Iliopsoas Bursitis

Iliopsoas Bursitis is a condition characterized by pain and tenderness in the hip and problems while lifting the leg. Get complete information about this disease, including its causes, symptoms, diagnosis, and treatment options.

What is Iliopsoas Bursitis?

It is the inflammation of the Iliopsoas bursa which lies between the front of the hip joint and the Iliopsoas muscle. Iliopsoas bursa happens to be the largest bursa in the body. It assists in reducing the rubbing and friction between the bones and soft tissues which meet at your hip joint capsule. This condition is often mistaken for Iliopsoas tendinitis or hip joint arthritis. The inflammation is usually caused due to trauma or over-usage, which can lead to tightness or imbalance.

Iliopsoas Bursitis Causes

The causes of this condition are the same as in other forms of bursitis. The causes are explained in detail below: Picture of Iliopsoas Bursitis

Picture 1 - Iliopsoas Bursitis

Over-usage

The condition is commonly caused due to injury resulting from an overuse of the hip joint. It is found in women and middle-aged people. Any activities that demand prolonged usage of the hip joint might lead to an irritation of the bursa. Activities that put stress on the hip bone are biking, climbing stairs and swimming – when done frequently. Movements like standing; bending of the hips or squatting for long periods exerts excessive pressure on the hip joint.

Arthritis

Medical experts are of the opinion that changes taking place in the hip joint due to Osteoarthritis, Gout and Rheumatoid arthritis can cause inflammation of the bursa and lead to Bursitis.

Disorders

Diabetes or any kind of infection can also provoke an immune system response in the form of an inflamed bursa.

Structural Changes

The bursa gets inflamed if the hip suffers an injury due to a direct blow, fall or bumping into any hard surface. Other injuries such as Tendinitis or problems of the bone can also result in calcium deposits which can rub against and irritate the bursa.

Spinal Changes

Changes that take place in the spine due to Arthritis, Scoliosis and other conditions can lead to pressure on the hip joint and cause hip bursitis. The shape of the spine gets altered as the muscles, tendons and ligaments exert a pull on the hip joint. In addition, if there is an imperfection in length of the tendons, as one being shorter than the other one, the ability to walk properly will be affected. Over time, one ends up stressing the hip joint – which can lead to Bursitis.

Iliopsoas Bursitis Symptoms

The common symptoms that one might experience due to this disorder include:

  • Weakness – It is experienced in your upper thigh or hip area especially when trying to lift the knee which results in a limp when walking or running.
  • Pain and tenderness – These are two of the most common symptoms experienced by people with this inflammation. The source of the pain lies deep in the groin and radiates around to the front of the hip or upper thigh area. It spreads throughout the length of the tendon down towards the knee. Pain shifts into lower back and buttock area also. This pain is experienced all at one time. Pain is usually experienced for a shorter period and specially during strenuous activities like jogging or kicking a ball. Passive activities like getting up from a seated position, climbing upstairs or lifting something heavy may also result in painful symptoms. Some individuals find it difficult to lie down without support. The pain goes away for sometime but returns with more intensity when the individual stops all activity. The pain increases due to the flexion of hip.
  • Stiffness in the hip/Tightness in the groin – It is felt as a result of the tight Iliopsoas muscle. Swelling, along with increased amount of fluid in the bursa, is often noticed. Redness and warmth of the groin are also felt. Clicking, popping or snapping may take place when the Iliopsoas gets inflamed. This can also lead to tearing or rupture of the Iliopsoas muscle.

You should seek immediate medical help on experiencing any of the following health issues:

  • Rashes in the groin
  • Problems in urinary functions
  • Development of a cut, lump or bulging in the groin area or bleeding in the groin area
  • Swelling in and around the genitalia
  • Exposure to STD
  • Major troubles in hip or thigh movement problems leading to a severe limp
  • Pain in the groin that has not subsided after 1 week
  • Indications of shock like shallow breathing, nausea, restlessness, weakness and light headedness

Iliopsoas Bursitis Diagnosis

A physician will perform a detailed physical examination, with special emphasis on the bursa, to identify the condition. An imaging test may be done to rule out other possible injuries and conditions. This may be any of the following exams:

  • Bone scan
  • MRI (Magnetic Resonance Imaging), which helps in evaluating painful conditions of the hip and pelvis
  • X-ray, to make sure whether or not there are bone problems
  • Diagnostic ultrasonography, to confirm Bursitis or Tendinitis

The most reported imaging appearance is the visual image of a thin-rimmed, homogeneous cystic fluid collection.

