So often we see patients in clinic who express to us that “they wish they had seen us before they got a Cortisone Injection“!
Why do they say that? Lets start from the beginning …
What is Hip Bursitis?
Hip Bursitis (aka Trochanteric Bursitis) is the inflammation of one of the 3 bursae located around the hip (subgluteus maximus, subgluteus medius, subgluteus minimus). Trochanteric bursitis is usually characterised by an aching pain over the lateral side of the hip combined with tenderness with touch around the hip bone.
As Hip Bursitis by definition is inflammation of the Hip Bursae, Corticosteroid Injections (CSI) are usually provided by doctors in the hope that they will address the inflammation in the bursae.
How do CSI work?
Steroids affect the metabolism and distributions of white blood cells without affecting the production of antibodies.
Usually, when an injury occurs, an Inflammatory Response is triggered.
CSI affects this response by narrowing the blood vessels to reduce blood flow. This reduces the transportation of the cells and chemicals released (that are usually released during an injury). Consequentially, this reduces the white blood cells (hence reducing swelling/inflammation)
When should I get a CSI?
CSI is recommended when the bursitis is at it’s Acute/ Early Stages of recovery. This would look like 8-10/10 pain, with movement and is extremely sore to touch
When should I not get a CSI?
If you have had previous CSI before with little affect. Chances are… you are the unlucky 30-40% who will not experience alleviation with the injection.
If you have been relying on CSI for pain management in the long-term. You will likely have become resistant to the steroid medication. This would mean that the effects won’t be as affective and will wear off faster.
What do I need to be aware of with CSI for my hip bursitis?
Although CSI addresses the inflammation in your bursae, it will not address the cause of the inflammation.
These causes include but are not limited to moving in a sub-optimal movement patterns leading to overactive ITB and hip flexors, non-optimal lumbopelvic alignment/ mobility/ stability or Gluteus weakness.
For example, if you have been walking funny, your body will create compensatory strategies like tightening up at your hip flexors. In the long term, this tightness can cause friction on the the bursa and over time it this friction will become irritating. CSI may address the inflammation, but will not address the friction being applied to the bursae.
This is where Physiotherapy is incredible helpful! By addressing these causative factors, you can finally get rid of the friction being applied to your Bursitis … for good.
One other thing to be aware of, is that after receiving a CSI, you should avoid the aggravating activity/position despite it not being sore anymore. This means if you keep walking with an altered gait, even though it may be temporarily free from pain, you will still be applying friction to the bursae. If you continue to irritate the bursae while the CSI is in effect, when it wears off… the pain will come back with a vengeance!
This further highlights the importance of physiotherapy to develop strategies and modifications to continue being mobile while avoiding the aggravating factors!
Want to know more? One of our Physiotherapy team would be happy to answer any questions you might have with regards to your Hip Bursitis, CSI or pain. Give us a call and start making some real progress towards alleviating your symptoms for good today!