Hip Bursitis II

bighipstatue2)      Whether or not you can figure out the source of the problem is irrelevant once it’s dug in. Now you have to figure out how to keep it from hurting and you have to look at this situation like it’s a cut on your finger tip. You won’t get it well if you keep hitting it on things. If your hip is painful to sleep on it at night, then quit sleeping on it at night. Sleep on the other side. If it’s both hips, then you’re screwed. Sleep on your back or your tummy. Put a pillow between your legs. Get a nice, thick memory foam mattress topper for your bed (I’m serious about this one).

If it hurts to get in and out of a chair then figure out how you can do that without hurting it, just like you’d figure out how to type without using your cut finger. I found that when I got in and out of a chair more like a guy, it was better. So how do you do that? Put your legs and feet in the 11:00 and 1:00 positions and stand up without letting your knees come in. Just watch guys getting up from a chair and then watch how gals do it. Our knees always come together because they naturally tend to do that and because we’re taught to keep our legs together. Well this just increases the distance that tendon has to go and grinds it across that bump (the greater trochanter). Use the arms on the chair to help push yourself up.

If it hurts to cross your legs, then don’t cross them. Frankly, sitting more like a guy (with your legs a little apart) works pretty well. When I was in junior high, I learned to keep my legs tight together at all times. We only wore skirts back then, and the boys were always trying to look up them. How many of you remember when the boys would drop pencils under the table during study hall in order to be able to look up our skirts and “shoot the beaver?” And if they got to shoot yours, it was actually your fault that it happened and everyone would make fun of you. The boy would never get in trouble for doing it. No wonder we keep our legs slammed together, even now that we wear pants 90% of the time! So loosen up a little. And don’t worry…no one’s  lookin’ anymore. And if they are…don’t worry…you probably don’t have greater trochanteric bursitis…

So the previous suggestions addressed the mechanical conditions that contribute to the problem. This condition also has an inflammatory component that can be addressed as well. That next time.

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28 Responses to Hip Bursitis II

  1. Gloria Hernande January 31, 2012 at 10:12 pm #

    Dr. Bergin this is my first time viewing your blog and I enjoyed it very much, especially your hip bursitis story. I went in for a cortisone shot about a month ago and it seems to have helped. I have no idea why it started hurting but I hope that it can be reliefed with the injections.
    Keep up the stories they are very informative.
    I also am walking with a cane today because my left knee has locked up on me. Chad in your office gave me a cortisone injection but it still does not want to loosen up. Old age is for the birds. Once I hit 50 down hill I’ve gone.

    Thank you.

    • Barbara February 1, 2012 at 3:26 am #

      Gloria,
      Thanks for reading my blog. Sorry you’re having so much trouble. I actually think 40 is the age when most people start to “go downhill.” So chin up…you’re ahead of the game! But all kidding aside…the process of aging is an unfortunate one. The only advantage I see to it is experience. My experience tells me that the good news, besides just being alive, is that for most of our orthopedic ailments, there is treatment and therefore, hope. Come on back into the office and let’s see what the next step is. But first take real steps toward modifying some of those activities which are contributing to, if not causing your pain. blb

  2. Cindy Berdan August 7, 2012 at 3:51 am #

    Dr. Bergin

    Thanks so much for your blogs about bursitis. It really is a very painful thing. I am to the point that I am limping around and don’t even realize it. I have had total knee replacement 4 years ago with good results from Dr. Goldberg. I have no idea what I am doing wrong to have caused the bursitis.

    I have had two cortisone shots. The first helped some, but I really didn’t feel much relief with the second one.

    I try to be active because I have had diabetes for sixteen years. Thanks for the exercises, I did do physical therapy, but that wasn’t too helpful either.

    Anyway, thanks for the valuable info!

