Hip Bursitis vs Arthritis: How to Tell the Difference

If you’ve been experiencing pain in your hip, you may be wondering if you have arthritis. Since most American adults are aware of arthritis as something they may experience as they age, this is a common assumption. However, there is a similar condition that is often overlooked: hip bursitis.  

Hip Bursitis vs Arthritis

hip pain x-ray

On the most basic level, the characteristics of your hip pain can help you determine whether you’re suffering from hip arthritis or bursitis.

If your pain is sharp and intense at first, then ebbs to a widespread ache, you may have hip bursitis. Alternatively, if your pain develops slowly and feels worse in the morning, you may be suffering from hip arthritis.

What is bursitis of the hip?

Bursitis of the hip – or of any joint – occurs when the jelly-like sacs positioned between bones and soft tissue are irritated and inflamed. These sacs, called bursae, act as a cushion for your joints. Bursitis, put simply, is the inflammation of bursa anywhere in your body.

There are two types of hip bursitis: trochanteric bursitis and iliopsoas bursitis. Trochanteric bursitis is caused by the bursa on the outside point of the hip, on the greater trochanter of the femur. The second type of hip bursitis is when the iliopsoas bursa, which is located on the groin side of the hip, is inflamed. While trochanteric bursitis is more common than iliopsoas bursitis, both are treated similarly.

What does bursitis of the hip feel like?

  • Sharp, intense pain that progresses to a widespread ache around the rest of the hip, groin and thigh
  • Pain or stiffness after too much activity
  • Pain or stiffness after too little activity
  • Pain when walking, squatting and/or climbing
  • Pain that worsens at night

Hip Bursitis Causes

Per the American Academy of Orthopaedic Surgeons, there are a number of risk factors and causes of hip bursitis:

  • Repetitive stress and overuse injuries
  • Traumatic or chronic hip injuries
  • Spine disease
  • Leg-length inequality
  • Rheumatoid arthritis
  • Previous surgery
  • Bone spurs or calcium deposits
hip

Hip Bursitis Treatment

Hip bursitis may improve over time with conservative measures, such as rest, ice, pain relievers and physical therapy. If conservative treatments do not relieve your hip bursitis pain, corticosteroid injections can quickly relieve pain and inflammation. Surgical fixes for hip bursitis is rare; however, hip surgery to drain inflamed bursa may be necessary if all other treatment options fail.

What is arthritis of the hip?

One of the most common causes of hip pain, arthritis is a “wear and tear” degenerative disorder that gets worse over time. Osteoarthritis – the most common arthritis of the hip – occurs when the cartilage within the hip’s ball-and-socket joint wears down. With less or no cartilage for cushion, the femoral head of the thigh bone rubs against the acetabular socket (hip socket).  

Less common, but still prevalent, is inflammatory arthritis of the hip. Rheumatoid arthritis, ankylosing spondylitis and systemic lupus erythematosus are the three types of inflammatory arthritis that affect the hip joint.

What does arthritis of the hip feel like?

  • Pain that develops slowly and is typically worse in the morning or with rainy weather
  • Stiffness, reduced range of motion and difficulty walking and/or bending
  • Locking, sticking or grating of the hip joint during walking or exercise
  • Pain in the hip, thigh, buttock and groin, especially during vigorous activity
  • Swelling of the hip
  • Tenderness in the hip joint
  • Pain severe enough to make walking difficult or cause a limp

Hip Arthritis Causes

Per the American Academy of Orthopaedic Surgeons, there are a number of risk factors and causes of hip osteoarthritis:

  • Increasing age
  • Family history of arthritis or osteoarthritis
  • Previous injury to the hip joint
  • Developmental dysplasia of the hip (improper formation of the hip joint at birth)
  • Obesity

Hip Arthritis Treatment

There are a number of nonsurgical hip arthritis treatments, including lifestyle changes, physical therapy, medications, assistive devices, such as canes and walkers, and corticosteroid injections.

If nonsurgical treatments are not an option, there are three common hip surgeries for arthritis: hip arthroscopy, hip resurfacing and total hip replacement. If hip surgery is the right source of treatment for your arthritis, your orthopedic hip specialist will walk you through all of your options.

If you are experiencing hip pain and would like to talk to an orthopedic specialist, please feel free to contact us. We are happy to answer your questions and help in any way we’re able.

14 Comments


Hello,
I’m looking for a cortisone steroid injection to treat hip bursitis in Park City. I’m covered by a select health high deductible insurance program
so looking for the most cost efficient way to get it done. Thank you,

Reply

    David,
    Unfortunately, our hip doctor in Park City isn’t currently on the Select Health panels at that location, though we are working on it. He is able to see you in our Salt Lake City office, if the drive wouldn’t be too much of an inconvenience. The most cost-effective way to get it done would likely be through your insurance, even though you have a high deductible plan. Please call our office for more information or to schedule an appointment @ 435-615-8822. We would be happy to help!

    Reply

I’m suffering g right hip inner joints pain, sometimes radiates to my knee and foot. Shatp pain at times.Aches at night. Now I limp. went to chiro, had one legs l different length. It helped some
Feels like my joint slips out of place at times. Did injections, exercises,but no change. continued working as a cna. Not good I know,but theres a pandemic, little help. A diagnosis of sciatica was earlier given. Thats 5 months ago. I’m losing strength in my r leg. Hurts to stand walk,lie down. My activities are limited now and job at risk. Should I quit working? Ct ordered but expensive. Arthritis or busa? Help. I’m at the end of my rope. Iceing did help at first. Ibuprofin a no no for me.

