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APM Spine & Sports Physicians

Iliopsoas Bursitis

What is the Iliopsoas Bursitis?

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


What causes Iliopsoas bursitis?

It is most commonly the result of the following:

  • Hip Pathology
  • 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
  • Pain is increased 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.


How is Iliopsoas Bursitis diagnosed?

Your APM physician will perform a comprehensive physical examination, tha may include:

  • A Physical Exam with stress on the bursa may identify the condition
  • Imaging test may be done to confirm the diagnosis and rule out other possible injuries or conditions. These test can include:

How is Iliopsoas Bursitis treated?

Your APM physician will do a thorough evaluation, ask about your symptoms and examine the affected region. Treatmment may include:

  • 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.
  • Use of a walking cane or crutches for a week or more when needed
  • Physical Therapy
    • Instruction on how to stretch your hip flexor and rotator muscles
  • Corticosteroid injections with a local anesthetic.
    • This is an injection into the bursa. Typically long lasting relief is achieved when combined with lifestyle changes. If pain and inflammation do return, another injection may be considered.
  • 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. These include, but are not limited to:

  • Avoidance of behaviors and activities that inflame the bursa will help to prevent the occurrence of iliopsoas bursitis.
  • Exercise regularly to maintain strength and flexibility of the hip muscles.