By 2. Injury and Trauma
Injury and trauma can irritate the bursa of the hip and trigger swelling as the body responds to protect the joint. A direct fall onto the side of the hip is a common cause. Landing on a hard surface such as concrete or tile places sudden pressure on the cushioning sac and nearby tissues. Similar stress may occur during sports, daily activities, or sudden events such as vehicle collisions, where impact directly affects the outer hip.
Minor bumps like slipping on stairs, falling on wet floors, or hitting your hip against hard objects can cause increasing irritation over time. When impacts happen often, the bursa may not have enough time to recover. Continued mechanical stress keeps the tissue inflamed. In some cases, trauma may also cause small amounts of fluid buildup or minor bleeding around the bursa, which increases pressure and contributes to swelling. Trauma can also strain nearby muscles and tendons, causing them to press and rub against the bursa during movement. This added friction increases swelling and discomfort.
3. Age
Age plays a direct role in structural changes that affect the hip. Over time, tendons lose collagen strength and become less flexible. The bursae, which are thin sacs filled with lubricating fluid, can also lose elasticity and become more sensitive to pressure. As these tissues stiffen, they absorb less shock during movement.
Reduced shock absorption increases the direct force on the outer hip during everyday activities like walking, climbing stairs, or standing for long periods. This added pressure makes the bursa more likely to become irritated. Cartilage inside the hip joint gradually thins with age. As the cartilage surface wears down, joint movement may become less smooth.
Even small changes in alignment can shift mechanical load toward the outer hip, increasing friction between tendons and the bursa. In addition, muscles that support the hip may gradually weaken with age, reducing joint stability and allowing greater stress to reach the surrounding bursa during movement.
4. Posture
When posture is poor, extra pressure builds on the hip joint and the soft tissues around it. As the hips fall out of proper alignment, the bursa may rub more against nearby bones, increasing stress and raising the risk of irritation over time.
Sitting posture often plays a major role. Long hours of sitting, especially when slouching, leaning to one side, or crossing the legs, can shift body weight unevenly. This added load places more force on one hip, straining the bursa and contributing to pain.
Standing posture also affects hip balance. Locking the knees, tilting the pelvis forward, or resting more weight on one leg disrupts even weight distribution and increases friction around the hip during routine activities such as cooking or waiting in line.
Walking posture adds further strain. Short steps, limping, or wearing shoes with poor support can change how the hips move. Over time, these altered movement patterns increase stress on the outer hip and can irritate the bursa.
5. Muscle Weakness
Muscle weakness around the hip increases mechanical stress on the joint. The hip depends on strong stabilizing muscles to keep movement steady during walking, standing, and lifting. When these muscles lose strength, the joint moves in less controlled patterns, placing greater strain on the outer hip structures.
Weakness often develops after long periods of sitting or reduced activity. Injury, aging, or nerve-related changes can also lower muscle strength. As muscle support declines, weak muscles absorb less force during activity.
The hip also relies on stabilizing muscles, especially the gluteal muscles, to keep the pelvis level during walking. When these muscles weaken, the pelvis may tilt slightly with each step. This change in movement increases pressure on the outer hip where the bursa sits.
As a result, more pressure shifts to the bursa along the outer side of the hip. Repeated loading without proper muscular support can irritate the bursa and lead to swelling and discomfort. Once discomfort begins, reduced movement may further weaken these muscles, increasing strain on the hip and allowing irritation to persist.
6. Bone Spurs
Bone spurs are hard growths that form along the edges of bones. In the hip, they often develop near joints where bones meet and move. Aging, joint wear, past injuries, changes in walking patterns, and increased pressure on the hip can all contribute to their formation.
Bone spurs may also develop alongside joint conditions that alter how the hip moves and bears weight. Problems begin when a bone spur repeatedly contacts nearby soft tissue. When a spur rubs against a bursa, it creates ongoing friction that irritates the tissue and triggers swelling and inflammation, even when the spur is small. This irritation tends to worsen with repeated movement or prolonged pressure on the hip.
As inflammation continues, pain may develop on the outer side of the hip or deep within the joint. Discomfort often worsens during activities such as walking, climbing stairs, or lying on the affected side. Stiffness and a reduced range of motion may also appear as the bursa remains irritated, making everyday movements feel restricted or uncomfortable.
7. Calcium Deposits
Calcium deposits can build up near the hip joint and irritate the bursa. This occurs when calcium collects in soft tissues instead of staying within the bones, allowing deposits to form close to the bursa. These deposits often develop after repeated strain, minor injuries, or ongoing stress around the hip.
In some cases, the buildup occurs within nearby tendons, a condition known as calcific tendinitis, which can place additional pressure on the surrounding bursa. Problems begin when a deposit presses against or sits near the bursa during movement. The body may react to the deposit as a foreign substance, triggering an inflammatory response.
This reaction causes the bursa to swell and become more sensitive to pressure, even when the deposit is small. Some deposits may develop gradually without symptoms until they grow large enough to irritate surrounding tissues.
8. Infections and Autoimmune Diseases
Hip bursitis can develop when infection or immune activity affects the fluid-filled sac near the joint. Infections occur when germs enter the bursa through a skin wound, a recent medical procedure, an injection near the hip, or a bloodstream infection. Once infected, fluid can build up inside the bursa, leading to swelling, warmth, redness, and pain around the hip.
