What Are Trochanteral Bursal Injections?
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The hip is a ball and socket joint that is formed by the acetabulum and the femoral head. The greater trochanter is the large bump that is found on the outside of the superior end of the femur. The greater trochanter is the area where the large gluteal muscles connect to the femur. Between the greater trochanter and the tendon that passes over it is a bursa sac.
This bursa sac contains fluids that help to lubricate your joint and reduce friction. When this bursa sac becomes inflamed because of too much friction or an injury, it leads to trochanteric bursitis.
If you’re suffering from this type of pain, you know how much it can affect your life. Trochanteric bursitis pain can be severe enough to limit an individual’s ability to perform simple tasks, such as walking and climbing without pain.
A simple and effective treatment that can be used to treat trochanteric bursitis pain is a trochanteral bursal injection. This involves the injection of a local anesthetic, combined with a corticosteroid, into the bursa of the hip joint. A trochanteral bursal injection is a minimally invasive technique that can be performed in an outpatient setting.
Conditions Related To Trochanteral Bursal InjectionsTrochanteral bursal injections especially help treat trochanteric (hip) bursitis.
The first symptom of trochanteric bursitis is usually pain that you feel in your hip over the area of the bump that forms the greater trochanter. The pain may radiate into your thigh. As the condition progresses, you may experience a limp when walking as well as joint stiffness. When there is severe inflammation of the bursa, pain can occur each time your tendon moves over the bone.
As the condition progresses, pain may be felt at rest and may result in hip pain at night. Additionally, you may have pain when climbing ladders or hills, and when running. Trochanteric bursitis usually does not cause much discomfort with walking.
Trochanteric bursitis risk factors
Risk factors for trochanteric bursitis include:
- Leg length discrepancies
- Rheumatoid arthritis
- Repetitive stress injuries
- Hip injury
- Spinal disease
- Previous surgery around the hip joint
- Bone spurs or calcium deposits within the tendons that attach muscles to the trochanter
- Friction that results from a tight iliotibial band
Diagnosing trochanteric bursitis
If you think you’re suffering from this condition, your doctor can help. To diagnose this condition, they’ll usually begin by asking you questions about your medical history and symptoms.
From there, they’ll physically examine the area. Trochanteric bursitis usually occurs approximately four inches lateral to the hip joint. It typically hurts when the patient lies on the affected hip. Your doctor’s physical examination may reveal tenderness upon palpation or swelling of the hip. They may also notice a slight limp or reduced range of motion during the exam.
If your doctor suspects that other conditions may be responsible for your hip pain, they may order X-rays to rule out other abnormalities. However, X-rays will not usually show trochanteric bursitis.
How Are Trochanteral Bursal Injections Performed?If your doctor does diagnose you with this condition, they’ll likely start with non-invasive treatments. Physical therapy or chiropractic care may help. If that doesn’t help relieve your pain, they may suggest a trochanteral bursal injection.
This injection is an outpatient procedure that is fairly quick to do. To start, you’ll be positioned on your good side with the skin over the affected hip exposed. Your hip is usually flexed 30 to 50 degrees, and the knee flexed 60 to 90 degrees. This helps to increase your comfort and stabilization.
Your doctor then palpates the hip joint to locate the painful area. They then mark the tender spot. Your healthcare team will then clean the area with an antiseptic solution to help prevent infection.
The injection itself doesn’t take much time at all. Your doctor inserts a 22- or 25-gauge, one and one-half-inch needle deeply into the area. The needle is inserted directly down to bone and is then withdrawn two to three millimeters before injecting the medication. This injection usually includes a combination of a local anesthetic and a corticosteroid.
You’ll usually feel pain relief soon after the injection, due to the local anesthetic. When the local anesthetic wears off, you may experience a slight increase in pain until the corticosteroid begins to take effect.
Trochanteral bursal injections aftercare
The duration of pain relief varies from patient to patient. If pain remains after a trochanteral bursal injection, the procedure can be repeated in a month. Some patients may only require one injection for their pain to resolve, however some patients may require two or three injections to experience optimal pain relief.
Limit activities on the day after your injection. If approved by your doctor, you can usually resume normal activities the day following the injection. Mild soreness may occur around the injection site. You can apply ice and heat compresses to the tender area. Over-the-counter pain and anti-inflammatory medications can also help reduce your pain.
Trochanteral bursal injections are considered a safe and effective treatment option however, as with any procedure, there are certain risks. These may include bruising, swelling, and inflammation at the injection site, as well as possible bleeding and infection.
ConclusionTrochanteric bursitis is a painful condition that results when the bursa sac around the hip joint becomes inflamed. It may occur due to acute injuries or repetitive injuries to the hip.
If you’re suffering from this condition, you’ll likely experience hip pain, joint stiffness, an altered gait pattern. Patients with severe cases report pain at rest and sleep disturbances due to pain.
Trochanteral bursal injections are an effective treatment option for managing trochanteric bursitis. If you’re suffering from this condition, speak with a doctor about a trochanteral bursal injection for your hip pain. You can find a pain doctor in your area by clicking the button below or looking for one in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.
- Brinks A, van Rijn RM, Willemsen SP, Bohnen AM, et al. Corticosteroid injections for greater trochanteric pain syndrome: a randomized controlled trial in primary care. Ann Fam Med. 2011;9(3):226-234.
- Cardone DA, Tallia AF. Diagnostic and therapeutic injection of the hip and knee. Am Fam Physician. 2003;67(10):2147-2152.
- Cole BJ, Schumacher HR. Injectable corticosteroids in modern practice. J Am Acad Orthop Surg. 2005;13(1):37-46.
- Kelly L, Minty L. The occasional injection for trochanteric bursitis. Can J Rural Med. 2011;16(1):20-22.
- Labrosse JM, Cardinal E, Leduc BE, Duranceau J, et al. Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. Musculoskeletal Imaging. 2010;194(1).
- aaos.org. Hip Bursitis-Orthoinfo – AAOS. N.p., 2015. Web 21 Mar. 2015.
- Williams BS, Cohen SP. Greater trochanteric pain syndrome: a review of anatomy, diagnosis and treatment. Anesthesia & Analgesia. 2009;108(5):1662-1670.