Reply

    Karen,
    We are unable to give you advice of how to move forward, or whether you should quit working, without an evaluation. I am sorry you are in pain and loosing strength. I would recommend following your doctor’s recommendation for a CT. Or you can consider getting a second opinion from an orthopedic spine specialist. Wishing you all the best.

    Reply

I’m homeless, about a week ago, I parked my van on an incline nose up and slept on my side causing pressure on my right hip. I woke up one day on my way to work with severe RT hip pain. I went to the Hospital and they claimed I had arthritis by X-ray. I been popping pain killers all night truck driving on my job to keep the throbbing pain down. When the pain medication wears off, the pain is so bad I’m moaning in the truck with the widows down at 2am. I heard Bursitis aches very bad at night like yesterday night, I was in terrible pain and couldn’t sleep. I heard arthritis has pain in the morning, and that’s how you know the difference between the two. Does Bursitis go away on its on? Any advise on home remedy treatments?

Reply

    Nate,
    Bursitis can go away on it’s own, typically in a few weeks, with the proper precautions and treatments. It can take much longer to heal if you are continuing to sleep or put pressure on it. Bursitis can also come back again/flare up again without precautions. If it is not treated properly, bursitis can lead to chronic inflammation and pain.
    One of the best things you can do at home is rest, warm compress and elevate. Ice is good for the first 48 hours after a flare up. Then switch to heat. You need to give the joint time to heal.
    It sounds like you are already taking anti-inflammatory medications, which can be very beneficial and aid in pain relief, if you’ve talked to your doctor. You can also talk to your doctor about a steroid injection, and supplements like Omega-3 fatty acids, Glucosamine and vitamin C.

    All that being said, if you believe your pain is caused by bursitis and not arthritis, and the home remedies aren’t helping, it might be time to see a specialist. I hope this helps!

    Reply

Hi. I tripped over our puppy (he’s not hurt;)) but I landed on my hip. My daughter applied ice. I was ok for a day; did a lot of walking the next day, noticed pain in my groin so had xray and ultrasound. Found out I have no fractures, very slight arthritis in my hip (never hurt before) and a bursa. The pain seems near my groin area. My hip doesnt hurt but I can’t put weight on my leg that was hurt and I walk with a cane or walker. It aches often but I can’t walk unaided. Has been 3 weeks now. Doctor said keep walking, that the inflamed bursa should go down. I seem to keep re-hurting it whilst walking and trying not to twist around. I’m in South Australia btw. 😉

Reply

    Hi Michele! I’m sorry to hear about your fall, but I’m glad the puppy is OK 🙂
    Injuries can take some time to heal. I would follow your doctor’s instructions and continue to stay mobile.
    If the pain persists, consider seeing a Physical Therapist to help you regain mobility in a slower, more stable way.
    If all else fails and you still feel like you’re not getting better, it’s never a bad idea to get a second opinion. I’m sorry you’re dealing with this. I’m wishing you happy healing.

    Reply

Thanks so much for your reply. I’m off the ibuprofen now, walking well and am fairly well pain free so I’m very fortunate. As I said I found out I have slight arthritis in my hip but I can’t feel anything and the bursa must be ok now too.
Thanks so much for the advice and for taking the time to reply. Best wishes, Michelle.

Reply

I moved a simple piece of furniture, 3 weeks ago. I have had pain in my waist. Now I have severe pain
in my hip and outer thigh. Urgent care x-ray was fine. terrible pain when I walk. I have had bursitis and have arthritis in the spine. Could this be from the spine or hip where the pain is severe when I walk.

Reply

    It’s possible that the severe pain in your hip and outer thigh could be related to your spine or hip joint, especially if you have a history of bursitis and arthritis. It’s possible you could be dealing with muscular or soft tissue strain, or possibly dealing with nerve compression.
    Since you’re experiencing severe pain and it’s affecting your ability to walk, it’s essential to consult with a medical professional for a thorough evaluation. You might consider seeing an orthopedic specialist or a spine specialist who can perform a more detailed assessment, which may include further imaging tests like an MRI to get a clearer picture of what’s causing the pain.

    Reply

I just started working so I was at work last month and was asked to lift something really heavy tho it wasn’t my first time and my work is based on lifting things alot. When I was done I was feeling little pain in the front of my right hip and just ignored it went home and got to bed. The next day when I went back to work the pains became worse and I started limping and decided to stay home till I’m better
Fast forward to today two weeks later I can’t even walk with the leg please I don’t know if it’s hip arthritis or hip bruises or maybe muscle strain what do you think it is because this has never happened to me before and I’m just 20 years old

Reply

    Samuel, since X-rays did not reveal any abnormalities, it may be necessary to consider other imaging techniques, such as MRI or ultrasound, to assess soft tissues and ligaments in the hip. Also, consulting with a healthcare professional, such as an orthopedic specialist, can help with a more accurate diagnosis and tailored treatment plan. They may recommend physical therapy, rest, anti-inflammatory medications, or other interventions depending on the underlying cause of the pain. It’s crucial to address the issue properly to avoid long-term complications and to facilitate a full recovery.

    Reply

I did an x-ray my joints are fine but I still feel severe pain when standing and trying to walk and the doctor told me to just get bed rest till I get better please I hope to get a response soon 🙏

Reply

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