Table of ContentsView AllTable of ContentsSymptomsCausesTreatmentDaily ActivitiesHealing Time
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Treatment
Daily Activities
Healing Time
Iliopsoas bursitis, also calledhip bursitis, isinflammationof the iliopsoas bursa. Thisbursais a large fluid-filled sac found under theiliopsoas muscle, which supports hip movement. The iliopsoas bursa provides cushion for tendons, ligaments, and muscles to prevent friction during movement.
Inflammation of this bursa can occur from factors such asoveruse, hip injury, orhip surgery. Spinal disease or other issues that prevent a normal gait (manner of walking) can also cause this problem. An inflamed bursa can cause pain and prevent normal leg movement.
This article explains iliopsoas bursitis symptoms, causes, and diagnosis. It also describes treatment and ways to prevent the problem from coming back.
How Iliopsoas Bursitis Symptoms Feel
Iliopsoas bursitis and other problems with your hip usually causegroin pain. Most people with iliopsoas bursitis feel pain in the front of their hip and the groin, like a pulled groin muscle. This pain may radiate down the inside of your groin through your thigh to your knee.
Main iliopsoas bursitis symptoms usually involve:
What Causes Hip Pain?
Do I Need an Ultrasound or MRI?
The first step in diagnosing iliopsoas bursitis involves a complete physical examination and discussing how and when your pain began. Your healthcare provider may ask you to perform simple movements, such as standing on the affected leg, to determine the impact of pain on your function.
An imaging test—such as an X-ray, ultrasound, or magnetic resonance imaging (MRI)—can aid in diagnosis if the bursa is too deep for physical examination. These tests can also confirm that the problem is bursitis and is unrelated to a broken bone or other condition.
Your healthcare provider determines the specific imaging technique necessary to diagnose the source of your hip pain. Considerations involve the following:
X-ray: An X-ray provides images of bony structures to identify bone fractures and the characteristics of those fractures. It can also show whether an injury to surrounding soft tissue is contributing to your pain.
Magnetic resonance imaging (MRI): An MRI uses a high-strength magnet and radio waves to produce cross-sectional, multiplanar images (images along the same plane) of structures such as cartilage, tendons, ligaments, and bones. If a subtle fracture or injury exists, an MRI can reveal swelling within the bone.
MRI may be best suited to evaluate damage to cartilage, bone, or other structures inside and around a joint. An MRI may be better if your provider wants a detailed image of an entire joint.
Ultrasound: Ultrasound images are obtained using high-frequency sound waves sent and received through a transducer (a small handheld device). Ultrasound images show details of soft tissues around joints, tendons, and muscles. The technology can provide a higher level of detail in a structure than MRI, especially those that are not very deep.
Ultrasound can effectively diagnose abnormalities near the surface, on the outside of a joint. These abnormalities are readily visible to an ultrasound probe on the skin overlying the structure, making ultrasound ideal for diagnosing hip bursitis.
Ultrasound can also beused in iliopsoas bursitis treatment procedures, such as corticosteroid injections or aspiratio,n so the provider can guide the needle to an exact location.
In many cases, ultrasound is advantageous over MRI in orthopedics because it costs less, is more widely available, and allows for dynamic examination of themusculoskeletal system. Since ultrasound is readily available, it can save time and prevent the need to schedule an MRI in a separate location at a later date.
The Anatomy of the Iliopsoas MuscleThe iliopsoas muscle runs from your lower back through your pelvis, where it attaches to the lesser trochanter (a small bump on the top of your thigh bone near your groin.) This muscle helps you bend your hip.A fluid-filled sac called a bursa protects and allows the tendon to glide when you make these movements. When this bursa becomes inflamed or overworked, it is iliopsoas bursitis.
The Anatomy of the Iliopsoas Muscle
The iliopsoas muscle runs from your lower back through your pelvis, where it attaches to the lesser trochanter (a small bump on the top of your thigh bone near your groin.) This muscle helps you bend your hip.A fluid-filled sac called a bursa protects and allows the tendon to glide when you make these movements. When this bursa becomes inflamed or overworked, it is iliopsoas bursitis.
The iliopsoas muscle runs from your lower back through your pelvis, where it attaches to the lesser trochanter (a small bump on the top of your thigh bone near your groin.) This muscle helps you bend your hip.
