Bursitis of the hip joint

Bursitis of the hip joint is an inflammatory process that develops in the synovial periarticular bag, which plays the role of a kind of "shock absorber" and when the muscles slide, it helps reduce the friction between the bones and the soft tissues that cover them.

In medicine, bursitis belongs to the group of orthopedic diseases, the development of which is characterized by inflammation in synovial articular bags leading to the accumulation of the formed exudate in the joint cavities. Inflammatory fluid.

A periarticular synovial bag is a small cavity located around the hip joint and filled with fluid. In various injuries, as well as excessive physical overload of the tendons and muscles, bursitis (Latin bursa - "bag") may occur as an inflammatory process that can include a spinal bag, a sciatic bag, or a ileo-scallop bag in the hip joint. Of the unfavorable factors that contribute to the development of the inflammatory process, you can note the lack of mobility of the body, hypothermia, obesity and congenital anomalies, in particular, the difference in the length of the legs. Most often, this disease occurs in middle-aged and elderly women.

[1], [2], [3], [4], [5]

Causes of bursitis of the hip joint

Bursitis of the hip joint is an inflammatory process that encompasses the synovial hip pouch (acetabulum or ischium).

The causes of bursitis of the hip joint are in most cases associated with various injuries and injuries to the femur. Of the main factors provoking the disease, you can also note:

• Excessive regular stress on the hip joint.
• Diseases of the spine (scoliosis, arthrosis and arthritis).
• Unequal length of legs.
• Surgical interventions on the hip joint.
• Rheumatoid arthritis.
• Osteophytes (so called "bone spurs").
• Salt deposits.

Intensive training in running and cycling, frequent climbing stairs, long standing of a person in a standing position lead to excessive stress on the hip joint, and subsequently - to the development of the inflammatory process in synovial bags. With different lengths of legs, irritation of synovial bags often leads to the development of bursitis. Various operations, in particular, hip arthroplasty, can cause this ailment. Damage to the femur with strong bumps and falls, as well as osteophytes that occur in the tendon area, attaching to the trochanter of the femur, often become the causes of bursitis development.

[6], [7]

Symptoms of bursitis of the hip joint

Bursitis of the hip joint is the main symptom of acute pain in the hip joint, which are localized from the outside of the thigh. At the beginning of the development of the disease, the pain is intense and intense, but as the pathological inflammation spreads over time, it becomes dull.

There are also other symptoms of bursitis of the hip joint:

• Painful swelling in the place of the damaged joint, which has a rounded shape and reaches a diameter of up to 10 cm.
• Edema of the tissues around the synovial bag.
• Elevated temperature (sometimes up to 40 °).
• Hyperemia of the skin.
• General malaise.
• Violation of the full functioning of the joint.

With the acetabulum bursitis, severe tenderness of the external part of the thigh occurs, which makes it difficult to lie on the involved side. The patient is disturbed by a heavy sleep. Burning pain prevents walking up the stairs and fetters a person in movements. The sciatic bursitis causes dull pain in the upper portion of the femur, especially when lifting upward, as well as flexing-extension of the thigh. Pain can increase with prolonged sitting on a hard surface.

When bursitis passes into a chronic form, the symptoms become less pronounced, and in the area of the inflamed synovial bag there is a slight swelling, which has a rounded shape and a soft consistency. The chronic form of bursitis is characterized by the absence of burning pain and the preservation of joint functions. Exacerbation of the disease causes an increase in the amount of exudate in the cavity of the damaged bag, which often leads to the formation of a cystic cavity filled with liquid.

If the inflammation of the synovial bag of the hip joint is caused by an infectious agent, purulent bursitis may develop. Its main symptom is the sharp soreness that is observed when the limb is withdrawn, as well as the flexion-extension of the thigh. On the external part of the thigh is localized swelling. Because of severe pain, a person can not fully bend or unbend the hip, thus explaining the constant presence of the hip in a semi-bent position and taking it outward.

Vertical bursitis of the hip joint

Bursitis of the hip joint arises from the inflammation of one of the three periarticular bags: ileal, scallop, sciatic or perpendicular.

