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The Differences of Hip Bursitis and Arthritis

The Differences of Hip Bursitis and Arthritis

woman on running track - differences between hip bursitis and arthritis

Are you having hip pain and don't know what the cause is? Are you confused between hip bursitis and arthritis? Your hips are an essential part of daily movement and support your body as it moves side to side, dispersing bodily weight where necessary. Because the symptoms of bursitis and arthritis are very similar, it may be hard to differentiate between the two without proper knowledge or a physical health check from a physician. The article below details the differences and will help you understand the pain you are having. 

What Is Hip Bursitis?

Bursitis originates from the fluid-filled sacs that help increase lubrication in your joints become inflamed and extremely painful. The fluid-filled sacs are called bursae, which is where the term bursitis derives. Each side of the hip has a total of four bursae, with commonly only two of them getting infected. The two areas known to become infected are the trochanteric and iliopsoas. The iliopsoas is near the inside of the groin, while the trochanteric is on the outside of the hip near the point.

Trochanteric inflammation is expected to occur when another inflammation of the area happens, such as inflammation of the hip tendons, also known as tendinitis. Since both the trochanteric bursae and the abductor tendon are near the pointy section of the hip, they closely affect one another. Symptoms can be hard to decipher since they share many of the same traits as arthritis. The pain felt with hip bursitis comes from the outside of the hip. The pain increases when applying pressure to the hip that is affected. Even lying on that particular side can cause pain and discomfort. 

The following are common symptoms of hip bursitis:

  • Sharp pain felt in the early stages stemming from the affected area. 
  • Pain is felt on the side of the hip or near the groin area. 
  • The pain is worse at night.
  • Whether you are very active or not very active, pain and stiffness will occur.
  • Lying on the affected area or applying too much pressure causes pain or discomfort.
  • Simple daily actions such as walking, utilizing stairs, or squatting become painful.

If your hip suffers any traumatic injuries, you are a candidate for hip bursitis

Because the bursae sacs are typically acting as a cushion to help your joints move smoothly and without rubbing, when they become inflamed, it causes a lot of pain when you start applying pressure to the area. There are quite a few risk factors and causes of hip bursitis. If you put repetitive stress on the areas in question or have an injury that has not had proper time to heal before you do any heavy lifting, it could cause hip bursitis to become a reality. 

If your hip suffers any traumatic injuries, you are a candidate for hip bursitis. It may not be common knowledge that spinal injuries and trauma increase the risk of your hip experiencing bursitis. Still, those injuries can severely increase the risk, so be aware if you have had or if you suffer any trauma to your spine in the future. 

Another factor that can put you at risk for hip bursitis is having slightly different lengths of your legs, otherwise known as leg-length inequality. Leg-length inequality comes from massive trauma during prime years of growth, or people can be born with it. It causes people to limp when they walk, find running challenging, and have hip and back pain. It applies unusual pressure to the hip bones that adequately control weight distribution as the body naturally flows during movement.  

Rheumatoid arthritis can also cause hip bursitis. Rheumatoid arthritis is an autoimmune condition, meaning it comes from the immune system attacking healthy tissue instead of creating antibodies to attack bacteria and viruses. The final two common situations that can cause hip bursitis are previous surgery done in the area or bone spurs and calcium deposits. Bone spurs can be a by-product of tendinitis, osteoarthritis, or other forms of local inflammation.

Treatment

Treatment of hip bursitis comes from many different angles. Start with getting extra rest and not putting unneeded pressure on the area that has pain. You can also try icing the area or taking anti-inflammatory pills, pain relievers, or even attending physical therapy. If none of these treatments help with hip bursitis, other avenues are explored, such as corticosteroid injections to relieve the pain and inflammation quickly. There is also the option for surgery of the affected area to drain the infected bursae sacs, but this process is rare and often not needed unless all other avenues have failed.

What Is Hip Arthritis?

Hip arthritis is more commonly a by-product of the degenerative disorder, which worsens over time. Arthritis is when joints get inflamed, stiff, and they start getting painful. It acts as a "wear and tear" on the body that wears down the joints faster than usual. The most common arthritis of the hip is called osteoarthritis, which occurs when the cartilage inside the hip joint wears down. When the cartilage wears down far enough to no longer provide a cushion in the joint, the thigh bone starts rubbing against the hip socket. 

There are other versions of arthritis that can affect the hip, but they are far less prevalent. The other inflammations of the hip are: 

  • Rheumatoid Arthritis
  • Ankylosing Spondylitis
  • Systemic Lupus Erythematosus 

There are typically two reasons osteoarthritis will occur: natural wear and tear from bodily use throughout the lifetime and post-traumatic arthritis that a hip injury can cause. Let's get into what hip arthritis feels like when it starts affecting your hip area. Many symptoms share similarities, so the more you know about what type of pain you are having and in which situations, the better you will be able to treat yourself or discuss your symptoms with your doctor. This may help guide you to hopefully recover without the need for invasive treatment options.

