Inflammation of the iliopsoas bursa (the largest bursa in the body) which lies between the front of the hip joint and the iliopsoas muscle (a hip flexor) is called iliopsoas bursitis. This bursa helps reduce rubbing and friction between the bones and soft tissues that meet at your hip joint capsule. Bursitis in this area can be mistaken for hip joint arthritis. It can become inflamed due to overuse or trauma, which can result in muscle tightness or imbalance.

Iliopsoas bursitis is most commonly caused by:   

  • Hip Pathology
  • Rheumatoid Arthritis
  • Osteoarthritis
  • Recreational Injuries which require repeated hip flexing, such as:
    • Soccer
    • Ballet
    • Jumping Hurdles
    • Martial Arts
  • Infection of the bursa (which is rare)

What are the symptoms of Iliopsoas Bursitis?

The onset of pain will generally be gradual with symptoms slowly worsening over weeks or months:

  • Pain and tenderness that radiates from deep in the groin region or front of the hip radiating around and down the front of the thigh and down to the knee
  • Increased pain with hip flexion
  • Pain in the front of the hip that will usually be experienced for a short period of time during
    • Vigorous activities like jogging or kicking a ball with your instep
    • Getting up from a seated position
    • Extending your leg while driving
    • Walking up stairs
    • Bringing your knee up to your chest (especially against resistance)
    • Lying down without support
  • Limping, which results from:
    • Weakness in the upper thigh/hip area
    • Only one leg is involved
    • Taking smaller steps because of hip tightness
  • Hip stiffness and tightness in groin as well as the knee, as a result of a tight iliopsoas muscle

Diagnosis of Iliopsoas Bursitis:

Our treatment team will perform a comprehensive physical examination, that may include:

  • A Physical Exam with stress on the bursa may identify the condition
  • Imaging tests may be performed to confirm the diagnosis and rule out other possible injuries or conditions. These tests may include:
    • X-ray to rule out bony problems that may cause pain
    • Bone Scan
    • MRI (Magnetic Resonance Imaging)
    • Hip Musculoskeletal Ultrasound

Treatments for Iliopsoas bursitis:

  • Rest and ice to the painful region
  • Modification of activities—avoiding the activities that worsen symptoms
  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Use NSAIDs cautiously and for limited periods. Talk with your doctor about the NSAIDs you use.
  • A walking cane or crutches used for a week or more, when needed
  • Physical therapy with dry needling, myofascial release and therapeutic exercise
    • Instruction on how to stretch your hip flexor and rotator muscles
  • Corticosteroid or PRP injections with a local anesthetic performed under Ultrasound guidance
    • An injection into the bursa  can produce long lasting relief when combined with lifestyle changes. If pain and inflammation do return, another injection may be considered.
  • Prolozone therapy
  • If an infected bursa is suspected (a rare circumstance), fluid is removed from the sac for testing

How can Iliopsoas Bursitis be prevented?

Avoidance of behaviors and activities that inflame the bursa will help to prevent the occurrence of hip bursitis. Avoid repetitive activities that put stress on the hips. Some preventative steps include:

  • Avoidance of behaviors and activities that inflame the bursa will help to prevent the occurrence of iliopsoas bursitis
  • Exercise regularly to maintain balanced strength and flexibility of the hip muscles
  • Improvement of lower extremity alignment including possible use prescription of custom foot orthotics

Can the Barr Center Help You with Hip Pain Relief?

Call us at 757-578-2260 or email us at [email protected] to get started on relieving your hip pain. To learn more about the anatomy of the hip and the causes of hip pain, visit our blog articles below for more information.

Learn More

Other pain management conditions we treat are: Neck Pain, Shoulder Pain, Back Pain, and Knee Pain. We often use Regenerative Medicine, and sometimes combine physical therapy, in our pain management treatments.