    Cindy Berdan

    • Barbara September 21, 2012 at 3:28 am #

      Sorry you’re having so much trouble with those bursae. The original title for this blog was “The Scourge of Hip Bursitis.” I changed it because it was too hard for people to find “Scourge.” But it truly is a scourge and so hard to get rid of. You might need to come back in and try some more shots. And last but not least, surgery…bursectomy. I’ve got a couple of partners who do that arthroscopically. Come in and let’s talk.

  3. Sherri Grasmuck June 30, 2014 at 7:47 am #

    This is a wonderful blog Dr. Bergin. Thanks so much for your astute, kind collective care! I am a 62 year old active woman who has jogged for much of my life. I am also a type 1 diabetic. Recently I was diagnosed with hip bursitis–happened at same time of ham string problem and so they did MRI to see if hamstring was torn. It was not but did diagnose bursitis. However, I am pretty sure I have the other kind–the interior kind (I’ll try to find some papers to see if specifies it). I had an ultra-sound guided cortisone shot (to the deep interior area around groin area and it felt great for 3 weeks but pain has returned alas. I have been doing strengthening exercise for the hamstring but there are some of the stretching ones that I don’t like (probably aggravating the bursa problem). I realize that one option is to get another or maybe several cortisone shots and see if it goes away after several. I may get there but would prefer to find a way of building it back up as I really hate the way cortisone wreaks havoc on my blood sugar–(for all the time I was feeling relief I got high blood sugars) I have read your many entries with care and see the exercise program you included. However–and here finally comes the question–it seems the exercises are for the more common type of bursitis and not the kind I have. Is there a different set of exercises you would recommend for the more interior kind? I am just bewildered at what to do to feel like I am making process. The dull ache that I felt before is now with me again. Many thanks for your help.
    Sherri Grasmuck

    • Barbara July 1, 2014 at 10:40 am #

      I’m glad you have enjoyed reading my blog. And if you’ve been following all the commentary I’ve left regarding hip bursitis, there’s pretty much nothing else up my sleeve.
      I’m not sure what you mean by the “internal” form of bursitis. Do you have a labral tear or do you have gluteal bursitis/tendonitis? If you have a labral tear, then it’s degenerative and you would likely not be a candidate for surgical treatment. Prepare to develop osteoarthritis. Treatment for that will likely, eventually be a total joint replacement.
      If you have gluteal tendonitis, tendonosis or a tear, then rest, NSAIDs, activity modifications and P.T. are the recommended treatments.
      One question I have is: was the bursitis just discovered incidentally on the MRI. Were and are you actually having lateral hip pain? Is the pain in the area of the hamstrings or more laterally, in the area of the bursa?
      Well, no matter the response to this question…it doesn’t sound like a common condition. I’m at a loss regarding your next step. The fact that the cortisone helped for three weeks might lead me to give it another go. Watch your sugar closely, and respond accordingly.
      And no matter what…Sit Like A Man!
      Sorry I couldn’t be more helpful this go round.

      blb

  4. Sherri Grasmuck July 2, 2014 at 3:56 pm #

    Hi Dr. Barbara,
    Thanks so much for your reply. The bursitis was discovered as they suspected a hamsting tear. I think itisthe gulteal tendonosis-as I have absolutely no pain in the outter hip area. It is more in the inner crack of my butt along with a hamstring strain. I love the sitting like a man therapy (I teach gender and so this is especially intriguing discovery) as it really helps and lengthens the time I can sit comfortably. But I am still wondering–if it IS
    gulteal bursitis along with hamstrain strain–are there any other more applicable exercises to do. I have been doing hamstring and glut strengtening ones along with deep tissue massage-which helps.
    Again, I remain astonished that you exist and offer this
    service.
    Sheri .

  5. nicola November 5, 2014 at 12:19 pm #

    At last some sensible information. Do you think that having plantar fasciitis caused my hip bursitis? Also have carpal tunnel as well are all these linked do you think? Am 58 year old early retired ex nurse.

