My doctor says I have hip bursitis. Is there really such a thing?

Is there really such a thing as hip bursitis? My grandma used to complain of that but I thought it was an old lady complaint like lumbago. Now my doctor says this is what I have. So my original question still stands: is there such a thing?

Pain along the side of the hip is still a common spot for bursitis (also known as greater trochanter pain syndrome. A large tendon passes over the bony bump on the side of the hip called the greater trochanter. Inflammation in the bursa (a protective gel sac) between the tendon and the greater trochanter is called trochanteric bursitis or lateral hip bursitis. You can see there are many names for this problem.Hip bursitis is common in older individuals. Women seem affected more often than men. It may also occur in younger patients who are extremely active in exercises such as walking, running, or biking.Sometimes a bursa can become inflamed (swollen and irritated) because of too much friction or because of an injury to the bursa. An inflamed bursa can cause pain because movement makes the structures around the bursa rub against it. Friction can build in the bursa during walking if the long tendon on the side of the thigh is tight. It is unclear what causes this tightening of the tendon. The gluteus maximus attaches to this long tendon. As you walk, the gluteus maximus pulls this tendon over the greater trochanter with each step. When the tendon is tight, it rubs against the bursa. The rubbing causes friction to build in the bursa, leading to irritation and inflammation. Friction can also start if the outer hip muscle (gluteus medius) is weak, if one leg is longer than the other, or if you walk or run on banked (slanted) surfaces.Most cases of trochanteric bursitis appear gradually with no obvious underlying injury or cause. Trochanteric bursitis can occur after artificial replacement of the hip joint or other types of hip surgery. The cause may be a combination of changes in the way the hip works, the way it is aligned, or the way scar tissue has formed from the healing incision.So, in answer to your question — yes! Hip bursitis is still a real problem with a real diagnosis. Treatment early on can prevent this painful condition from becoming a chronic problem that might require surgery. Short-term use of nonsteroidal anti-inflammatory medications along with physical therapy may be all the person needs. The physical therapist will correct any postural components, muscle imbalances, and help restore normal function of the affected hip muscles.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

What is calcific bursitis of the hip?

Have you ever heard of calcific bursitis of the hip? That’s what I have. What can you tell me about it?

Calcific bursitis occurs as a result of tiny calcium deposits in the collagen tissue around the hip. The cause is chronic inflammation of the bursae. The bursa is a normal structure. It is a thin sac of tissue that contains fluid to lubricate areas and reduce friction between muscles, tendons, and bones. The patient reports pain and/or tenderness along the side of the hip. This is the area of the greater trochanter. The greater trochanter is a large bump of bone that juts outward from the top of the femur (thigh bone). Large and important muscles connect to the greater trochanter. Sometimes these muscles are referred to as the rotator cuff of the hip. Chronic tendinitis of the hip rotator cuff can also contribute to this problem. The calcium deposits are called calcification. They can occur as long as there is inflammation of the bursae (or tendons). The deposits don’t always go away after the inflammation has been taken care of, but the symptoms improve.

Treatment can help to prevent further calcification as well as relieve pain and stiffness. Antiinflammatory drugs, cortisone injections into the bursa, and physical therapy have been shown effective. In rare cases, the inflamed bursa is surgically removed.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Why hip pain is a red flag for total hip replacement patients

My right hip has been bugging me off and on for two weeks. I have a hip replacement on that side so I’m a little worried. Could this be caused by a problem with the implant?

For anyone with a total hip replacement (THR), hip pain is a red flag. Medical evaluation is important because of the risk of joint infection. Treatment depends on knowing if there is (or isn’t) an infection. There are many possible causes for the pain you are having. They may or may not be related to the implant. The first thing the orthopedic surgeon will examine is the hip itself. Your history along with the clinical presentation are very helpful. But then the spine (above) and the knee (below) will be tested as possible sources of referred pain. X-rays and lab tests may be needed to rule out a fracture, implant loosening or infection. Other possible causes include bursitis, ossification (bone formation in the muscle or surrounding soft tissue), or synovitis. Cultures of the joint taken directly from the area during surgery are the most accurate way to confirm (or rule out) joint infection. But this type of testing is not practical for the patient who doesn’t have an infection or who doesn’t need surgery. And there is a fair amount of false-positive test results with intraoperative cultures due to errors in sampling technique. Instead, the physician may rely on lab tests that are sensitive, reliable, and accurate with a low false-positive and high true-positive results. The following tests may be needed to evaluate for hip infection: erythrocyte sedimentation (SED rate), C-reactive protein (CRP), and synovial fluid white blood cell count (WBC). Don’t wait to get tested. See your surgeon now. Early diagnosis can prevent a lot of complications from delayed treatment.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

What is bursitis? I’ve heard of it and wonder if that’s what’s causing my shoulder pain.

What is bursitis? I’ve heard of it and wonder if that’s what’s causing my shoulder pain.

Bursitis is an infection, irritation, or inflammation of a bursa. The bursa is a small fluid-filled sac or cushion. There are many bursae throughout the body. They are found where a muscle or tendon slides across bone. 

Bursae decrease friction between two moving surfaces. With aging, they can become paper thin. Then they no longer provide the necessary cushion. When the two body parts start to rub together, bursitis can occur. Sometimes repetitive motion causes the bursae to become inflamed.

The shoulder is a very complex joint with many moving parts, ligaments, tendons, and muscles. There is a fairly large bursa between the rotator cuff and the head of the humerus (upper arm bone). The rotator cuff is a group of four muscles and tendons that surround the shoulder joint.

