There are a number of possible causes of hip bursitis, as well as factors that make some people more likely to develop hip bursitis than others.
The most common causes and risk factors include:
Hip injury or trauma. Falling on the outside of the hip, or banging the hip on any hard surface, can cause the bursa to fill with blood and its lining to become inflamed. Even though body reabsorbs the blood, the bursa lining may stay inflamed, causing bursitis symptoms. This condition is termed traumatic bursitis.
Repetitive pressure on the hip. Most often bursitis is caused by frequent "mini-traumas," which can cause the same problems as a single, more serious trauma. People who bike, run, or stand for long periods of time may be more prone to hip bursitis.
Age and gender. Women are more likely to report pain at the side of the hip than men.1 Though people of any age can be affected, people in their 40s, 50s and 60s are more likely to have hip bursitis.
Rheumatoid arthritis and gout. Bursitis occurs when the bursa's outer lining, called a synovial membrane, is inflamed. People who suffer from rheumatoid arthritis, which affects the synovial membrane that encapsulates joints, are more likely to get bursitis. Similarly, people who suffer from gout, in which there is a painful build-up of urate crystals in the synovial joints, are more likely to have to bursitis.
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Problems that affect biomechanics. Physical conditions that alter the biomechanics of the lower limbs can have a domino effect that results in pain at the side of the hip. For example, knee osteoarthritis, lower back pain, and tenderness of the iliotibial band (a thick tendon that runs from the pelvis down the side of the hip and thigh to just below the knee) have been associated with Greater Trochanteric Pain Syndrome.2 Scoliosis and other spine problems such as a pinched nerve in the back may also increase the risk of hip bursitis. In addition, people who have one leg longer than the other - by about an inch or more - may walk in a way that irritates the bursa.3
Previous hip surgery. A surgery at or even near the hip can increase the likelihood of developing hip bursitis.
Bacterial infection of a bursa. An infection of the trochanteric bursa is septic bursitis. Certain medical conditions and medications suppress people's immune systems and make them more susceptible to septic bursitis. For example, people with cancer, HIV/AIDS, lupus, alcoholism, chronic obstructive pulmonary disease (COPD), and diabetes may be more likely to get septic bursitis.
History of inflammation of the bursa. Patients who have had bursitis in the past are more likely than others to get it again.
Bone spurs or calcium deposits. Hip bursae and other soft tissue can become irritated by bone spurs, also called osteophytes, and calcium deposits, which are small collections of calcium that are often small and soft but can grow and harden over time.
- "Hip Bursitis," OrthoInfo, American Academy of Orthopaedic Surgeons, last updated August 2007. Accessed February 24, 2012, http://orthoinfo.aaos.org
- Segal NA, Felson DT, Torner JC, Zhu Y, Curtis JR, Niu J, Nevitt MC; Multicenter Osteoarthritis Study Group. Greater trochanteric pain syndrome: epidemiology and associated factors, Arch Phys Med Rehabil.
- "Hip Bursitis," OrthoInfo, American Academy of Orthopaedic Surgeons, "http://orthoinfo.aaos.org