Hip effusion: Causes, symptoms, treatment, and exercises

Hip effusion is characterized by an abnormal fluid accumulation in the joint space that leads to swelling and pain of the hip joint. Our joints normally have a modest amount of liquid between them called synovial fluid that provides smooth movement and protects the cartilage. Having excess fluid in the joints can be easily recognized, as the joint can be seen and felt as being puffy or swollen. Joint effusion is commonly referred to as having water on the joint. Hip effusion may occur in response to inflammation, infection, or trauma.

Related: What is knee effusion (water on the knee)? Causes, symptoms, and tests for water on the knee

What causes hip effusion?

Trochanteric bursitis

An inflammatory condition of the bursa (fluid-filled sac near a joint) at the outside or lateral point of the hip known as the greater trochanter. A bursa is a thin, lubricated cushion located at points of friction between bones and surrounding soft tissue, such as ligaments, tendons, muscles, and skin. It can be visualized as a tiny water balloon that has a few drops of fluid in it, wedged between two surfaces, aiding in friction reduction for moving joints. Trochanteric bursitis may be caused by:

• Injury to the hip: Includes falls, direct trauma to the hip, or even simply lying on one side of the body for an extended period.
• Overuse of the hip joint: Includes activities such as running up the stairs, climbing, or standing for long periods of time.
• Incorrect posture: Due to conditions such as scoliosis, arthritis of the lower (lumbar) spine, and other spine problems.
• Other diseases or conditions: May include rheumatoid arthritis, gout, psoriasis, thyroid disease, or even an unusual drug reaction.

Tendinitis of the hip joint

Inflammation of the tendon—a tough band of fibrous connective tissue that usually connects muscle and bone. This condition is commonly due to overuse or repetitive movements of muscles and tissues involved in hip joint movements. It can occur at any age but is more common among adults who are very active. However, older individuals are also likely to get tendinitis of the hip joint as their tendons in the body lose their elasticity, becoming weaker with age.

Osteoarthritis

A type of arthritic joint disease that is caused by the breakdown of joint cartilage and the underlying bone. This often leads to the development of joint pain and stiffness. Additional symptoms include joint swelling, a decreased range of motion, as well as weakness and numbness of the affected region. Osteoarthritis is generally considered an age-associated disease, with most presentations occurring much later in life, as their joints have gone through excessive wear and tear over time.

Rheumatoid arthritis

An autoimmune disorder caused when your own immune cells mistakenly target healthy tissue as being foreign and attack it. This leads to chronic inflammation that not only affects the joints but can damage a variety of body systems, including the skin, lungs, and even the heart. Rheumatoid arthritis affects the lining of joints, causing painful swelling and eventual bone erosion and joint deformity.

Infection

When occurring in the body, an infection can lead to the activation of immune cells and begin the process of inflammation, designed to kill the foreign invader. This can occur anywhere in the body, including the hip joint, due to bacterial infection via a small cut that travels through the bloodstream. Infections reaching the hip joint can lead to hip effusion.

Osteonecrosis

Occur due to decreased blood supply to bones, causing them to break down. While the exact causes of this condition remain unknown, it is believed people with inflammatory conditions or people receiving cancer treatment are at higher risk.

Symptoms of hip joint effusion

The most common hip joint effusion symptoms include pain and stiffness in the groin, buttocks, and thigh when waking up in the morning. Depending on the cause of hip effusion, pain may get better or worse as the day goes by.

If hip pain continually gets worse to the point where rest does not provide relief, it is important to seek help as soon as possible as significant hip damage has likely occurred. It is recommended to seek medical attention right away if you experience painful hip movements, losing the ability to rotate, flex, or extend your hip. A common feature that should signal to you that you may have a hip problem is you become less active to avoid hip pain.

How to treat hip effusion?

There are a number of different causes of hip effusion. Some may be infectious while others have something occurring more acutely, such as a traumatic injury. The underlying cause of hip joint effusion will ultimately guide treatment.

For the most part, regardless of the underlying cause, non-steroidal anti-inflammatory drugs (NSAIDs) will be the most common medication prescribed to reduce swelling and pain associated with a hip effusion. The use of corticosteroids is another class of drug that may be utilized to help reduce these symptoms if NSAIDs are found to be insufficient. The application of heat and cold pads may provide additional pain relief in the affected area.

In case of an infection causing fluid buildup, antibiotics can be used when first identifying the causative organism and removing the fluid buildup.

Arthrocentesis (fluid aspiration/removal) is a therapeutic procedure that serves as a diagnostic tool. It is the most accurate test for diagnosing the cause of knee effusion while at the same time helping to relieve pain.

Arthrocentesis has the added benefit of being quick and easy while inflicting minimal discomfort on the patient.

In severe cases of hip effusion where damage is beyond repair, joint replacement may be the only option.

Exercises for hip effusion

The following exercises can help increase the endurance of hip movements by strengthening surrounding muscles. It is recommended to discuss your plans for performing these exercise with your doctor first, as they can tell you if it is safe. Do not attempt the following exercises without first getting advice from an expert.

• Aqua exercises: Can help relieve stress on the hip joints, allowing you to move freely while in the water. The resistance provided by performing various exercises in the water will also help to build strength and regain flexibility. Water exercises or water aerobics are commonly offered at community centers across the country and are generally an affordable investment.
• Walking: An exercise that most everyone can do no matter your current activity level. Best of all, walking can be made easier or harder depending on your desired fitness level. Walking can help strengthen the muscles surrounding the hip as well as increase your endurance. However, it is advised when first starting out to start slowly with short walks in your local area, then branch out to longer walks that include steep inclines and rougher terrain.
• Butt pressure retention: This exercise can be performed while lying on your bed or sitting on the couch. All it requires is for you to tighten your butt until the tension is felt in the butt and hip area. Hold this level for about 10 seconds, then release slowly.

Performing any type of exercise should come with some degree of caution, especially in those suffering from hip joint effusion. It is also a good idea to adhere to the sound judgment of an experienced medical professional and to know your limits, resting whenever you need to.

Related:

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Fluid around the heart (pericardial effusion) in the elderly: Causes and treatment tips