A cortisone shot in the hip bursa addresses inflammation and pain. Cortisone is a corticosteroid, a powerful anti-inflammatory medication that mimics hormones naturally produced by the body. The hip bursa, specifically the trochanteric bursa, is a small, fluid-filled sac on the outer side of the hip bone that cushions tendons, muscles, and bones during movement. When this bursa becomes inflamed, a condition known as bursitis, it causes pain and limits movement. The injection delivers the anti-inflammatory medication directly to this irritated sac to alleviate symptoms.
What Happens During the Injection
The procedure involves several steps to minimize discomfort. Before the injection, the skin over the hip is thoroughly cleaned to prevent infection. You will be positioned to allow easy access to the hip, often lying on your side.
A local anesthetic, such as lidocaine, is then injected to numb the area. This initial needle stick for the anesthetic is usually the most noticeable sensation, often described as a brief sting or pressure. The anesthetic begins to work quickly, providing immediate pain relief in the hip area for a few hours.
Once the area is numb, the main injection of cortisone, often combined with more anesthetic, is administered. You might feel pressure or fullness as the medication enters the bursa, rather than sharp pain, due to the numbing. Imaging guidance, such as ultrasound or fluoroscopy (a type of X-ray), is often used to ensure precise needle placement within the bursa. This guidance improves accuracy and can reduce the need for multiple attempts. The entire injection is quick, often taking less than a minute for needle insertion and removal, with the overall process lasting 10 to 30 minutes.
Immediate Post-Injection Experience
Immediately after the injection, the local anesthetic will continue to numb the hip area, providing temporary pain relief for a few hours. As the anesthetic wears off, the initial hip pain may return or even temporarily increase. This phenomenon, known as a “cortisone flare” or “steroid flare,” occurs in about 1 in 5 patients. It is caused by the body’s reaction to the cortisone crystals and is a temporary worsening of pain and swelling around the injection site.
To manage this discomfort, applying ice packs to the hip area can be helpful. Resting the hip and avoiding strenuous activity for at least 24 hours after the injection is recommended to allow the steroid to begin working. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be used if needed.
Expected Outcomes and Important Considerations
Pain relief from the cortisone shot is not immediate and typically begins within a few days to a week after any initial “cortisone flare” subsides. The full effect of the steroid usually peaks around 10 to 14 days post-injection. Many patients experience significant pain reduction, with some feeling relief within days.
The duration of pain relief from a hip bursa cortisone shot can vary considerably among individuals and depends on the underlying condition and its severity. Relief commonly lasts for several weeks to several months, with some individuals experiencing relief for up to one year or even permanent symptom relief with a single treatment. If the pain returns, injections can sometimes be repeated, though doctors often limit the number of injections into a single joint per year due to concerns about potential side effects from cumulative steroid administration.
While cortisone shots are generally considered safe, some mild side effects can occur. These include temporary skin discoloration or dimpling at the injection site, or a flushed feeling in the face and chest. For individuals with diabetes, a temporary increase in blood sugar levels can occur, requiring careful monitoring.
Rare but more serious considerations include infection, which may present with symptoms such as fever, worsening pain, redness, or discharge at the injection site, and requires immediate medical attention. Allergic reactions, though uncommon, can also occur, and symptoms like swelling of the lips, throat, or difficulty breathing warrant emergency medical care. If the injection does not provide sufficient relief or if pain returns, discussing further treatment options with a healthcare provider is advised.