to inflammation of the tendons around the hip or the bursa (fluid-filled sac) on the side of the hip. Trochanteric bursitis is the most common type of hip bursitis and refers to inflammation of the bursa covering the bony point of the hip bone. Hip bursitis can cause pain and stiffness in the hip, but it can also cause referred pain in other parts of the body, including the back. The hip bursae, small fluid-filled sacs located near the hip joint, act as a cushion that protects the tendon and muscles from rubbing against bone. When the bursae become inflamed, they can cause pain that radiates to the lower back muscles and nerve roots.
Hip joint arthritis is another common cause of hip and lower back pain. It typically leads to pain in the groin (front of the hip) with activity and is usually worse with stairs, getting in and out of cars, and other daily tasks that require hip motion. Hip injuries, such as falling onto the side of the hip, striking the hip on a hard surface, or lying on one side for a long time, can also irritate the bursa and cause bursitis. Other lower-body conditions, such as knee osteoarthritis, scoliosis, and pinched nerves, can cause instability that can lead to bursitis of the hip.
In some cases, hip pain may actually be coming from the spine or lower back. Spine disorders such as scoliosis or arthritis in the lower spine can cause hip bursitis. Hip bursitis can be particularly painful at night when lying on your side, and this pain can cause radiating pain toward the knee similar to nerve pain from the lower back. Several factors can contribute to the development of hip bursitis, including:
- Repetitive Stress: Engaging in activities that put consistent pressure on the hip, such as running or cycling, can lead to hip bursitis.
- Injury: A direct blow to the hip or falling on the hip can cause inflammation of the bursa.
- Underlying Conditions: Conditions like rheumatoid arthritis or gout can increase the risk of developing hip bursitis.
- Poor Posture: Prolonged sitting or standing in an improper position can lead to hip and lower back issues.
Symptoms of Hip Bursitis
The most common symptom of hip bursitis is hip pain and tenderness at the outside part of the hip. The pain may be sharp and shooting or a dull ache. When bursitis affects the hip’s trochanteric bursa, pain is felt at the outside of the hip, where the upper thigh curves out. If the hip’s iliopsoas bursa is affected, the pain will be felt in the groin area. As the condition progresses, the pain may radiate down the outside of the thigh and occasionally to the buttock, knee, and low back.
Other symptoms of hip bursitis include swelling of the hip joint, warmth in the skin surrounding the hip, and pain with movement. Pain from hip bursitis tends to get worse after sitting or lying down and may increase when doing a repetitive activity, like climbing stairs. Most people find that hip bursitis pain is worse at night when they lie on the affected hip. It may also be more intense when standing up after sitting for a long period of time, or when walking, climbing stairs, or squatting for prolonged periods.
If pain from bursitis lasts longer than one to two weeks, it’s a good idea to see a doctor. While it isn’t common for the inflamed bursa in the hip to become infected, when it does happen, it’s called septic bursitis—and it can be dangerous. Septic bursitis requires treatment with antibiotics so the infection does not spread. To confirm that the cause of the pain is bursitis, a doctor will do a complete physical exam and ask about how and when the pain started, as well as other symptoms
Common symptoms of hip bursitis include:
- Pain on the outer hip and thigh
- Tenderness to touch
- Stiffness in the hip joint
- Swelling and warmth around the affected area
- Pain that worsens during activities or at night
Lower Back Pain and Its Connection to Hip Bursitis
Hip bursitis and lower back pain can be connected. Hip bursitis refers to inflammation of the tendons around the hip or the bursa (fluid-filled sac) on the side of the hip. The pain from hip bursitis is typically felt at the outside part of the hip and can be sharp and shooting or a dull ache. However, hip bursitis can also cause radiating pain towards the knee similar to nerve pain from the lower back. This is because the hip bursae, small fluid-filled sacs located near the hip joint, act as a cushion between bones and soft tissue, and when they become inflamed, they can cause pain and discomfort in nearby areas, including the lower back.
Lower back pain can also be the root cause of hip bursitis. Dysfunction in the spinal levels that relate to the hip can both increase and elongate painful symptoms. Lower back dysfunction can deactivate and tighten the muscles around the hip, amplifying the pain. Therefore, treating the lower back can help improve how quickly the hip settles
Where Does Hip Bursitis Pain Radiate To?
