Causes | Bursitis of the hip

Causes

The capsule of the bursa, which is permeable in places, ensures above all the supply of nutrients, which can diffuse from the bloodstream into the bursa. Due to the less sealed parts of the bursa capsule, however, pathogens can also penetrate and promote the development of inflammatory processes in the bursa. As a rule, the pathogens that cause bursitis of the hip originate from a focus of infection located elsewhere in the body.

In patients who suffer from a limited immune system or who do not receive timely and targeted treatment, these pathogens can spread further. Especially viral and bacterial pathogens can easily enter the bloodstream and settle in another part of the body. In this way, the causative pathogens are also transported into the hip area and can penetrate the bursa through the smallest tissue defects.

Within the bursa these pathogens can settle, multiply and initiate inflammatory processes. As a result, an inflammation of the bursa at the hip develops. Usually, the presence of such a bursitis at the hip is first noticed by the affected patients themselves.Due to the deep location of the bursa of the hip, the typical inflammatory features (for example redness and swelling) on the body surface can hardly be observed.

A further cause for the development of bursitis is a persistent pressure overload in the affected joint. Direct causes in this context are persistent and/or recurring movement sequences. For this reason, especially athletes (for example cross-country skiers) are affected by inflammatory processes in the area of the bursa.

Furthermore, external injuries can be the cause of bursitis of the hip. In this context, a distinction is made between two different forms:

  • By a direct impact (for example a blow on the hip) the bursa can fill with blood and become inflamed
  • Bacterial pathogens can penetrate the joint through an open injury in the hip area and lead to bursitis of the hip.

Joggers and hobby runners have a particularly high risk of developing bursitis of the hip compared to the rest of the population. They often expose their hip joints to certain over- or incorrect loads, which can lead to bursitis.

The bursa serves as a kind of buffer, which is supposed to distribute the pressure acting on the joint and the friction there evenly over the tendons, the bone, the muscles and the skin. This is intended to protect the joint apparatus and enable smooth movement. Bursitis is usually caused by small injuries or excessive pressure on the bursa.

In addition, the bursa of the Achilles tendon is often at risk for bursitis in runners, since high forces act on the foot when rolling and pressing off the foot. Patients suffering from bursitis typically experience few symptoms at the beginning of the disease. Occasionally, affected patients report a burning or slightly rubbing sensation.

If the hip affected by the bursitis continues to be strained, the symptoms usually increase rapidly in intensity. Typical symptoms of bursitis of the hip are strong pain, which is mainly provoked by pressure loads. In addition, a significant warming of the skin surface is noticeable in the area of the affected hip, especially in pronounced disease processes.

Visible reddening of the skin occurs in the case of bursitis of the hip in most cases very late. The reason for this is the fact that the structures of the hip joint are very deep and covered by strong muscle layers and subcutaneous fatty tissue. Furthermore, swellings are also noticeable quite late in the presence of a bursitis of the hip.

However, if fluid retention occurs in the area of the affected hip, significant swelling usually develops. Since the inflammatory processes cause an increase in the volume of the bursa, the normal range of movement of the hip joint is also significantly restricted. In particular, the ability of the inflamed hip to stretch and rotate is inhibited at an early stage in most patients.

In some cases, the inflammation of the bursa in the hip even spreads to the surrounding tissue. This can lead to significant redness of the adjacent extremities. In addition, particularly pronounced courses of the disease can cause pronounced general symptoms. The affected patients often develop increasing fatigue, exhaustion and fever. Since bursitis of the hip is often a bacterial infection, swelling of the regional lymph nodes can also occur.