The Science of Hip Bursitis
Hip bursitis involves inflammation of the fluid-filled sacs (bursae) that cushion the hip joint. The most commonly affected bursae are the trochanteric bursa (lateral hip) and iliopsoas bursa (anterior hip). However, true isolated bursitis is actually less common than previously thought, and this represents one of the most important diagnostic updates in hip pain management. What was traditionally called "trochanteric bursitis" is now understood to be primarily Greater Trochanteric Pain Syndrome (GTPS) - a gluteal tendinopathy affecting the gluteus medius and minimus tendons. For years, lateral hip pain was attributed to an inflamed bursa, and the presumed treatment was rest, ice, and anti-inflammatory injections. Research has shown that the primary issue is frequently not an inflamed bursa, but a distressed gluteus medius or minimus tendon. The bursa can become secondarily irritated, but it's rarely the main driver. This distinction is crucial because treating a tendinopathy is not about rest and inflammation control; it's about managing load and progressively strengthening the tendon. True isolated bursitis typically occurs secondary to other conditions, direct trauma, or in rare cases, infection or inflammatory conditions. The bursa becomes inflamed due to mechanical irritation or repetitive friction, but this is usually part of a broader mechanical problem rather than an isolated inflammatory condition.