You are walking up the stairs and suddenly experience shooting pain at the side of your hip. It subsides after a while but returns. Only this time, the pain is more of a continuous ache. The ache continues for weeks, particularly when you sleep on the affected side. If the above scenario seems familiar, you could have Trochanteric Bursitis. You might need a trochanteric bursitis injection to get rid of the pain. Consulting a specialist at the earliest is, therefore, a good idea.
Consider another scenario, you have started playing tennis after a long hiatus. Your body is not accustomed to repeated shoulder thrusts, and once again, you feel a pinch in your shoulder every time you move or turn around during sleep. You try to move through the pain and get accustomed to it. But the ache persists. If you’re experiencing an ache in your shoulder, you better get an ultrasound, as you could be suffering from shoulder bursitis. The shoulder also has an important bursa called the subacromial bursa. In severe cases that are resistant to conservative treatment, your doctor may recommend a steroid injection in the shoulder.
The above-mentioned scenarios are merely representative ones, and there could be multiple reasons behind the development of pain in your hip and shoulder. In this post, we’ll examine the bursitis of the hip in more detail, its causes, and the treatment method, with a special emphasis on corticosteroid injection.
Trochanteric Bursitis
Before we understand this condition of the hip, it is crucial to know about the hip anatomy. The hip is a ball and socket-type joint. The ‘ball’ is the upper end of the thigh bone (the femur). This has a prominence at the outer aspect (greater trochanter) where the gluteal tendons attach. The trochanteric bursa is a thin sac containing fluid located in this area and ensures the smooth gliding of the tendons over the greater trochanter. The socket is formed by a cup-shaped hollow portion, called the acetabulum.
To remove friction between the bones, the femur and acetabulum are lined by smooth articular cartilage. There’s also the synovial fluid present in the joint to act as a lubricant. The bursa ensures smooth hip movements and provides cushion support to the side of the hip (the trochanter). Without the cushioning of the bursa, the bone movement will cause irritation and inflammation in the area. This usually results in pain and swelling at the outside of your hip. This condition is known as trochanteric bursitis.
Causes of Trochanteric Bursitis
Hip bursitis is commonest among women and the middle-aged or elderly. However, age is not the only cause of this condition. A hard fall or a direct blow to the side of the hip can also cause Trochanteric Bursitis. Repetitive stress on the hip due to running, weightlifting, and cycling can also lead to this hip condition. Other causal agents include rheumatoid arthritis and gout.
Diagnosis and Treatment of Shoulder and Trochanteric Bursitis
The diagnosis of bursitis is done in three stages –
Assessment of patient’s medical history
Physical examination
Imaging Tests
In-depth knowledge of the patient’s medical history is important. It reveals the presence of allergies or other conditions that could hinder the treatment. Following a review of their current and prior medical conditions, the patient undergoes a physical examination in the clinic to determine the next course of action: an imaging test. MRI and Ultrasound Imaging are almost equally efficient tests; however, MRI might not be suitable for every patient. MRI has a big magnet and may not be suitable for patients who have certain devices (like a cardiac pacemaker, cochlear implant or neurosurgical clips in the brain). MRI machine is small and usually not well tolerated by patients who are claustrophobic. On the other hand, ultrasound is readily available, non-invasive and safe. Ultrasound imaging provides moving images in real-time, while MRI scans take longer to develop and are generally static.
Modern ultrasound diagnostics has seen phenomenal progress in quality progress, and the high image resolution is a testament to that. For example, an ultrasound-guided steroid injection in the shoulder is a very effective treatment for shoulder bursitis. Similarly, hip bursitis injections are commonly done using ultrasound guidance. The injection contains corticosteroids which reduce inflammation of the bursa. The precision-guided administration of corticosteroid injection is possible with the real-time imaging of ultrasound. What makes the treatment method so popular is its direct effect. The corticosteroids go right to the inflamed bursa and carry out its pharmacological action. Compared to oral medicines, this is much more successful.
In most cases, the corticosteroid medication follows a local anaesthetic. The anaesthetic is for immediate pain relief, while the corticosteroid reduces inflammation and manages pain for a longer time. The effects of the injection may vary among people but remain effective for several weeks to months on average. You might need repeat injections depending on the severity of your pain.
Conclusion
Bursitis of the hip and shoulder is a common problem these days. The increasing age demographic face an increased risk of bursitis. If you develop bursitis symptoms, visit a specialist healthcare professional at the earliest. Depending on the medical assessment and imaging test results, the doctor will recommend that you undergo the appropriate treatment. When it comes to healing the pain in your hip joint, Trochanteric bursitis injection is one of the most effective treatment methods.