What Is Iliopsoas Bursitis?
Iliopsoas bursitis is an inflammation of the bursa (a liquid-filled sack that is present between muscles, joints, tendons, and ligaments) located beneath the iliopsoas muscle. The iliopsoas muscle is a group of two muscles in front of the hip. The iliopsoas bursa is the largest bursa of the body, and the primary function of the bursa is to act as a cushion between tissue to reduce irritation and friction.
Damage to the bursa can occur when the hip is subjected to continual trauma, leading to inflammation and swelling that may reduce a person’s range of motion and make it difficult to move. Iliopsoas bursitis is commonly seen in athletes such as footballers, soccer players, and runners who put the entire weight of their body on their hips and people who exercise regularly, such as lifting and squatting, which may cause tightness or imbalance of iliopsoas muscle. Also, it is seen in people with chronic conditions, such as arthritis or tight hips.
What Causes Iliopsoas Bursitis?
Several potential reasons can cause iliopsoas bursa. The most common cause is repetitive use of the muscle, which puts physically active individuals and athletes at risk more than others who are less physically active.
Other causes include:
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A direct blow to the iliopsoas bursa caused by falling or hitting on the outside of the hip or the buttocks can cause irritation and inflammation.
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Repeated friction or stress injury as the tendon rubs over the iliopsoas bursa during any physical activity.
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Some chronic conditions, such as rheumatoid arthritis, osteoarthritis, or gout.
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Infection of the iliopsoas bursa.
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Some individuals have tight hip muscle structures like the iliotibial band, psoas hip flexor, and hamstrings.
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Lying on that side may produce constant pressure on the iliopsoas bursa.
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Weakness of the muscles situated over the iliopsoas bursa.
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Some hip conditions can cause inflammation of the iliopsoas bursitis.
What Are the Symptoms of the Iliopsoas Bursitis?
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Patients with iliopsoas bursa have pain as the primary symptom of iliopsoas bursitis. Patients may experience pain and tenderness that starts around the front of the hips.
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The pain may also radiate down the thighs to the knees in some people. In other cases, people may experience pain in their buttocks.
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Stiffness and tightness of the hip may be experienced in the mornings.
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Snapping sensation at the front of the hip.
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Pain in the front of the hip that is often experienced for a short period during vigorous activities like kicking a ball or jogging, extending the leg while driving, getting up from a seated position, bringing the knee up to the chest, walking up stairs, lying down without support, etc.
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Taking rest can relieve the pain.
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The condition can progress and cause severe pain over a period of time. Pain and weakness of the upper thigh/hip area muscle may also cause limping. In most cases, only one leg will be involved.
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Taking smaller steps while walking because of hip tightness.
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Tightness of the iliopsoas muscle may cause hip stiffness and tightness in the groin.
How Is the Iliopsoas Bursitis Diagnosed?
Iliopsoas bursitis is often misdiagnosed due to its unspecific symptomatology. So the patient should be specific and explain how long they have felt the discomfort. Specific clinical procedures are commonly used to elicit a patient’s hip pain, involving the extension of the abducted, flexed, and externally rotated hip, which produces an audible snap in the hip in most cases. Also, in most cases, pain in the inguinal region is possible when palpating. Patients with a history of osteoarthritis, a palpable inguinal or pelvic mass, or snapping hip syndrome could raise the suspicion of iliopsoas bursa inflammation.
To exclude other possible hip problems, a 3D image is recommended,
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MRI-scan (magnetic resonance imaging) - It helps distinguish the iliopsoas bursitis from other conditions such as a hernia, a hematoma, an aneurysm, and a tumor.
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Arthrography - It helps to determine instability and intra-articular pathology.
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Ultrasound - It is the most cost-efficient way of diagnosing iliopsoas bursitis.
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X-ray.
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Bone scan.
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CT-scan (computed tomography).
What Are the Treatment Options for Iliopsoas Bursitis?
The treatment options will differ depending on the severity and cause of the condition. If the bursitis is mild and diagnosed early, rest to the joints, and at-home remedies are often enough to relieve pain. In severe cases, medical advice to treat the pain will be needed.
For Mild Cases - Adequate rest and icing to stop the inflammation are recommended. People experiencing mild episodes of iliopsoas bursitis should modify their activities by avoiding or reducing the activities that worsen symptoms of iliopsoas bursitis. Some people might also benefit from nonsteroidal anti-inflammatory drugs (NSAIDs) or over-the-counter anti-inflammatory medications. NSAIDs should be cautiously used for limited periods.
For Severe Cases - Patients may require additional therapies.
Some therapies include:
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Physical therapy focuses on hip strength and flexibility.
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Anti-inflammatory medications may be required to ease pain and inflammation.
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Antibiotics may be required when the infection is present.
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Corticosteroid injection or PRP injections into the bursa. This can produce long-lasting relief when adequate lifestyle changes are also made. If pain and inflammation return, the patient may consider another injection.
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A walking cane or crutches can also be used for a week or more.
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If an infected bursa is suspected, in rare circumstances, the fluid is removed from the sac for testing.
In Association With Other Conditions - If a person has other severe medical conditions like arthritis or gout, it is necessary to treat the underlying condition. The drugs designed to target the medical conditions will likely help relieve bursitis. A person should clearly explain to their healthcare professionals the hip pain associated with other medical conditions.
What Are the Complications of Iliopsoas Bursitis?
Iliopsoas bursitis should not be ignored, as it will get worse over time if proper treatment is not provided. When left untreated, the mild initial discomfort will aggravate severe pain that may radiate through other parts, such as the leg and hips. In rare cases, patients may also develop an infection if the iliopsoas bursa ruptures.
Some symptoms of infection include,
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Chills.
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Severe joint pain.
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Warm and tender skin that appears red.
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Feeling sick.
Conclusion:
Iliopsoas bursitis is commonly seen in athletes and physically active people, which is an inflammation of the bursa beneath the iliopsoas muscle. The symptoms may be mild initially, but when left untreated, they can get aggravated, and the pain can spread to other parts of the body, such as thighs, legs, and hips. So consult a physician before the symptoms get severe to avoid complications.
