Whenever you experience frequent pain or stiffness in one of your joints, it’s natural to wonder what underlying condition is causing your discomfort. Joint pain can be caused by several different conditions, including bursitis and several types of arthritis, osteoarthritis is the most common.
Bursitis results from inflammation of the bursa – a fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body. The most common causes of bursitis are repetitive motions or positions that put pressure on the bursa around a joint.
Osteoarthritis, or OA, is the most common kind of arthritis. There are many contributing factors to osteoarthritis, including age. The hallmark pathologic feature of OA is articular cartilage loss, which is typically recognized on plain radiographs as a reduction in joint space. Loss of cartilage and joint disruption is linked with new bone formation occurring and the development of subchondral sclerosis and osteophytes.
Both bursitis and osteoarthritis can cause significant joint pain that can impact your ability to perform daily physical activities. These conditions share many similarities in terms of their symptoms and treatment, which can make it hard to distinguish between the two conditions. In fact, those suffering from bursitis or osteoarthritis frequently describe a near-identical experience. The biggest difference between these conditions is the actual cause of your pain.
The simplest way to realize and appreciate the difference between hip bursitis and hip osteoarthritis is to understand where the pain is coming from. When you have hip osteoarthritis, the pain is coming from inside the joint. With hip bursitis, the pain is coming from the outside.
Signs & Symptoms
Hip Bursitis
- Pain that may be sharp and intense in its first stages
- Pain that worsens at night
- Pain may progress to a widespread ache (spreading to a larger hip area including the thigh, groin, etc.)
- Laying down or placing pressure on the hip may cause discomfort, tenderness, or pain
- Pain or stiffness after too little or too much activity
- Activities like walking, climbing, and squatting may be difficult and painful
Hip Osteoarthritis
- Pain that develops slowly
- Pain that is worse in the morning
- Pain is localized in the buttock, groin, thigh, and hip
- Locking, grating and grinding may happen when walking or moving
- Vigorous or excessive activity may cause pain
- Stiffness that decreases your range of motion, making walking or bending challenging
- Swelling
- Pain may spread to the knee or back
Treatment & Management:
Treatment procedures for bursitis and osteoarthritis are both designed to reduce the amount of inflammation in and around the joint.
For bursitis, conservative measures of treatment are often recommended initially. First-line treatment for bursitis may include:
- Applying ice and heat to the affected joint
- Resting and avoiding repetitive movements in the affected joint
- Performing specific exercises to loosen the joint
- Adding padding to sensitive joints when engaging in manual activities
- Wearing a brace or splint to support the joint
- Taking OTC medications like nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen to manage pain and reduce swelling
In contrast, mild osteoarthritis can sometimes be managed by making lifestyle changes to increase activity levels. Treatment for OA will focus on reducing symptoms, rather than curing them, and maintaining function. This may include:
- Medications (OTC and prescription drugs) including topicals
- Exercise and other physical activity
- Lifestyle modifications, like avoiding repetitive activities and managing your weight
- Braces, splints, and other supports
- Surgery, if symptoms are very debilitating
Pain-relieving and anti-inflammatory medication may be recommended for both bursitis and osteoarthritis. In more moderate cases, corticosteroids may be injected into the bursa or joint to help reduce inflammation and pain.
Untreated bursitis can lead to a permanent thickening or enlargement of the bursa, which can cause chronic inflammation and pain. Long-term reduced use of joints can lead to decreased physical activity and loss of surrounding muscle, which eventually may lead to muscle atrophy.
Osteoarthritis is a degenerative disease that worsens over time, often resulting in chronic pain. As the cartilage surface wears and thins, a progression of symptoms will develop. Eventually, at the end stage of arthritis, the articular cartilage wears away completely and bone on bone contact occurs.
Bursitis will likely improve with treatment; however, bursitis can also become chronic. This is more likely if your bursitis is not diagnosed and treated appropriately and if the cause cannot be cured.
Osteoarthritis is a chronic condition that is irreversible and not curable, but with treatment, the outlook is positive. Don’t ignore symptoms of chronic joint pain and stiffness. The sooner you speak with your doctor, the sooner you can receive a diagnosis, begin treatment, and improve your quality of life.
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