A fluid-filled sac called a bursa protects and allows the tendon to glide when you make these movements. When this bursa becomes inflamed or overworked, it is iliopsoas bursitis.
Cause of Iliopsoas Bursitis Pain
Inflammation of the iliopsoas bursa can occur when the area becomes overworked or irritated. While the condition can affect anyone, it happens more often in people who are middle-aged or older. Women are more likely to develop it than men.
A Note on Gender and Sex TerminologyVerywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
A Note on Gender and Sex Terminology
Verywell Health acknowledges thatsex and genderare related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female,” “male,” “woman,” and “man” as the sources use them.
Having any of the following risk factors can increase your chances of developing iliopsoas bursitis pain:
What Is Trochanteric Bursitis?Trochanteric bursitisis another type of hip bursitis. It occurs in the bursa that covers the greater trochanter, the bony part of the hip bone where it meets your femur (thigh bone). This type of hip bursitis usually causes pain in the outer edge of your upper thigh.
What Is Trochanteric Bursitis?
Trochanteric bursitisis another type of hip bursitis. It occurs in the bursa that covers the greater trochanter, the bony part of the hip bone where it meets your femur (thigh bone). This type of hip bursitis usually causes pain in the outer edge of your upper thigh.
Iliopsoas Bursitis Treatment Options
Iliopsoas bursitis treatment options vary based on the severity of your condition and other factors concerning your overall health. Treatment for most cases of iliopsoas bursitis often begins with conservative treatment that addresses the cause of the inflammation.
Pain Relief
The first steps in pain relief of iliopsoas bursitis symptoms involve:
Consult your healthcare provider about the use of over-the-counter pain relievers.Nonsteroidal anti-inflammatory drugs (NSAIDs)can be used for limited periods but should not be considered a long-term solution. NSAIDs that may help symptoms of iliopsoas bursitis include:
Nonprescription NSAIDs include:
Prescription NSAIDs include:
Home Exercises and Stretches
Home exercises and stretches can helpincrease hip strength and flexibility. While these exercises are performed at home without supervision, you should consult a healthcare provider or a physical therapist before starting any exercise while you have pain and/or swelling.
Build in time for warm-up and cooldown in any home exercise routine. Some home exercises and stretches commonly used to relieve Iliopsoas bursitis include:
Press-Ups: This simple exercise stretches the iliopsoas tendon. It is performed as follows:
Hip adductor stretch: This exercise stretches the hip adductors, a group of muscles on the inner aspect of your thigh that promote balance. It is done as follows:
Hip bridges: This exercise works all your hip muscles at the same time and is performed in the following way. It is done in the following way:
With a Physical Therapist
Working with a physical therapist can often help speed up recovery.Physical therapyinvolves a personalized treatment plan that uses hands-on care, patient education, and prescribed movement. If you work with a physical therapist, your program will likely involve the following:
Steroid Injections
Asteroid injectioninvolves a single injection of acorticosteroid drugwith a local anesthetic into the inflamed bursa.This in-office procedure may provide temporary or permanent relief of pain and swelling.
If symptoms do not improve after a few months, you may qualify for another injection. However, steroid injections can’t be used as a long-term solution if the problem persists.
For Infection
Rarely, the iliopsoas bursa can become infected with bacteria, resulting in septic bursa. This can occur when bacteria living on your skin gain entry into the bursa through a cut, scrape, puncture, bug bite, or other trauma to your skin. It can also occur from a previous surgery or corticosteroid injection or as a result of an infection in another part of your body that has spread.
Septic bursa is a serious condition that requires prompt medical treatment to prevent the infection from spreading to other areas of your body. The most serious complication issepsisorseptic shock, a life-threatening infection.
Get immediate medical attention if you develop any of the following symptoms of a bursa infection:
Treatment for septic bursitis includesantibiotics. In more severe cases, aspiration of the affected fluid or surgical drainage and removal of the infected bursa sac may be required to eradicate the infection.
Surgical Treatment
Surgery is rarely needed to treat iliopsoas bursitis. If pain persists, fluid may be removed from the affected bursa with a needle.
