Bursas are small sacs of fluid that reduce friction and help in the smooth movement between bones and muscles or tendons (band of tissue connecting muscle to bone) around a joint. Injury or overuse of joints can cause inflammation of these bursas. Trochanteric bursitis is the inflammation of the bursa that lies on the side of your hip bone (femur), causing pain, stiffness or pressure every time you move your hip. The pain may radiate down your thigh and also result in sleeping problems.
Pain can be relieved with a trochanter bursitis injection, which is a local anesthetic and a corticosteroid drug (anti-inflammatory) injected into the bursa of the trochanter (part of the thigh bone that connects to the hip bone) with the help of an imaging technique like X-ray.
Indications and Contraindications
The injection for trochanter bursitis is indicated to diagnose bursitis from other conditions, and also to reduce pain and inflammation of the bursa, but is contraindicated during pregnancy or failed response to previous 2-3 injections. Other contraindications include:
Your physician will physically examine your hip and back and evaluate your medical history. Pressure will be applied over the trochanteric area, if u experience tenderness and pain, trochanter bursitis is confirmed.
Trochanter bursitis injection is suggested if other conservative therapies, such as rest, oral analgesic medications and ice packs, fail to relieve pain and inflammation of the bursa. Steps in conducting the procedure include:
Following the procedure, you may experience immediate pain relief due to the local anesthetic, but the steroid will show its effect around two or three days after the injection. Avoid driving for the remaining day. Ice can be applied for 20 minutes to relieve soreness or discomfort at the injection site. You can resume your normal activities on the day after the procedure. Normal diet and medications can be continued after the procedure. The length of pain relief may vary between individuals.
Risks and Complications
As with any procedure, trochanter bursitis injection involves certain potential risks and complications. These may include:
Trochanter bursitis injection provides temporary pain relief: its effect lasting anywhere between a week to 6 months. You can be given repeated injections of up to three per year for treating the condition.
Hip joint injections involve injecting medicine directly into the hip joint to diagnose the source of pain or treat pain due to conditions such as arthritis, injury or mechanical stress of the hip joint. Hip pain may be experienced in the hip, buttock, leg or low back. The injection contains a combination of a numbing medicine and cortisone (an anti-inflammatory agent). Numbing medicine delivers temporary relief from pain, provided the hip joint is the source of the pain. It thus serves a diagnostic function and helps to confirm or deny whether the joint is the source of pain. Cortisone serves to reduce the inflammation in the joint providing long term pain benefit.
If needed, a relaxation medicine is given to the patient through an IV line. The patient lies face down on an X-ray table. The small area where the injection needs to be given is numbed with an anesthetic. The patient may feel a sting for a few seconds. A small needle is then accurately placed by the doctor into the joint guided by the real time X-ray images (fluoroscopy). Before injecting the medicine, a contrast dye is injected through this needle into the joint to confirm that the medicine will reach the joint. A combination of anesthetic and anti-inflammatory cortisone is then slowly injected into the joint. The whole procedure usually takes about 30 to 60 minutes.
After the procedure
After the injection the patient is made to rest for 20 to 30 minutes and is then asked to move the joint, provoking pain. The patient may or may not find a decrease in pain depending on whether the injected joint is the main source of the pain. The patient is also asked to maintain a record of relief in pain during the coming week. Physical therapy may also be recommended. Even when pain relief is significant the patient should increase activities gradually over one to two weeks to avoid reappearance of pain.
Risk and complications
The possible risks of hip injections include: swelling and pain in the joint after the injection, infection, depigmentation of skin, local thinning of the skin and rupture of a tendon.
If the injected hip joint is the source of the pain, the pain may reduce two to five days after the injection. However, if no improvement is found within ten days after the injection further diagnostic tests may be required to ascertain the cause of pain.