Key Differences Between Hip Arthritis and Hip Bursitis

Key Takeaways

• Hip arthritis is characterized by joint degeneration, while hip bursitis involves the inflammation of the bursa outside the joint.
• Hip arthritis is typically spurred by aging, autoimmune conditions, or past injuries, while hip bursitis is usually caused by overuse or prolonged pressure.
• Most patients with hip arthritis report deep groin pain, stiffness, and reduced mobility. In contrast, patients with hip bursitis report sharp, localized pain and tenderness on the outer hip.
• Since management strategies for these conditions can differ, it is essential to consult a trusted medical provider to get an accurate diagnosis.

Diagnosing Hip Pain as Arthritis or Bursitis

Due to the joint’s weight-bearing nature and high mobility, the hip is particularly vulnerable to degenerative and inflammatory conditions. On average, 12 to 15 percent of adults over 60 years old experience chronic hip pain; that likelihood increases to between 30 and 40 percent if the adult plays sports. 

Since hip pain is one of the most common musculoskeletal complaints, it is essential to comprehend potential causes, including arthritis and bursitis. Understanding the difference between hip bursitis and hip arthritis can be key to uncovering the most effective path to relief.

Consulting an experienced joint specialist is the best way to understand your specific hip-related problem. Nevertheless, this guide breaks down the difference between hip bursitis and hip arthritis, covering their unique and overlapping characteristics to facilitate informed decision-making. Read through the considerations below to learn about the conditions’ symptoms, causes, diagnosis methods, and treatment options.

Hip Arthritis Overview

Hip arthritis develops as the protective cartilage within the hip joint begins to break down. This condition is characterized by bone surfaces rubbing—it is usually caused by wear-and-tear or, in some cases, immune system dysfunction, and results in pain, stiffness, and inflammation.

Definition and Types

Arthritis is an umbrella term used to refer to more than 100 joint-related disorders. In the hip, the most common types of arthritis are:

• Osteoarthritis – This degenerative condition is the most prevalent form of arthritis, and it usually develops in older adults as cartilage wears away over time.
• Rheumatoid arthritis – This autoimmune disease occurs when the body’s immune system mistakenly attacks the soft lining of the hip joint, leading to pain, swelling, and eventual joint damage.
• Post-traumatic arthritis – This arthritis develops if a severe hip injury or fracture causes cartilage breakdown.

Common Causes

Some common causes for hip arthritis are:

• Natural, aging-fueled cartilage breakdown
• Autoimmune dysfunction, specifically for rheumatoid arthritis
• Structural abnormalities like hip dysplasia
• Past injuries, such as fractures or dislocations
• Family history of arthritis

Symptoms

Some examples of symptoms someone with hip arthritis may experience are:

• Hip or groin pain that gradually progresses
• Stiffness each morning that lasts longer than 30 minutes
• Limited range of motion and joint flexibility
• Pain that is exacerbated with activity or after long periods of inactivity
• Difficulty bearing weight while walking or standing up

Who It Affects

Some of the most common hip arthritis-susceptible groups include:

• Adults over age 50
• People with a history of arthritis in their family
• Individuals with past joint injuries
• People with autoimmune diseases (RA)
• Individuals who are overweight, since excess weight can put stress on the hip

Hip Bursitis Overview

If someone has hip bursitis, at least one of the bursae in their hip joint is inflamed. The most commonly affected bursa in the hip is the trochanteric bursa, located on the hip bone’s outer point.

Definition and Function of the Bursa

Bursae are small fluid-filled sacs strategically placed throughout the body to reduce friction between moving structures and help joints function smoothly. There are usually six bursae in the hip joint alone—these bursae include:

• Trochanteric bursa – Found on the outer part of the hip, close to the greater trochanter. 
• Iliopsoas bursa – Located on the inside of the hip, around the groin area. 
• Subgluteus medius bursa – Positioned below the gluteus medius muscle. 
• Deep subgluteus maximus bursa – Found beneath the gluteus maximus muscle. 
• Obturator internus bursa – Located close to the obturator internus muscle. 
• Obturator externus bursa – Situated around the obturator externus muscle.

If one of the bursae above becomes irritated or inflamed and leads to bursitis, the individual may feel localized pain and tenderness, especially during movement or pressure.

Common Causes

Some of the most noteworthy sources of hip bursitis are:

• Overutilization from repetitive activities like running or climbing stairs
• Fall- or collision-induced trauma to the hip
• Prolonged pressure from lying on one side for too long
• Poor posture or atypical gait
• Underlying inflammatory conditions like gout or rheumatoid arthritis

Symptoms

Some examples of symptoms that hip bursitis may cause are:

• Sudden and sharp pain throughout the outer part of the hip
• Tenderness when pressure is applied to the bony point of the hip
• Discomfort while lying on the affected side
• Pain that is exacerbated after prolonged walking, stair climbing, or standing
• Severe cases may result in swelling or redness at the site

Who It Affects

When it comes to hip bursitis, some of the most affected groups are:

• Athletes and recreational runners
• Workers who are required to perform repetitive squatting or climbing
• Individuals who are overweight 
• People who have uneven leg lengths

In addition to the groups above, women are more commonly affected by hip bursitis than men.

Differences Between Hip Arthritis and Bursitis

Even though both arthritis and bursitis can limit mobility and reduce quality of life, these conditions affect separate structures and are treated differently in clinical settings. Learning to distinguish these two conditions by reading the considerations below is an excellent way to help find the appropriate treatment plan.

Location of Pain

Hip arthritis pain can materialize in the groin, front of the thigh, or occasionally in the buttocks. However, hip bursitis pain is usually limited to the outside of the hip, though it may radiate down the thigh.