    • Barbara November 5, 2014 at 12:35 pm #

      Nicola,
      Frankly, I think you can get an ingrown toenail on the other leg, and have it result in greater trochanteric bursitis! I haven’t had GTB for about 15 years, and recently I developed a little intestinal issue, the pain from which caused me not to be able to stand up totally straight for about 2 weeks. So I spent a lot of time leaning on an upright hall desk in my clinic. So picture the position. I’m a little forward flexed with my left elbow resting on the desk and my right hip kind of cocked out. Within about a week, I began to experience GTB again! Of course, recognizing it immediately for what it was, I stopped leaning on my desk, reminded myself even more consistently, to sit like a man and get in and out of chairs like a man. It’s been about 2 more weeks, and my pain is almost totally resolved. One other thing that made a difference: slowing down. It hurts more if I take off down the hall in a hurry, as compared to “strolling” down the hall in a more upright position. Go figure.

      Plantar fascitis, carpal tunnel syndrome and GTB are not related to each other, other than the fact that almost everyone who has them has been alive for at least years! I’ve had all 3! It’s good to be alive!

      Thanks for following my blog. Hope you get better!

  6. Ben March 12, 2015 at 6:03 am #

    Dear Dr. Bergin,

    Firstly, I would like to thank you for making this wonderfully informative site. Secondly though, I have a question as well. I am a sixteen year old male and I play both soccer and track, and recently I have been experiencing some pain and aching on the side of my right hip, near the large bone. I also have a bruise in that area that will not heal, that I think may be related to this. The pain is not bad at all, but its been hurting me whenever I run for about the last month. I hope that you can help me find the cause of my pain and what to do and also if it is serious or if it will go away on its own. Thank you so much in advance.
    Sincerely,
    Ben

    • Barbara March 15, 2015 at 5:05 pm #

      Ben,
      Thanks for checking out my blog!
      I don’t want to try an make a diagnosis from afar. Needless to say, that can cause problems for both of us. Nonetheless, I want to steer you in the right direction, by telling you it would be best for you to see your pediatrician, primary care physician or orthopedic surgeon for this complaint. If you have been reading my blog, you will notice that it focuses most of its attention on those over the age of forty. It’s rare to see bursitis in a young person, especially a guy. But I do have some concerns. You could simply have a bruise. But there are two conditions which could cause your symptoms, and for both of these you should see a medical professional.
      One would be a Morel-Lavallee lesion. These are usually sheer type injuries across the hip seen after high speed kinds of injuries. We often see them in the emergency room following motorcycle or bicycle accidents, in which victims slide across a road. But that’s not to say you can’t have these from a sports injury too! The skin and subcutaneous tissues are sheered away from the underlying muscle and fascia. It can sometimes be mistaken for a hematoma, but they aren’t the same, and they can be quite large. And they are unlikely to heal. It can be a very serious injury.
      The other is a muscle or tendon tear from the iliac crest. That’s the big bone you feel at the top of your pelvis. There are several muscles which attach there and they can be torn. Only occasionally do they require surgery, but they can take a long time to heal. Since I can’t see you as a patient, obviously I can’t see exactly what is going on. But as you can see, there are some serious, and important conditions which can occur around that area. Please seek consultation with a physician.
      By your email address, I would assume you’re an American. Even though pizza was probably first invented in Italy, certainly it has been perfected and sold in the hugest numbers in our good ol’ US of A. And if you’re living stateside, your school is likely to have a team physician (they probably have them in Europe too…but maybe not). So if you have one, then maybe you should go see him…or her! But go see someone!

      • Ben March 21, 2015 at 12:22 pm #

        Thank you so much for your response!

        Ben

  7. Michelle April 16, 2015 at 4:51 pm #

    I recently have not been able to lift my elbow above 90 degrees From my body. I also have been having great pain in my right hip. But the front side of my hip not really bone pain. I have also been complaining for 3 years about my 4 year old mattress! could my mattress have caused this? Do you think getting a new mattress will help? Or the damage is done, I now need medical attention to get this fixed. My chiro is having me ice my bicep but seems to think the hip pain is coming from Lower back. I’m just wondering because all the adjustments in the world will do me no good if I go back to that horrible mattress every night? We spent $1600 on the crappy thing. We were hoping it would last 10 yrs. It barely lasted a year.

