Hip Bursitis: Symptoms, Relief, and Treatment in the UK

Hip bursitis, medically known as trochanteric bursitis, occurs when the bursa—a small, fluid-filled sac that acts as a cushion between bone and soft tissue—becomes inflamed. There are several bursae in the hip, but the one located at the bony point of the hip bone (the greater trochanter) is most commonly affected.

This condition is a frequent cause of musculoskeletal pain in the UK, particularly among middle-aged and older adults. In line with NICE guidelines, it is often categorised under 'Greater Trochanteric Pain Syndrome' (GTPS), a broader term that also includes injuries to the surrounding tendons. While uncomfortable, hip bursitis is rarely a sign of a serious underlying disease and usually responds well to conservative management.

Primary Indicators

The hallmark of hip bursitis is pain on the outer side of the hip. Unlike arthritis, which typically causes pain in the groin area, bursitis affects the lateral (side) aspect of the joint. Patients often describe the pain in two stages:

• Acute stage: A sharp, intense pain that makes it difficult to lie on the affected side.
• Chronic stage: A duller, spreading ache that may radiate down the outside of the thigh towards the knee.

Common Triggers

Pain often flares up during specific activities, such as:

• Getting out of a low chair or car.
• Walking up stairs or on inclined surfaces.
• Lying on the affected side in bed.
• Prolonged standing or walking.

Inflammation of the bursa can be triggered by several factors. In the UK, common causes identified by health professionals include:

• Repetitive Strain: Activities like running, cycling, or climbing stairs can irritate the bursa over time.
• Hip Injuries: A fall onto the hip or bumping it against a hard surface can cause traumatic bursitis.
• Poor Posture and Gait: Conditions like scoliosis, a leg-length discrepancy, or lower back issues can alter how you walk, putting extra pressure on the hip bursa.
• Underlying Health Conditions: People with rheumatoid arthritis, gout, or psoriasis are sometimes more prone to inflammation of the bursae.
• Sedentary Lifestyle: Weak gluteal muscles can lead to instability in the hip, causing the tendons to rub more forcefully against the bursa.

Before seeking medical intervention, many patients find relief through home-based management. The NHS recommendation for soft tissue injuries often follows the RICE principle (Rest, Ice, Compression, Elevation), though elevation is less practical for the hip.

Rest and Activity Modification

Avoid the activities that aggravate your pain. This doesn't mean total bed rest, which can cause stiffness, but rather avoiding high-impact exercise and finding comfortable sitting positions.

Temperature Therapy

Applying an ice pack or a bag of frozen peas (wrapped in a towel) to the outer hip for 15 minutes several times a day can significantly reduce inflammation. Some patients find that alternating with a heat pad after the initial 48 hours helps relax the surrounding muscles.

Over-the-Counter Medication

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can be effective. If you cannot take NSAIDs, paracetamol may help manage the pain, though it will not reduce the inflammation itself. Always consult a pharmacist before starting new medications.

If your hip pain has not improved after 2-3 weeks of home treatment, or if the pain is so severe that it prevents you from sleeping or performing daily tasks, it is time to consult a professional. You can speak to a GP online to discuss your symptoms from the comfort of your home.

An online GP consultation is a convenient way to:

• Confirm the diagnosis: Discuss the location and nature of your pain to rule out other issues like referred back pain or hip joint wear and tear.
• Receive Prescription Medication: If over-the-counter options are insufficient, a doctor can prescribe stronger anti-inflammatories or neuropathic pain relief if appropriate.
• Obtain a Referral: If your condition is persistent, the doctor can refer you to a private physiotherapist or suggest an NHS pathway for further imaging or steroid injections.
• Discuss Sick Notes: If your job involves heavy lifting or standing and your hip pain makes this impossible, an online doctor can provide a fit note (sick note) to support your recovery.

The long-term solution for hip bursitis usually involves strengthening the muscles that support the hip joint. Physiotherapy is considered the gold standard of treatment for recurring cases. Exercises typically focus on:

• Gluteal Strengthening: Improving the strength of the gluteus medius and minimus to stabilise the pelvis.
• Iliotibial (IT) Band Stretching: Reducing the tension in the thick band of tissue that runs down the side of your leg.
• Core Stability: Ensuring the lower back and abdominals support proper gait and posture.

In some resistant cases, a doctor may recommend a corticosteroid injection directly into the bursa. This provides potent anti-inflammatory relief, often lasting several months, allowing the patient to engage more effectively in their physiotherapy exercises.