Vertical bursitis of the hip joint is caused by an inflammatory process in the sternum, which is located near the large trochanter of the hip bone, and occurs much more often than the other two types of bursitis. This disease is characterized by symptoms such as pain that occurs in the area of the large trochanter (ie, the bony elevation on the lateral surface of the femur), as well as swelling in the area of inflammation, discomfort in movement, general malaise, fever. Often, this disease develops in people who are actively involved in sports, mainly in women, tk. The female pelvis is in the order wider than the male one, so a large spit in women is located farther from the midline of the body, and this provokes more intense muscle friction about it.

The pain resulting from the development of the vertebral bursitis, acute, burning, spreading along the external surface of the thigh. Unpleasant pain sensations decrease in a state of complete rest, but at the slightest loads (climbing the stairs, hip rotations, squats) sharply increase. The patient often complains of nocturnal pains that occur when lying on a sore side. At the sportsmen who are engaged in professional run, at increase of a sports load pain is observed, - more often it happens is connected with increase in a distance or complexity of training.

Bursitis can occur in chronic form for an extended period of time. The acute form of vertebral bursitis most often occurs with trauma - a fall or a sharp collision with an object. This blow is accompanied by a characteristic click. Diagnosis of vertebral bursitis is carried out with the help of Auber's test (the method of leg removal), palpation, and in some cases - a special radiographic study to identify calcifications (ossified areas). With the help of magnetic resonance therapy, it is possible to identify areas of accumulation of exudate and inflammation.

Diagnosis of bursitis of the hip joint

Bursitis of the hip joint requires accurate diagnosis by a full objective examination by a qualified medical professional. Upon examination, the doctor asks the patient about the nature of the pain, the prerequisites for its occurrence, localization, etc. The palpation of the hip joint is performed, as well as the Auber's test with hip removal.

Diagnosis of bursitis of the hip joint is characterized by some difficulties due to the deep disposition of the hip joint and covering it with muscles. Thus, external examination of the joint is impossible, as well as there are difficulties with taking a puncture or performing arthroscopy. Therefore, the diagnosis of this disease is based on two main factors: the analysis of the pain syndrome and a special radiographic study. In detecting pathology, increased soreness and sensitivity in the areas of the projected portions of the femur are taken into account. To exclude injuries and other pathologies associated with the hip joint, such as arthritis, MRI is performed and bone scans are performed. The diagnosis is confirmed by administering to the patient an anesthetic in the form of a local injection, followed by a relief of the condition. 

[8], [9], [10], [11], [12]

Treatment of bursitis of the hip joint

Bursitis of the hip joint, first of all, requires conservative treatment, which consists in modifying physical activity, i.e. Limiting any activity that enhances pain. The doctor appoints the patient non-steroidal anti-inflammatory drugs, with which you can remove the pain and stop the development of the inflammatory process. To alleviate pain in bursitis, effective hormonal drugs are used in their competent combination with local anesthetics.

Treatment of bursitis of the hip joint in unopened cases is performed on an outpatient basis and includes single administration of medicines directly into the damaged synovial bag. With repeated exacerbation of bursitis and the resumption of pain, the patient may need another injection.

Conservative treatment includes physiotherapy exercises. Selection of an effective set of exercises will depend on the course of the disease, but first the patient is prescribed anti-inflammatory drugs and only after that - preventive manipulation (electrophoresis and ultrasound, therapeutic gymnastics).

In the treatment of bursitis of the hip joint, it is very important not only to remove the inflammation, but to prevent the chronic development of the disease. For this, along with medicamental therapy compresses with plantain, sage, and also calendula and pine buds are used, medicinal plants that have pronounced anti-inflammatory and anti-edematous properties. Among other effective means for reducing the recurrence of bursitis of the hip joint, it should be noted:

• Osteo-Vit. A modern biologically active complex, an effective natural chondroprotector that ensures the speed of recovery processes, as well as the normalization of venous blood supply of articular and cartilaginous tissue. The composition of the drug includes vitamins D and B6, which contribute to the normalization of mineral metabolism in the human body. The preparation contains homogenate tartar brood, which is a natural source of amino acids.
• Dihydroquercitin plus. Antioxidant, whose action is directed to the nutrition of the joint tissue and the rapid restoration of blood microcirculation. With the help of this tool cells of the articular tissue are released from free radicals that interfere with the regeneration process.
• Elton P, Leweton P. Effective biologically active complexes, including bee products, as well as various medicinal herbs, whose action is aimed at increasing efficiency, endurance, providing the body with the necessary trace elements, vitamins for strengthening bones, enzymes and useful amino acids. Especially important is the intake of these drugs during the rehabilitation period, because with the help of these biologically active complexes it is possible to restore normal microcirculation of blood in damaged tissues and vessels. The drugs have pronounced anti-inflammatory, anti-edematous and wound-healing properties. This is especially important if the root cause of bursitis of the hip joint is trauma.