Surgery is reserved as a last resort for cases in which the bursa remains inflamed and painful despite conservative treatment. Surgical removal of the inflamed bursa (bursectomy) does not interfere with normal hip function.
In some cases, the bursa is removed using minimally invasivearthroscopic surgeryrather than open surgery. This procedure is typically faster and less painful than open surgery.
It involves removing the bursa through a one-fourth-inch incision over the hip. An arthroscope, a small camera, is placed into a second incision to guide the instruments during the procedure.
Many people who have pain from iliopsoas bursitis benefit from working with a physical therapist two to three times weekly for a few weeks. The number of weekly visits can be reduced as your symptoms improve.
Quadricep (front of thigh) stretchis done as follows:
Calf stretchis done as follows:
Inner-thigh, hip, and groin stretchis done as follows:
Iliopsoas Bursitis Healing Time
Other personal characteristics, such as your medical history and conditions, may impact which treatments are available and relevant. Depending on your situation, iliopsoas bursitis can improve in periods ranging from a few days to a few weeks.
The American Association of Hip and Knee Surgeons (AAHKS) advises that it can take four to six weeks to improve the pain and discomfort typically associated with iliopsoas bursitis. Having surgery can involve longer recoveries. A good stretching program performed two to three times daily is key to managing iliopsoas problems.
Some cases develop into chronic iliopsoas bursitis. This is more likely if you continue putting pressure or stress on an injured bursa before it heals or if you injure your hip after the original episode. Chronic iliopsoas bursitis involves repeated attacks of pain, swelling, and tenderness that go away and return.
Recurring episodes of inflammation can thicken the bursa, which can worsen swelling. This can deteriorate muscles and cause a limited range of motion in the affected joint.
Summary
Iliopsoas bursitis can occur as a result of overuse or repetitive injuries. Having certain health problems that hinder the way you walk can also increase your risk.
While iliopsoas bursitis can cause severe hip pain, the problem often resolves with proper treatment. Getting the right diagnosis ensures that you get appropriate treatment to promote healing. A physical therapist can provide education and movements needed to stretch and strengthen muscles and prevent a chronic problem.
When pain or swelling persists despite conservative treatment, contact your healthcare provider for further treatment. A corticosteroid shot or draining fluid from the affected bursa may be needed. In rare cases, removing out the affected bursa is the only way to achieve relief.
18 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Association of Hip and Knee Surgeons.Iliopsoas tendonitis/bursitis.American Academy of Orthopaedic Surgeons.Hip bursitis. February 2022.American Family Physician.Hip pain in adults: evaluation and differential diagnosis. January 15, 2021.Buoy Health.Iliopsoas bursitis.UCLA Health.Bursitis pain comes from inflammation of bursae. November 4, 2023.American Academy of Family Physicians.Bursitis of the hip. October 2023.Hospital for Special Surgery.Imaging for diagnosing hip pain.Cleveland Clinic Health Essentials.When is ultrasound used vs. an MRI for bone, muscle and joint problems?September 5, 2019.Terhoeve C, Zura R, Reach J, King A. (2021).The techniques and merit of ultrasound in orthopaedics. In: Li J, Ming-Der Chow R, Vadivelu N, Kaye AD. (eds)Ultrasound Fundamentals. Springer, Cham. doi:10.1007/978-3-030-46839-2_9Aurora Health Care.Hip bursitis symptoms and treatment.UCSF Health.Trochanteric bursitis.American Physical Therapy Association.Physical therapy guide to hip bursitis. August 31, 2022.Osmosis.Septic bursitis. January 4, 2024.Stanford Medicine Health Care.Septic bursitis.Khodaee M.Common superficial bursitis.afp. 2017;95(4):224-231.Dignity Health.Hip bursitis.American Academy of Orthopaedic Surgeons.Warm up, cool down and be flexible.Johns Hopkins Medicine.Bursitis.