Iliopsoas Bursitis Treatment

The treatment for this type of Bursitis comprises of relieving the symptoms. The goal is to keep the pressure off the bursa. If there is a problem like bone spur, surgery may be required. If the Bursitis is caused by an infection, a physician will drain out the fluid from the sac of the bursa and prescribe antibiotics to cure the infection. If there is no presence of infection, the initial treatment starts with cold therapy. The primary part of the treatment is to make sure that the hip gets enough rest. Some of the treatment options available for this condition include: Image of Iliopsoas Bursitis

Picture 2 - Iliopsoas Bursitis Image

Cold Compression Therapy

It is the first step to curing the inflammation associated with the condition. Applying cold to the inflamed bursa will reduce the swelling and the redness around it. This cold therapy also helps to numb the pain in your acetabular joint and is quite effective in controlling the inflammation. The deep cooling effect also minimizes the risk of tissue damage. The inflamed bursa should be cooled throughout the day. Ice should be applied over the swollen area for 2 to 4 times a day for a span of about 15-20 minutes. The ice should be wrapped in a towel or cloth or compression wrap before application on the affected region to avoid the risk of frostbite.

Blood Flow Stimulation Therapy

Once the inflammation of the bursa has been minimized with cold therapy, it is time to make sure that the blood flow improves. It is also time to improve the elasticity of the surrounding soft tissue. This is because the body needs fresh blood to repair the tissue and bring your Iliopsoas bursa back to normal. It is due to this reason that a patient requires blood flow stimulation therapy which would render the tissue with oxygen, water, antibodies, and nutrients that are necessary to heal the bursitis injury. This speed up the entire repairing process of tissue, removes the toxins and dead cells, and also improves elasticity.

Anti-inflammatory Medications

Non-steroidal anti-inflammatory drugs (NSAIDs) can be taken to help manage the pain. However, these should not be used for long periods as they can cause gastrointestinal problem and maximize the risk of cardiovascular disease.

Healing Exercises

Physical therapy is a good way to restore muscles that have been atrophied, and improve the strength and mobility, following the treatment of Bursitis. The extent of tissue damage and the symptoms would determine the type of physical therapy. Once the pain starts to fade away, a physiotherapist would suggest a personalized strengthening and stretching exercise program for the patient to perform at home or in the gym. This will help him/her return to a normal routine. Individuals should learn to strengthen muscles in the right way. Otherwise, it may cause more damage to the joint. Strengthening exercises are important as the muscles turn weak due to non-usage. An expert instructor assists a patient to ensure that the rehabilitation process is appropriate and effective. Maintaining the regularity of exercise programs tends to yield faster results.

Surgical Treatment

If an affected bursa does not heal with conservative treatments, it has to be removed surgically. This is done with the help of a surgical procedure known as Hip arthroscopy. In this technique, tiny incisions are made and a camera (that of the size of a pencil) is inserted into the hip. A small shaver is inserted through another incision to remove the swollen bursa completely. A surgeon will also look for other damages and repair them if necessary. Any bone spurs are also removed by this method. The occurrence, as well as recurrence, of Iliopsoas Bursitis can be prevented by avoiding activities and behaviors that trigger inflammation of the hip. One must also avoid repetitive activities that put stress on the hip. Regular exercise will help maintain the strength and flexibility of the hip muscles.

References:

http://www.sportsinjuryclinic.net/sport-injuries/hip-groin-pain/iliopsoas-bursitis

http://www.livestrong.com/article/122942-causes-iliopsoas-bursitis-hip/

http://apmspineandsports.com/diagnosis/iliopsoas-bursitis/

http://www.mendmeshop.com/bursa/illiopsoas-bursitis-symptoms.php

By    Last updated October 1st, 2012

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