Autoimmune diseases affect the hip bursa differently. In these conditions, the immune system mistakenly attacks healthy tissue, including the bursa, even without injury or overuse. This response keeps the bursa inflamed and more sensitive to normal movement. Inflammation may involve one or both hips and can persist for long periods.
Because the hip supports body weight, repeated use can worsen symptoms in both cases. Pain may come and go, stiffness may last longer than expected, and flare-ups can occur without a clear trigger. Chronic inflammation can restrict movement, weaken surrounding muscles, and slow recovery, raising the risk of recurring hip bursitis.
9. Poor Movement Patterns
Poor movement patterns often develop through daily habits that go unnoticed. Sitting for long hours, standing with more weight on one leg, or walking with uneven steps can gradually change how the hip handles pressure. Poor posture and limited joint mobility can also alter normal hip alignment. As these habits continue, movement may repeatedly load one side of the hip more than the other. This uneven loading increases stress on the bursa, especially during weight-bearing activities.
Changes in walking mechanics may also develop, allowing tendons around the hip to glide unevenly over the outer joint surface. In some cases, tight structures such as the iliotibial band can pull across the outer hip and add pressure to the bursa during movement. Repetitive actions add to the strain. Bending, twisting, or lifting in the same way each day limits recovery time for the hip. As nearby tissues rub more than they should, swelling can build within the bursa.
10. Sitting
Long periods of sitting can raise the risk of hip bursitis. Desk work and long drives often keep the body seated for hours at a time, allowing posture habits and surface pressure to affect the hips without notice. Sitting puts pressure on the bursae, soft fluid-filled sacs near the hip bones that reduce friction between bones and muscles.
As sitting continues, steady pressure can overwhelm these sacs and make them more sensitive over time. Pressure increases further when sitting on hard or narrow surfaces, as the outer hip and lower buttock absorb most of the force. This repeated stress can irritate the bursa and lead to swelling.
Prolonged sitting can tighten the hip flexors, affecting hip movement and putting extra strain on nearby tissues. Prolonged sitting also limits movement and reduces blood flow to the hip area. Lower circulation slows tissue repair and allows inflammation to persist longer, increasing the risk of ongoing hip discomfort.
11. Impact Sports
Impact sports place repeated force on the hip joint. Activities such as running, soccer, basketball, tennis, and high-impact fitness classes involve jumping, quick turns, and sudden stops. These movements place increased pressure on the hip area where the bursae sit, particularly during weight-bearing phases.
With each hard landing or rapid change in direction, the bursa can be compressed between bone and muscle. Frequent hip flexion and extension during running or jumping may also increase friction between nearby tendons and the bursa. Over time, this repeated compression irritates the bursa and leads to swelling. Pain often develops on the outer side of the hip, especially during or after activity.
The risk rises when training intensity, speed, or duration increases too quickly. Hard playing surfaces, poor movement form, or worn footwear can further increase stress on the hip. Falls, collisions, or direct blows to the hip during sports may also trigger bursitis, making symptoms more likely to persist without adequate recovery.
12. Gout
Gout can cause hip bursitis when uric acid builds up in the body. Excess uric acid can form tiny crystals that settle in joints and nearby soft tissues. When these crystals collect near a bursa, they trigger irritation, swelling, and inflammation.
Gout is most often linked to the big toe, but it can affect other joints, including the hip. Because the hip sits deep within the body, pain may feel dull or difficult to pinpoint at first. As crystals irritate the bursa, inflammation can increase and limit normal movement. Gout flare-ups often occur when uric acid levels in the blood rise or shift suddenly, which can trigger inflammation in nearby tissues.
Symptoms may appear suddenly, even without injury. Hip pain may occur along with swelling, warmth, or tenderness near the joint. Stiffness can make walking uncomfortable, and discomfort often worsens at night or after periods of rest.
13. Sprains
A sprain occurs when a ligament around the hip stretches or tears. Ligaments connect bones and help keep the joint stable. Sprains often result from everyday movements such as slipping on uneven ground, making sudden direction changes, or lifting while turning.
When a sprain occurs, nearby tissues react with swelling and irritation. This irritation can spread to the bursa near the hip joint. As swelling develops, the bursa may produce extra fluid and become inflamed, which can lead to hip bursitis.
A sprain can also temporarily reduce joint stability. When the hip becomes less stable, nearby muscles and tendons must work harder to support the joint, which increases pressure on the surrounding bursa.
Continuing to move on a sprained hip can increase stress on the bursa. Changes in walking patterns may shift pressure across the joint, allowing inflammation to persist and raising the risk of ongoing bursitis symptoms.
14. Torn Muscle
A torn muscle near the hip can raise the risk of bursitis. Muscle tears may occur after a sudden movement, a fall, lifting too much weight, or repeated strain over time. When muscle fibers tear, nearby tissues react with swelling and pain. This swelling can press against the bursa and increase friction during movement.
If the muscle does not heal fully, continued pulling can keep irritating the bursa. As irritation persists, the bursa may become inflamed and less able to cushion the joint. Sharp or aching pain may occur along the outer hip, along with tenderness to touch and stiffness after periods of rest. Pain often worsens with walking, standing, or lying on the affected side.
Because torn muscle pain can resemble bursitis pain, the two problems often occur together. Changes in movement to avoid discomfort can shift stress across the hip, allowing inflammation to persist and making everyday activities more uncomfortable.