  • Hip pain that is often worse in the morning or during stormy weather
  • When there are extended periods of inactivity, the hip pain worsens
  • Reduced range of motion
  • Stiffness and trouble bending
  • When exercising, there is grating, locking, or sticking of the hip joint
  • Swelling of the hip
  • When doing intensive activities, there is pain in the hip, thigh, buttock, and groin
  • Tender joints 
  • Severe pain that causes a limp when walking

Woman in nature in holding hips - heredity and genetics in hip arthritis

There are many causes for hip arthritis to develop. Obesity is a major player in causing hip arthritis because of the enhanced inflammation with a higher body mass index. The increased weight can cause back, knee, and hip pain. When you have less body weight, there is less pressure on the joints and areas that the weight rests on and depends on, which lowers the risk of having hip arthritis. Increased age, previous hip joint injury, and family history are some other causes of hip arthritis. 

A family history of hip arthritis can come from a couple of different angles: heredity and genetics. The most common form of hip arthritis passed down through heredity is osteoarthritis. The mutations in the collagen gene are what cause this and form at a young age. When the genetics fully come into fruition on family history and hip arthritis, there is also a chance of rheumatoid arthritis. However, the factors surrounding the genetic inheritance pattern are not completely understood. 

There are too many factors within the genetic and environmental components involved to track an exact pattern yet. If you have a close relative with rheumatoid arthritis, it does increase the chances that you will develop it.

Treatment

There are several ways to treat hip arthritis. If you are very active and do a lot of hiking, mountain climbing, running, or other activities that take a toll on your hip and movement, finding less stressful activities can help. You can also opt for physical therapy and have a physician try to help you retain proper motion in your hip without the pain or stiffness. Medications are always a form of nonsurgical treatment you can try during these other steps to help relieve pain and inflammation the best you can while trying to regain full hip functionality.

Suppose none of those options are working or you progress slowly. In that case, there are also assistive devices such as canes and walkers that can help alleviate pressure on your hip when you are walking, so you don't increase the possibility of the affected areas getting worse in between treatments and therapy. Much like with hip bursitis, there are also options for corticosteroid injections to help quickly relieve pain. If none of these options work for you, there are a few surgical treatments you can try.

  • Hip arthroscopy
  • Hip resurfacing
  • Total hip replacement

Hip Bursitis vs. Arthritis

Person at the beach holding hip - hip arthritis vs. arthritis

There are a few basic ways to know if you have hip bursitis or arthritis. If the pain you feel is sharp and severe before spreading out into an ache in the affected area, you may have hip bursitis. On the other hand, if your pain develops slower and is more painful in the morning, it may be hip arthritis. Hip bursitis and arthritis are also anatomically different. Hip bursitis is temporary, and the bursae sacs only swell for a while, making treatments conducive to recovery.

Arthritis is a chronic condition and damages the bone, cartilage, and joints beyond repair. Treatments can help stave off pain and prevent the effects from getting worse, but arthritis is not curable at this time. You can also have both hip bursitis and osteoarthritis simultaneously or connected to other issues such as lower back arthritis or a hip labrum tear. Both have distinct outlooks on the conditions and different treatment plans to help with the pain and progression. 

Key Differences of Hip Bursitis and Arthritis

Hip Bursitis:

  • The pain originates on the outside of the hip in the lower region
  • When too much pressure is applied to the area, there is more tenderness and pain
  • The pain worsens at night
  • Pain develops into a widespread ache over the region

Hip Arthritis:

  • Pain comes from the inside of the hip joint
  • Pain can also come from the groin, thigh, or buttocks
  • Decreased range of motion and having stiffness in the joints
  • Grating sensation in the hip 
  • Pain develops slowly
  • Pain is worse in the morning
  • Swelling
  • Can spread to knee or back

Multiple genes can trigger arthritis that is hereditary from generation to generation. If your family has that history, it does increase the risk of hip bursitis triggering because of it. Hip bursitis on its own, however, is not genetically passed through families. If you have been experiencing pain for weeks and it shows no sign of subsiding, you may need to see a doctor for a professional opinion. The doctor can diagnose your symptoms and tell you definitively what is going on with your body.

After the diagnosis, the doctor can provide all the necessary treatment options and track your progress. Your doctor will know if surgery will help or if physical therapy combined with medications works fine for you. Keep an eye on your pain in the affected area and keep track of pain levels rising or lowering throughout the treatment plan. Even if you end up having both hip bursitis and osteoarthritis, remember hip bursitis can go away eventually, so you won't have to worry about having both attacking your body the rest of your life.

Professional Diagnosis

Mufaddal Gombera, MD, is a certified orthopedic surgeon. Dr. Gombera specializes in sports medicine, arthroscopy, and injuries to the shoulder, hip, and knee. Call today and book an appointment if you have been experiencing constant or worsening hip pain. There are many helpful tips on the blog for you to check out while waiting for your appointment. Patients who have worked with Mufaddal Gombera, MD, have reported lasting recovery and unforgettable experiences. Take your life and how you live it back into your own hands and book an appointment to better your future.

Today is the first step you will take to control your pain, treat your pain, and take control over how you go about your day instead of letting your pain control your decisions. Please don't waste time searching anymore, and speak with us today and get started on your recovery. With the multitude of services provided, ranging from fracture care, MRI reviews, and treatments including stem cells, there is something here for everyone to help treat their pain and discomfort and regain control over their life.

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American Academy of Orthopaedic Surgeons The American Orthopaedic Society for Sports Medicine Arthroscopy Association of North America american shoulder and elbow society international society for hip arthroscopy