    • Barbara April 20, 2015 at 5:30 pm #

      Michelle,
      Your condition is not straight forward enough for me to really try to help you figure it out. I must first recommend you see your primary care physician, an orthopedist or a physiatrist (physical medicine and rehabilitation specialist) for this. But in response to one of your questions, I do not think a mattress can actually cause your pain. I think a good mattress is desirable, but not a necessity. And spending a lot on a mattress in no way guarantees a good night’s sleep. Mattresses are like shoes. What feels comfortable to one person, may not work for someone else, and there are no true ratings of mattresses that I know of. I do know that some companies really back up their products and will take the mattresses back in exchange if it doesn’t work for you. I’m sure there are time limits on it, but I have returned mattresses and many of my patients have told me they returned them. Now let’s say you can’t return yours. I have converted some plank-like mattresses to pretty comfy ones by just adding a 3 inch memory foam mattress topper. Give it a try. I don’t think it can hurt, but as I said before, your problem seems a little more complex than something which can be addressed simply by changing mattresses. Please seek professional help.

  8. Sandie May 11, 2015 at 5:58 am #

    Hi Barbara, your blog has given me some insight into my problem of bursitis in the hips which I have had for many years (8). I have had cortisone injections on both hips a couple of times but with no relief. I have basically decided that I have to live with it as my gp says there is no point in operating. I exercise 4 to 5 times a week, do not wear high shoes any more. I battle at night to sleep although this seems to go in phases. I try and sleep on my stomach but I find that far too uncomfortable. I also try a pillow between my legs but end up having restless night. So basically I do try and get on with things. I am 48 years old and as you say it seems to happen from 40 onwards. I need to get a new mattress however in Zimbabwe (my home) there is not great choice of mattresses. Assuming I should try and get a foam memory topper you mentioned above but I need to do research on that as to how to get one. the information on how to sit and stand is a great help as I battle to sit cross legged so therefore I shan’t. Thanks again for your read.

    • Barbara May 11, 2015 at 8:48 am #

      Sandie,
      Wow…all the way from Zimbabwe! Thanks so much for reading my blog. In fact your comment has reminded me that I need to do a blog on my Sit Like A Man (SLAM) program. I’m off today, and it’s raining, so I can’t go ride my horse. Think I’ll finish that blog I’ve been meaning to do for a long time. Thank you for the reminder! So…in addition to everything you’ve mentioned in your comment, continue to try to sit like a man and stand like a man. You’ve read some of my other replies to comments, so you know this already. Women are taught from a young age, to sit lady-like, with our legs together. This is not natural and in my opinion, it increases the predisposition for women to get hip bursitis, gluteal tendonitis and patellar tracking problems. So observe men. They sit with their legs in a naturally, slightly parted position. No need to go crazy with it, and I still encourage lady-like behavior when sitting around men, especially when one has on a skirt. But most of the time, in this modern world, we are wearing pants, shorts, warm ups, etc. Watch for my blog on this, hopefully later today.
      You can order the mattress toppers on Amazon.
      Here’s a link: http://www.amazon.com/Density-Elastic-Memory-Foam-Mattress/dp/B004AR5X92/ref=sr_1_2?s=home-garden&ie=UTF8&qid=1431358875&sr=1-2&keywords=mattress+topper
      I hope Amazon delivers to your location. That’s how I got mine. But Austin, Texas is on the beaten trail. Don’t know about Zimbabwe! Thanks for reading my blog. I went and put my finger on a globe, just to see how far away I am reaching out to my fellow human beings. Despite the distance, unfortunately we are all related in the way our body suffers. Hello over there!