Surgical treatment is used by doctors only in rare cases, when conservative treatment does not give the desired results, and pain and inflammation persist. In such a situation, the only solution is to remove the damaged synovial bag, which in no way affects the normal functioning of the hip joint. In modern medicine is actively used so-called. "Arthroscopic" removal of the damaged synovial bag. Such an operation is performed by a small dissection of the thigh area and the internal introduction of an arthroscope, a device that allows the doctor to freely manipulate surgical instruments to extract the synovial bag. Such surgical intervention is characterized by a minimal level of traumatism for the patient, as well as a less painful course of the recovery period.

Treatment of bursitis of the hip joint with alternative medicine, above all, is effective in reducing the inflammatory process. You can recommend the use of such a resorbable compress: grate it is necessary to grate 1 tbsp. Spoon of laundry soap, add 1 tbsp. A spoonful of honey, as much grated onions and mix everything. On a piece of polyethylene, you should put a clean cotton cloth and lay out the prepared medicinal mass. Apply the compress to the inflamed area and wrap it with a woolen cloth. It is advisable to apply the compress for 7 days. Before treatment, it is recommended that you consult with your doctor.

Prevention of bursitis of the hip joint

Bursitis of the hip joint can be prevented if you take care in advance about the methods of prevention.

Prevention of bursitis of the hip joint, first of all, reduces to the exclusion of any load on the joint, as well as the restriction of physical activity, which can provoke inflammation of the synovial bag. It is necessary to maintain muscle tone, weight control, the use of special devices with unequal length of legs.

Of course, it is impossible to insure against strokes and injuries of the musculoskeletal system, but the risk of developing bursitis can be reduced by minimizing the loads on the pelvic bones. To do this, you must refrain from lifting various weights and excess weight. When excessive load on the legs (for example, with standing work) it is necessary to give the body a full rest. To strengthen health and prevent the development of bursitis will help an active lifestyle, as well as moderate physical activity and the rejection of bad habits.

For training hip joints, it is recommended to perform exercises aimed at strengthening the abducens muscles of the hip, which are the muscles-stabilizers of this joint:

• Take the position for pushing away from the table, while keeping your back straight, without bending in the waist. The body must take the position of a straight line. In this position, you should smoothly take your right foot to the side and go back. Do the same with the left foot. The frequency of exercise is 5-10 times for each leg.
• Take the original standing position, fold the legs together, then bend the left leg in the knee, move the pelvis towards the right leg and gently slant the body forward, keeping the back straight. Repeat the exercise with the other leg.

Regular exercise, a healthy lifestyle, a diet rich in minerals (in particular, fluoride and calcium) will help prevent the occurrence of any pathology of the hip joint.

Prognosis of bursitis of the hip joint

Bursitis of the hip joint is treated very successfully, especially if the disease is detected on time. Naturally, the diagnosis and treatment of bursitis requires the qualification and experience of a medical specialist. Self-treatment with analgesics alone and alternative agents (compresses, ointments, etc.) will not yield positive results, therefore, if symptoms of bursitis are detected, it is necessary to consult a doctor as early as possible.

The prognosis of bursitis of the hip joint with effective treatment is always favorable. In most cases, this disease responds well to conservative therapies used in modern medicine. Anti-inflammatory drugs in combination with anesthetics and other medicines completely eliminate the symptoms of bursitis in 5-7 days. Infectious bursitis should be treated with antibiotic therapy, more severe cases - through surgical intervention.

Bursitis of the hip joint, first of all, is associated with a large load on the joint with various movements, running and walking, so it is not surprising that this pathology takes the leading position among other pathologies of the joint apparatus.