A trochanteric bursa injection is a common medical procedure designed to alleviate pain in the hip region. This minimally invasive treatment involves precisely injecting medication directly into the trochanteric bursa, a small, fluid-filled sac situated near the outer part of the hip bone. The primary objective is to reduce inflammation and discomfort that can arise from a condition affecting this specific bursa.
Understanding Trochanteric Bursitis
The trochanteric bursa is a thin, fluid-filled sac located on the outer side of the upper thigh bone, specifically over the greater trochanter, which is the bony prominence of the hip. Bursae act as cushions, reducing friction between bones and surrounding soft tissues during movement. When this bursa becomes inflamed, the condition is known as trochanteric bursitis, also frequently referred to as greater trochanteric pain syndrome.
This inflammation can stem from various factors, including repetitive activities like running or cycling, direct injury or trauma to the hip, or prolonged pressure from lying on one side. Differences in leg length, poor posture, or bone spurs can also contribute to bursa irritation. Certain conditions like rheumatoid arthritis or previous hip surgery might increase the likelihood of developing trochanteric bursitis.
Individuals experiencing trochanteric bursitis report pain on the outside of the hip, which may extend down the side of the thigh or into the buttock. The pain often worsens with activity, such as walking or climbing stairs, or when lying on the affected side. Tenderness to the touch over the bony prominence of the hip is also a common symptom.
The Injection Procedure
The trochanteric bursa injection is performed in an outpatient setting, often taking about 5 to 10 minutes. The patient is positioned lying on their unaffected side, allowing the medical professional clear access to the hip. Before the injection, the skin over the hip area is thoroughly cleaned with an antiseptic solution to prevent infection.
A local anesthetic, such as lidocaine or bupivacaine, is administered to numb the skin and deeper tissues around the injection site, which helps reduce discomfort. Once the area is sufficiently numb, a thin needle is carefully guided into the trochanteric bursa. To enhance accuracy and ensure proper placement, imaging guidance, such as ultrasound or fluoroscopy (real-time X-ray), may be utilized. A combination of medications is typically injected, including a corticosteroid like triamcinolone or methylprednisolone, which works to reduce inflammation. A local anesthetic is also included, providing immediate, though temporary, pain relief.
Before and After the Injection
Preparation for a trochanteric bursa injection involves steps to ensure patient safety and optimize the procedure’s effectiveness. Patients should inform their doctor about all medications they are taking, including over-the-counter drugs, supplements, and blood thinners, as some might need temporary adjustment or cessation. Disclose any known allergies to medications, anesthesia, or latex. While fasting is generally not required, patients should arrange for a ride home, as temporary numbness or discomfort may affect their ability to drive safely.
Immediately following the injection, patients may experience temporary numbness in the hip area due to the local anesthetic. Rest the hip and avoid strenuous activities for a day or two to allow the medication to settle. Applying ice packs to the injection site can help alleviate soreness or bruising. While some immediate pain relief may be felt from the anesthetic, the full effect of the corticosteroid typically takes several days to a week to become noticeable.
Expected Outcomes and Potential Side Effects
The effectiveness of a trochanteric bursa injection in providing pain relief can vary among individuals. While some patients experience significant improvement, the relief is often temporary, lasting from several weeks to a few months. For some, a single injection may be sufficient, but others might require repeat injections. The number of injections per year is typically limited to prevent side effects. If pain returns, additional treatments or evaluation may be necessary.
Potential side effects are associated with trochanteric bursa injections. Common, usually mild, side effects include temporary pain flare-ups at the injection site, bruising, or localized skin discoloration. Diabetic patients may experience a temporary increase in blood sugar levels, which should be monitored closely. Less common side effects include facial flushing or temporary insomnia.
While rare, more serious complications can occur, such as infection at the injection site, allergic reactions, nerve damage, or localized fat atrophy, which can result in a visible skin depression. Patients should contact their healthcare provider if they experience severe pain, fever, increasing redness, significant swelling, or any signs of pus at the injection site, as these could indicate a more serious complication.