From the Guidelines
Hip bursitis in a sedentary 20-year-old male with normal BMI is typically caused by prolonged sitting with poor posture, repetitive movements, or sudden increases in activity without proper conditioning. The most common causes include sitting for extended periods with pressure on the hip area, improper ergonomics while sitting, sudden intense exercise without proper warm-up, or minor trauma to the hip region. Even in sedentary individuals, activities like crossing legs for long periods, sitting on hard surfaces, or sleeping on one side consistently can irritate the bursa. Anatomically, the bursa is a fluid-filled sac that cushions the joint, and when irritated, it becomes inflamed, causing pain on the outside of the hip. According to the American Heart Association, initial treatment should focus on nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics 1. Treatment typically involves rest, avoiding activities that worsen symptoms, over-the-counter NSAIDs, applying ice for 15-20 minutes several times daily, and gentle stretching exercises. Breaking up long periods of sitting, improving posture, using cushioned seating, and gradually introducing physical activity can help prevent recurrence. If symptoms persist beyond 2-3 weeks despite these measures, medical evaluation is recommended as persistent bursitis may require physical therapy, corticosteroid injections, or rarely, surgical intervention. Key considerations for managing hip bursitis include:
- Avoiding activities that aggravate the condition
- Using NSAIDs judiciously, considering both safety and efficacy 1
- Implementing preventive measures to reduce the risk of recurrence.
From the Research
Causes of Hip Bursitis
- Lateral hip pain is most commonly caused by greater trochanteric pain syndrome, which includes:
- Gluteus medius tendinopathy or tear
- Bursitis
- Iliotibial band friction 2
- Hip bursitis can be a cause of lateral hip pain in a 20-year-old male, even if he is mostly sedentary
- The study suggests that a definitive diagnosis may require radiography, ultrasonography, or magnetic resonance imaging, in addition to a thorough history and physical examination 2
Risk Factors
- Sedentary lifestyle may contribute to the development of hip bursitis, although the exact mechanism is not specified in the study
- The study does not provide specific information on the causes of hip bursitis in a normal BMI 20-year-old male, but it does mention that intra-articular pain is often caused by a labral tear or femoroacetabular impingement in younger adults 2