      • Sandie May 12, 2015 at 4:07 am #

        Thanks Barbara for your response. Yes Zimbabwe really is very far away from you and always pretty much forgotten by the rest of the world :-). most people assume we are South Africans. Anyways, I will check out amazon – people do get things on there so I am sure I can try and organise otherwise I will try from neighbouring south Africa. Its a pain this bursitis business but fortunately not life threatening just uncomfortable. Take care.

  9. Andrea O'Brien October 16, 2015 at 3:08 pm #

    Thank you so very much, your words have helped me understand so very much.
    3years ago I was injured at work, which has left me with both sciatica and bursitis. The first led to the other. I was told by my doctor it was nothing and would just go away on its own. I was made to return to work after 2weeks. I am a nurses add. In ICU. It was hell, for 6 months walking with both injurys, and being on Workcover. Which means. Working 3days injections physiotherapy and doctors. Nothing was working. I was a mess. And going out of my mind. Being told over and over its nothing. On one occasion my doctor gave me a tennis ball told me to place it on the wall and place my hip on the ball.
    After many months later I had CT and MRA X-rays showing my back injury and both hips had tears. I cried for days. From the relief, That I wasn’t going insane. I have left my doctor of 30 years who I loved and respected, Which was heartbreaking. Many many doctors think of it as nothing but. Quote: Something Women get, and as women know pain we should get use to it. It’s 3 years now, had u/sound and nothing has changed. Thank you. So very much.

    • Barbara October 20, 2015 at 3:36 pm #

      Andrea,

      Patients hate being told a painful condition “is nothing.” Rarely is it “nothing.” It’s usually “something,” and we docs have just got to keep digging.

      With regard to the hip, there are tears and there are tears. Tears of the labrum can be quite disabling depending on your age and the history. They can also be degenerative tears, occurring as an early precursor to arthritis.

      Then there are tears of the gluteal tendon. Most of the time, these are degenerative, and most often occur in women. It is thought that this might be due to the mechanical stresses across our feminine hips and perhaps the way we move our hips and stand further adds to the stresses in this area. If I see 100 people with painful gluteal tears, 99% are women over 40.

      You’re not my patient and I haven’t seen your studies, therefore I can’t really help you, other than to give you two recommendations which can’t hurt you and might help: avoid as many of the activities which cause pain as possible, and Sit Like A Man. Soon I’ll have a blog on this so you can start trying it yourself.

  10. Willette December 16, 2015 at 6:31 pm #

    Hello Dr. Bergin, three months ago I was experiencing some pain in the middle of my butt cheeks, I thought I would go to the chiropractor, well that made everything worse. Then I had pain in my lower back, hips, and butt. I could barely walk. I went to the dr who prescribed anti inflammatories and muscle relaxants. That worked for a bit and then the pain returned. I have had X-rays, and a bone scan with no definite diagnosis. Then I when to PT and he diagnosed me with bursitis in my hips. Had 5 or 6 dry needling treatments which helped, but not permanently. My mobility is much better, but I’m still not back to normal. I am to have cortisone shots in my hips in about 1 month, but I’m a little nervous, because no one has really told my what I have. Sometimes my hips and upper buttocks feel numb. Do you have any advice as to what may be wrong with me? Would a MRI be helpful to me. They said I had slight inflammation in my SI Joint, but nothing to concerning.

    • Barbara December 19, 2015 at 7:41 am #

      W.,
      I’m sorry, but your problem is a little too complex for me to deal with on a blog comment. Wish I could be more helpful. Perhaps you can glean some information from some of my other comment responses, but yours is not a simple problem.