Pain Pattern and Onset Duration

Hip arthritis pain is known to develop gradually over time and worsen with ongoing use. Many hip arthritis patients report morning stiffness that tends to improve with controlled, light activity.

Conversely, hip bursitis pain may show up suddenly, especially after heightened activity or hip-related trauma. Pain severity is often dependent on the position the person is in, meaning their discomfort can worsen when they are lying on the affected side or climbing stairs.

Inflammation Type

Historically, both of these conditions have caused inflammation, but they impact different bodily components. Hip arthritis can result in inflammation inside the joint capsule, while bursitis involves inflammation of the soft-tissue bursa surrounding the joint.

Joint Movement

People with hip arthritis usually experience restricted movement due to cartilage loss and the bone-on-bone friction that occurs. On the other hand, people with hip bursitis don’t typically lose much joint mobility; however, pain may still limit certain activities.

Diagnostic Approach

A hip arthritis diagnosis usually demands medical imaging—X-rays can help medical professionals visualize joint space narrowing and bone spurs. In the same vein, MRIs are sometimes used to help assess soft tissue and cartilage damage. Additionally, blood tests may be needed if an autoimmune type, like rheumatoid arthritis, is suspected.

In most cases, hip bursitis can be diagnosed through a physical exam. During this process, the medical professional will press on the outer portion of the hip to reproduce pain in a controlled setting. Nevertheless, an ultrasound or MRI is occasionally used to confirm the bursa’s fluid buildup or at least rule out other issues.

Treatment Options

As mentioned earlier, both conditions require unique, targeted approaches to manage symptoms and prevent further deterioration. Check out the differences below to help tailor your expectations.

For Hip Arthritis

Some of the most common treatment approaches for hip arthritis are:

• Lifestyle changes – Weight loss and activity modifications may be needed. For instance, there are several exercises hip arthritis patients should avoid, including high-impact sports like basketball.
• Physical therapy – An experienced physical therapist can provide a list of safe exercises and stretches tailored to your needs that can help you improve strength and flexibility.
• Medications – Over-the-counter Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) can help with inflammation, while disease-modifying antirheumatic drugs (DMARDs) can address rheumatoid arthritis.
• Joint injections – Corticosteroid injections can provide short-term pain relief by reducing inflammation. Alternatively, hyaluronic acid injections can add lubrication and cushioning to the joint and help with long-term relief.
• Supportive devices – Wearing or utilizing devices like a hip brace for arthritis can reduce pain and improve mobility by giving the wearer more stability.
• Surgical options – Although it is usually used as a last resort, total hip replacement surgery may be required in advanced cases. You may obtain long-lasting relief by replacing the damaged joint with a prosthetic.

For Hip Bursitis

Some of the most noteworthy hip bursitis treatments include:

• Rest and activity modification – It is vital to avoid unnecessary repetitive hip movements and excessive pressure.
• Cold therapy – Applying ice packs for 20-minute increments throughout the day can help reduce swelling.
• Anti-inflammatory medications – Trying over-the-counter NSAIDs or responsibly taking prescription medication can reduce inflammation in bursae.
• Physical therapy – With the hands-on guidance of a physical therapist, correcting gait issues and strengthening supporting muscles can be easier.
• Injections – Corticosteroid joint injections can offer rapid relief by decreasing inflammation.
• Assistive devices – Temporary use of a brace or a cane can mitigate the stress the hip is subjected to.

Overlapping Approaches

Some strategies are known to work well for both conditions, such as:

• Weight management – Maintaining a healthy weight can help avoid unnecessary stress on the hip joint and surrounding tissues.
• Low-impact exercise – There are gentle stretches and exercises for hip bursitis and arthritis, such as swimming, cycling, and yoga, that can improve strength without overstressing the hip.
• Supportive footwear – Getting custom orthotics can help enhance alignment and fix uneven gait that can otherwise worsen arthritis and bursitis.

When to See a Doctor

Unfortunately, many people ignore early signs of hip arthritis and bursitis, assuming the pain they feel will resolve on its own, but that is usually not the case. Early diagnosis can significantly improve treatment outcomes and increase your chances of preventing chronic issues.

Some signs indicating you should seek a medical evaluation include:

• Persistent or progressively worsening hip pain
• Difficulty walking, such as limping
• Joint stiffness that negatively affects daily tasks
• Sudden swelling, redness, or warmth
• Fever or other systemic symptoms

Getting an accurate diagnosis as early as possible can help guarantee you’re not treating the wrong problem. For example, rest and ice might help bursitis, but have little to no effect on forms of advanced arthritis.

Identify the Right Approach to Your Hip Pain

With a comprehensive understanding of the difference between hip bursitis and hip arthritis, finding the best path for relief can be easier. Remember that hip arthritis is usually deep, groin-based, and progressive, while hip bursitis is characterized by sharp, outer-hip pain that flares with pressure or activity. Treatments for these conditions can differ, but usually range from lifestyle changes and physical therapy to injections or surgery for severe cases.

Still, you shouldn’t jump into surgery without hearing a few medical professionals’ viewpoints. The well-trained joint specialists at the Joint Replacement Center of Scottsdale offer second opinions for hip surgery. We also offer top-of-the-line alternative therapies, such as Pulsed Electromagnetic Field (PEMF) therapy, that can help manage hip pain and reduce inflammation without surgery. If needed, we can still perform minimally invasive surgeries using cutting-edge technology like Mako SmartRobotics™, allowing patients to return to the activities they love as soon as possible. 

Schedule an initial consultation with our team if you’re experiencing hip pain. We can help identify the source and develop a personalized treatment plan.