What to know about iliopsoas bursitis
- When a person develops iliopsoas bursitis, they may experience painful inflammation.
- Iliopsoas bursitis is often referred to as a repetitive use syndrome.
- As might be expected with swelling around the hip joint, pain is the primary symptom.
What is iliopsoas bursitis?
Iliopsoas bursitis affects the muscles around the hip joints.
Iliopsoas bursitis is an inflammatory response in the bursa located under the iliopsoas muscle.
The iliopsoas muscle is a group of two muscles located toward the front of the inner hip.
A bursa is a liquid filled sack that sits between muscles, ligaments, and joints.
When functioning normally, a bursa provides cushioning and reduces irritation from rubbing and friction.
A damaged bursa causes inflammation that may reduce a person's range of motion, making it difficult for them to move.
Athletes and people who exercise regularly tend to develop this condition. It can also develop in people with chronic conditions, such as arthritis, or in people with tight hips.
Depending on the severity of the swelling, the pain may start in the front of the hip and radiate down the leg. The pain may also radiate towards the buttocks.
In addition, people with iliopsoas bursitis are likely to experience stiffness in the morning. Often, the stiffness will subside throughout the day. However, a person might also experience pain when:
- walking up and down stairs
- standing up from a sitting position
- extending or lifting one or both legs
It is not uncommon for the pain and discomfort to get more severe over time.
What are the causes?
Repetitive use of the iliopsoas muscles, such as from running, may cause iliopsoas bursitis.
Several potential causes can lead to iliopsoas bursitis. One of the most likely causes is from repetitive use. Athletes and physically active people are more at risk than people who are sedentary. Runners, skiers, and swimmers are all at risk of developing the condition.
Also, a person who has tight hips may develop iliopsoas bursitis. Tight hips put additional pressure on the ligaments, joints, and muscles. The pressure causes friction, which can lead to the condition.
Some chronic conditions can also cause iliopsoas bursitis. In particular, people with arthritis, both rheumatoid and osteoarthritis, are at an increased risk. Both of these conditions can cause excess friction in the hips that then leads to iliopsoas bursitis.
Treatment for iliopsoas bursitis depends on the cause and the severity of the condition. When diagnosed early, at-home remedies are often enough. In more severe cases, a person may need to seek medical advice to treat the pain.
Mild cases often require little more than rest and icing to the stop the inflammation. Some people might also benefit from over-the-counter anti-inflammatory medications. People experiencing mild episodes of iliopsoas bursitis should consider stopping or reducing the activity that causes the bursitis.
In more severe cases, a person may seek additional therapies. Some therapies include:
- physical therapy that focuses on hip strength and flexibility
- corticosteroid injection directly into the bursa
- anti-inflammatory medications
- antibiotics when infection is present
- walking aids, such as canes, to relieve pressure
If a person has arthritis, the doctor will treat the underlying condition. Medications designed to target the arthritis symptoms will likely help relieve the bursitis. A person should talk to his or her doctor if experiencing hip pain associated with arthritis.
Stretches and exercises for prevention
Stretching and exercise can be used to help prevent iliopsoas bursitis. One of the primary causes is friction and rubbing that can occur when the hips are too tight. Stretching can help alleviate the tightness.
There are many stretches that focus on the hips including the following:
Lying hip rotation
Lay on the floor with feet flat and knees bent. Lay one ankle across the other knee. Rotate the hip in and out.
Sit on the floor and put soles of the feet together. Gently push the knees toward the floor.
The pigeon stretch may help to strengthen the hips and prevent iliopsoas bursitis.
Sit with one knee bent in front of the body at a 90-degree angle, with the heel toward the opposite hip.
Extend the other leg behind the body as far as possible. Gently move the back hip forward and backward. Repeat with the other side.
When stretching for the first time, go very slowly and gently. Try to hold each stretch for 10-30 seconds and repeat several times on either side. Do these stretches as often as possible.
In addition to stretching, a person may wish to strengthen their hips. Stronger hips can help prevent overuse injuries caused by inadequate support. Some exercises that will help strengthen the hips are listed below.
Standing up, raise one leg out to the side. Do this on both sides and repeat between 10 to 15 times per side. As strength increases, try adding light weights to the ankles. Hold onto a wall for balance, if required.
Lie on the ground with both feet planted on the floor near the buttocks. Raise one leg straight up, keeping the thighs parallel. Raise the hips off the ground. Repeat about 10 to 15 times.
Place both hands and knees on the floor. Raise one foot back towards the sky and return to all-fours. Repeat on each side between 10 to 15 times.
Iliopsoas bursitis will get worse over time if left untreated. What started as mild discomfort will grow into a pain that may radiate through parts of the leg and hips.
Rarely, a person may develop an infection. An infection can occur if the iliopsoas bursa ruptures. Some symptoms of infection include:
- joint pain
- warm skin that appears red
- feeling ill
What is psoas syndrome?
Psoas syndrome is an injury to the psoas muscle. The psoas muscle is one of a group of muscles that join up to form the iliopsoas muscle. It is essential for the movement of the back, pelvis, legs, and hips. Psoas syndrome is an uncommon condition that can be mistaken for iliopsoas bursitis because it causes similar symptoms.
An injury to the psoas muscle can take several weeks to heal. Typical recovery times range between 6 to 8 weeks. Often, people will have physical therapy, take medications, and ice the injury. Doctors recommend limited activity during the recovery period.
Iliopsoas bursitis is easy to treat in most cases. It usually requires rest and some minimal care to improve symptoms and heal the damage. Stretches and exercises that target the hips are helpful in preventing iliopsoas bursitis.