18 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Association of Hip and Knee Surgeons.Iliopsoas tendonitis/bursitis.American Academy of Orthopaedic Surgeons.Hip bursitis. February 2022.American Family Physician.Hip pain in adults: evaluation and differential diagnosis. January 15, 2021.Buoy Health.Iliopsoas bursitis.UCLA Health.Bursitis pain comes from inflammation of bursae. November 4, 2023.American Academy of Family Physicians.Bursitis of the hip. October 2023.Hospital for Special Surgery.Imaging for diagnosing hip pain.Cleveland Clinic Health Essentials.When is ultrasound used vs. an MRI for bone, muscle and joint problems?September 5, 2019.Terhoeve C, Zura R, Reach J, King A. (2021).The techniques and merit of ultrasound in orthopaedics. In: Li J, Ming-Der Chow R, Vadivelu N, Kaye AD. (eds)Ultrasound Fundamentals. Springer, Cham. doi:10.1007/978-3-030-46839-2_9Aurora Health Care.Hip bursitis symptoms and treatment.UCSF Health.Trochanteric bursitis.American Physical Therapy Association.Physical therapy guide to hip bursitis. August 31, 2022.Osmosis.Septic bursitis. January 4, 2024.Stanford Medicine Health Care.Septic bursitis.Khodaee M.Common superficial bursitis.afp. 2017;95(4):224-231.Dignity Health.Hip bursitis.American Academy of Orthopaedic Surgeons.Warm up, cool down and be flexible.Johns Hopkins Medicine.Bursitis.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Association of Hip and Knee Surgeons.Iliopsoas tendonitis/bursitis.American Academy of Orthopaedic Surgeons.Hip bursitis. February 2022.American Family Physician.Hip pain in adults: evaluation and differential diagnosis. January 15, 2021.Buoy Health.Iliopsoas bursitis.UCLA Health.Bursitis pain comes from inflammation of bursae. November 4, 2023.American Academy of Family Physicians.Bursitis of the hip. October 2023.Hospital for Special Surgery.Imaging for diagnosing hip pain.Cleveland Clinic Health Essentials.When is ultrasound used vs. an MRI for bone, muscle and joint problems?September 5, 2019.Terhoeve C, Zura R, Reach J, King A. (2021).The techniques and merit of ultrasound in orthopaedics. In: Li J, Ming-Der Chow R, Vadivelu N, Kaye AD. (eds)Ultrasound Fundamentals. Springer, Cham. doi:10.1007/978-3-030-46839-2_9Aurora Health Care.Hip bursitis symptoms and treatment.UCSF Health.Trochanteric bursitis.American Physical Therapy Association.Physical therapy guide to hip bursitis. August 31, 2022.Osmosis.Septic bursitis. January 4, 2024.Stanford Medicine Health Care.Septic bursitis.Khodaee M.Common superficial bursitis.afp. 2017;95(4):224-231.Dignity Health.Hip bursitis.American Academy of Orthopaedic Surgeons.Warm up, cool down and be flexible.Johns Hopkins Medicine.Bursitis.
American Association of Hip and Knee Surgeons.Iliopsoas tendonitis/bursitis.
American Academy of Orthopaedic Surgeons.Hip bursitis. February 2022.
American Family Physician.Hip pain in adults: evaluation and differential diagnosis. January 15, 2021.
Buoy Health.Iliopsoas bursitis.
UCLA Health.Bursitis pain comes from inflammation of bursae. November 4, 2023.
American Academy of Family Physicians.Bursitis of the hip. October 2023.
Hospital for Special Surgery.Imaging for diagnosing hip pain.
Cleveland Clinic Health Essentials.When is ultrasound used vs. an MRI for bone, muscle and joint problems?September 5, 2019.
Terhoeve C, Zura R, Reach J, King A. (2021).The techniques and merit of ultrasound in orthopaedics. In: Li J, Ming-Der Chow R, Vadivelu N, Kaye AD. (eds)Ultrasound Fundamentals. Springer, Cham. doi:10.1007/978-3-030-46839-2_9
Aurora Health Care.Hip bursitis symptoms and treatment.
UCSF Health.Trochanteric bursitis.
American Physical Therapy Association.Physical therapy guide to hip bursitis. August 31, 2022.
Osmosis.Septic bursitis. January 4, 2024.
Stanford Medicine Health Care.Septic bursitis.
Khodaee M.Common superficial bursitis.afp. 2017;95(4):224-231.
Dignity Health.Hip bursitis.
American Academy of Orthopaedic Surgeons.Warm up, cool down and be flexible.
Johns Hopkins Medicine.Bursitis.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