  11. Anne February 12, 2016 at 1:20 pm #

    I have Had Bursitis for nearly 4 months confirmed with ultrasound tried injection-physio-massage-acupuncture-changing diet none have worked and everyday is agony it is now in both hips I do not have a Thyroid and spinal stenosis wonder if it can be linked to this used to walk long distances but cannot at current time any advise you can give even though I am in Australia sick of hearing it will go away eventually-is there any other treatment out there that I can try

    • Barbara February 15, 2016 at 10:41 am #

      If you have read some of these comments and my responses, you will know that there is no easy answer to this problem. If indeed you have greater trochanteric bursitis, then you will need to persevere with a conservative course of treatment. Please add my Sit Like A Man program to your regimen, as it worked for me and has helped many of my patients as well. You’ve been doing all the other stuff. Shots often help…transiently. You must identify the activities which aggravate the condition and try to modify them to the point that it doesn’t hurt. It took me 9 months to get rid of mine about 10 years ago. Recently it came back with a vengeance. I quickly started assessing what I was doing to aggravate it, and soon realized that it had to do with the way I was standing at a desk in my office. I started standing like Mr. Clean (legs straight, turned slightly outward to about 11:00 and 1:00. No standing with the hip cocked to one side. It quickly resolved.
      Be certain you have bursitis and not something else. Gluteal tendonitis and piriformis syndrome can cause pain in a similar area. Nonetheless, for the most part the treatment is the same.

  12. Alex Garcia February 19, 2017 at 3:06 pm #

    Please help! I am a 16 year old high school track/cross country runner and 6 months ago right before school started my hip started hurting after a hard workout, 2 weeks later I realized it was an overuse injury since I increased my running mileage too much over the summer. Later on my other hip started hurting too and now the side of my thigh hurts along with my knee, the side/back of my butt also hurts. I have had X-rays and they found nothing wrong then I went to physical therapy once and I was instructed to do stretches, I have done the stretches every single day and also ice both hips afterwards but its not healing. I have looked up the symptons of bursuits and their exactly like what I have. Why is it not healing?

    • Alex Garcia February 19, 2017 at 3:11 pm #

      I also kept running and pushing through the pain the first 3 months after my hips starting hurting but after that I stopped running completely and now I am doing absolutely no exercise so that makes me more confused on why its not healing.

      • Barbara February 21, 2017 at 11:01 am #

        Alex,
        I’m assuming you’re a young woman, so it is possible to have hip bursitis. In folks your age, it often presents as a snapping hip syndrome, but occasionally I do see young gals with straight up hip bursitis. It’s rare though. In view of failure to improve after rest and PT, I would recommend you return to your doctor for further evaluation. There could be something else going on in this area of your body, but I really can’t speak to that since I can’t examine you or look at your X-rays myself. Please go back and see your doc.

  13. Robin February 23, 2017 at 12:04 pm #

    Hey Barbara,
    I was diagnosed with TGB December 2016. I have had it off and on for years. The dr first prescribed or. This seemed to aggravate rather than help it. He then gave me a cortisone shot in both his. One responded well and the other was back in 3 weeks. The pain is awful at night. My muscles in my legs just get so tight and ache. I am a hairdresser so I stand all day. I can’t take nsaids because my stomach can’t take that. Do you have anymore suggestions on how to get this inflammation to go down? I am starting to get depressed because I can’t exercise at all. Any help would be appreciated. Thanks in advance!!

    • Barbara March 2, 2017 at 6:52 am #

      Perhaps make sure that the diagnosis is absolutely correct. If it is, then you could try shots again. Sometimes they work, sometimes they don’t. I know that sounds kind of bad, coming from a doctor, and for the most part they are fairly effective…in some people. The fact that it helped on one side, speaks to that fact. You might consider trying it again, if the pain of the shots was tolerable to you. I have a few patients who come in every 6 months for cortisone injections in their hip bursae. Then the condition either resolves or the shots stop working.
      Of course, I always go back to Sit Like A Man, and that’s been the most effective treatment.
      There are no other “anti-inflammatories,” other than pills and shots. Take that back…I have a few patients with very thin hips, who have used Flector patches (anti-inflammatory patches), with some success. But that’s a very small number and those patches are fairly expensive.

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