An orthopedic surgeon can help diagnose the problem. A careful history and examination may pinpoint the exact cause of your painful symptoms. There is treatment available for bursitis, if that’s what’s causing your pain. 

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Is it possible to get a frozen knee?

I’ve heard of a frozen shoulder before. Is it possible to get a frozen knee?

A frozen shoulder, also known as adhesive capsulitis occurs when the shoulder stiffens up. There’s usually pain and always a loss of motion. The process involves thickening and contracture of the capsule surrounding the shoulder joint.

A “frozen knee” is possible. Like the shoulder, loss of motion is the defining symptom although the patient often has pain as well. This condition in the knee is most common after a knee injury, chronic bursitis, or a total knee replacement.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Hip pain not related to weather, what else could it be?

My older aunts used to always complain about hip bursitis when the weather changed. I have pain alongside my hip in the same place they always rubbed when complaining. It doesn’t seem to be related to the weather. Is it bursitis or something else?

Hip bursitis is an inflammation of the bursa located between layers of tissue over the hip. The bursa is a round or oval-shaped, gel-filled protective pad. There are several bursaes located throughout the body, usually over a bony prominence.

With inflammation, there are usually symptoms of warmth, redness, or swelling over the painful area. A closer look at many women with hip pain suggests a different problem called greater trochanteric pain syndrome (GTPS). There is no inflammation with this problem. The person experiences pain or tenderness with pressure along the outside of the hip. It’s worse when lying on that side.

Women seem to be affected by this condition more than men but men are not immune to it. The cause of the problem remains unknown. With the gender differences, there may be hormonal or anatomic issues. But since nine per cent of the adult male population also report this problem, it’s likely there are other factors.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Boomeritis – a real diagnosis?

I just came back from my doctor’s office. After examining my shoulder, she said that I have boomeritis. I’ve heard of bursitis, but what’s boomeritis?

There’s been a dramatic increase in the number of exercise- and sports-related injuries in adults aged 50 to 60. Since most of these adults were born during the post World War II baby boom era, these problems are being referred to as boomeritis.

Tacking the ending or suffix: itis on a word indicates inflammation. So a bursitis would refer to inflammation of the bursa in a joint. Boomeritis is just a nickname for who (you, the baby boomer) and what (inflammation from overuse) but doesn’t identify the true underlying problem. You could have a bursitis, shoulder impingement problem, or tendinitis.

If you are unclear about your problem and what to do about it, don’t hesitate to call your physician back and discuss your situation further.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Thigh pain may not be a result of recent total hip replacement

My mother has been complaining of thigh pain after her total hip replacement. Could this be caused by a problem with the new hip? Or is something else going on?

Thigh pain can be caused by a wide range of problems. Pain can be referred to the thigh from a problem in the abdomen, low back, hip, or knee. For example, kidney stones, tumors, or blood clots can cause thigh pain.

But muscle strains, bursitis, pressure on the nerve, and hernias can also cause thigh pain. It is also possible that a problem with the implant can send pain to the thigh. Loosening of the implant, infection, and wear debris from the implant can cause thigh pain.

A simple X-ray can help show what might be going on. First, the radiologist will look for fractures. Rotation of the femur (thigh bone) indicates loosening of the implant. The X-ray can also show subsidence or sinking of the implant down into the bone.

Don’t put off having this problem checked. Early diagnosis and treatment can prevent more serious problems later. It could be something as simple as muscle weakness or even a problem with posture. If this is the case, a physical therapist can help your mother with a program of exercise and posture awareness. More serious problems can be addressed by the surgeon.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Snapping hip syndrome affects this ballerina

Whenever I lift my leg straight up in front or to the side, I feel (and I think I can hear) a snapping sound. It doesn’t hurt but it’s very annoying. I’m taking a ballet class and we use this movement often. What can cause this problem?

You may be experiencing a condition called snapping hip syndrome. In medical terms it’s called external coxa saltans. The sound is caused by the iliotibial band (ITB) sliding over a part of the hipbone called the greater trochanter.

The ITB is a long piece of fascia (a thick layer of connective tissue) attached at the top to a hip muscle. It goes from the hip all the way down to the outside edge of the knee.

In between the ITB and the greater trochanter is a small, round cushion called the trochanteric bursa. As the ITB rubs over the greater trochanter, the bursa tries to cushion the friction. But repeated snapping back and forth can cause inflammation of the bursa called bursitis. When bursitis occurs the patient has both snapping and pain.

The first step may be to ask your dance instructor to watch how you are doing the barre or floor exercises that cause snapping. There may be an acceptable way to change your form. Stretching the ITB may also help. Doing something now before a painful response begins is always a good idea!

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Steroid injections for pain relief – how long do they last?

I had a steroid injection into my shoulder for a problem with bursitis. I got immediate relief that lasted about a week. Now my symptoms are starting to come back. How long do steroid injections usually work?

There aren’t too many studies just on the duration of pain relief with steroid injections into the joints. Results range from one week as in your case up to 13 weeks.

It’s clear that steroid injections work better than placebo injections with saline solution. And studies show that some steroids work better than others. Long-term pain relief may require a higher dose of the steroid.

In some cases steroid injections are used to control pain and reduce rehab time after arthroscopic surgery. In a patient with recurring bursitis there may be other factors such as posture and overuse to be addressed. The injection may help calm the joint enough to work on improving alignment and motion. Combining physical therapy with steroid injection may be one way to improve overall results.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.