The psoas (‘so-ass’) bursa lies in front of the hip joint and sits underneath the powerful muscle that bends the hip and the trunk.  Psoas bursitis produces a local groin pain that can travel downwards to the knee or shin.  The pain usually comes on gradually and the patient finds it hard to recall what might have brought it on although it is likely to be caused by overuse and sudden unaccustomed activity, such as bike riding, fell running or a weekend of decorating involving climbing ladders.  The patient will complain of pain on bending to put on socks, walking upstairs or leaving the leg behind whilst walking.  Any bursitis presents with a ‘muddle’ of signs with several movements being painful.  Careful assessment is needed to distinguish the problem from other hip joint conditions or the pain could also be referring from the back, including the sacroiliac joint.

Physiotherapy can help by explaining the condition and advising on avoiding aggravating activities to allow the pain to settle.  Electrotherapy can be used for pain relief and to promote healing.  If the response to treatment is slow, an injection of anti-inflammatory steroid may be given to speed recovery.