Hip bursitis pain usually radiates to the outside of the thigh area. The main symptom of trochanteric bursitis is pain at the point of the hip that usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may become more of an ache and spread across a larger area of the hip
Can bursitis spread to lower back?
There is no evidence that bursitis spreads to the lower back. If you’re experiencing hip bursitis and low back pain, you’re probably experiencing organ dysfunction. The large intestine can create tension in the lower back and also tightness in the hips, creating hip bursitis.
Diagnosis and Treatment of Hip Bursitis and Lower Back Pain
To diagnose hip bursitis and lower back pain, healthcare providers may perform a physical examination, review your medical history, and order imaging tests, such as X-rays or MRIs, to rule out other possible causes of your pain.
Once a diagnosis is confirmed, your healthcare provider may recommend a combination of treatments to alleviate your symptoms:
- Rest and Activity Modification: Avoid activities that exacerbate your hip and lower back pain, and give your body time to heal.
- Ice and Heat Therapy: Apply ice packs to the affected area for 15-20 minutes several times a day to reduce inflammation. After a few days, you can use heat therapy to relax the muscles and promote healing.
- Medications: Over-the-counter pain relievers and anti-inflammatory medications, such as ibuprofen or naproxen, can help manage pain and inflammation.
- Physical Therapy: A physical therapist can design a personalized exercise program to strengthen your muscles, improve your posture, and alleviate pain in your hip and lower back.
- Corticosteroid Injections: In more severe cases, your healthcare provider may recommend corticosteroid injections to reduce inflammation in the hip joint.
Prevention and Maintenance
To prevent hip bursitis and lower back pain from recurring, it’s essential to practice good posture, maintain a healthy body weight, and engage in regular exercise that targets your core and lower body muscles. Some preventive measures include:
- Strengthening the muscles surrounding your hip and lower back
- Stretching your hip and lower back muscles regularly
- Warming up before exercise and cooling down afterward
- Practicing good posture while sitting and standing
- Using proper form during exercise and daily activities
How I would treat hip bursitis and lower back pain in my clients
I would use a special massage therapy technique called visceral manipulation and pair it with a release in the TFL, adductors, and calf.
Visceral manipulation is a gentle manual therapy technique that focuses on the internal organs, their fascia, and ligaments to improve function and promote overall health. It is important to note that I am an AI language model and not a healthcare professional, so it’s always best to consult a qualified practitioner for personalized advice.
That said, here’s a general overview of how visceral manipulation may help with lower back pain and hip bursitis:
- Improving organ mobility: Visceral manipulation aims to restore the natural mobility of organs, which can indirectly help alleviate pain in the lower back and hips. By working on the organs and their surrounding tissues, the therapy can release restrictions that may be contributing to discomfort in these areas.
- Addressing compensatory patterns: Chronic pain in the lower back and hips may be the result of the body compensating for restrictions or imbalances elsewhere. Visceral manipulation can help identify and address these compensatory patterns, leading to improved alignment and reduced pain.
- Enhancing circulation and lymphatic drainage: Visceral manipulation can improve blood and lymphatic circulation, which may help reduce inflammation and promote healing. This could be beneficial for those suffering from hip bursitis, as it can reduce the inflammation in the bursa (the fluid-filled sac that provides cushioning between bones and soft tissues).
- Releasing fascial restrictions: Fascia is the connective tissue that surrounds and supports organs, muscles, and bones. When fascial restrictions occur, they can contribute to pain and dysfunction in the lower back and hips. Visceral manipulation can help release these restrictions, improving overall function and reducing pain.
- Promoting relaxation and stress reduction: Visceral manipulation can have a calming effect on the nervous system, leading to reduced stress and muscle tension. This can help alleviate pain in the lower back and hips.
Understanding the causes, symptoms, and treatments of hip bursitis and lower back pain can empower you to manage these conditions effectively. Remember, it’s essential to consult with your healthcare provider before starting any new treatment plan. By taking the necessary preventive measures and maintaining a healthy lifestyle, you can significantly reduce the risk of hip bursitis and lower back pain affecting your daily life.