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What is bursitis?

A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. “Bursae” is the plural form of “bursa.” The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When a bursa becomes inflamed, the condition is known as “bursitis.”

Hip bursitis is –

  • A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between moving tissues of the body.
  • There are two major bursae of the hip.
  • Bursitis, or inflammation of a bursa, is usually not infectious, but the bursa can become infected.
  • Treatment of noninfectious bursitis includes rest, ice, and medications for inflammation and pain. Infectious bursitis (uncommon) is treated with antibiotics, aspiration, and surgery.
  • Bursitis of the hip is the most common cause of hip pain.
  • Trochanteric bursitis frequently causes tenderness of the outer hip.
  • Ischial bursitis can cause dull pain in the upper buttock area.

I saw a hip consultant last week for pain in my hips, mainly my right side. He sent me for an X-ray which showed medial osteoarthritis in the right hip but I had no symptoms or problems on examination for this problem.

What he did find was that I was very tender over the bursa area on my right and also on my left hip which he diagnosed as Bursitis. I was then given a steroid injection into both Bursas in the hope this would relieve my pain.

He also noticed how much discomfort I was in when he touched my sacroiliac joint and in my midline so he is sending me for an MRI of my sacroiliac joint and lumbosacral spine to make sure there is no impingement and to see if there is any inflammation of the sacroiliac joint.

It may be that I require a CT guided injection of my sacroiliac joint if there is arthritis seen on my scan so I will just have to wait for this result after my scan in a couple of weeks.

My pain after the injection initially went much worse and I had a really bad night but within 24 hours I could actually lie on my left hip without pain. My right took about another 24 hrs for it to kick in but I still get low back and sacroiliac pain when I lie on that side so it could be the pain is more related to that problem.

Steroid injections is something I’ve had in the past for my lumber spine and neck. Some work and last for months, others not so long but I always think this type of treatment for your pain is worth trying.

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As you will have read from some of my previous posts I am unable to have facet joint injections as funding for this has been stopped in certain parts of the UK. Instead, I was offered trigger point injections. Initially, these seemed to work ok but as the time has passed since having them I have found myself in a lot more pain so I decided to research other types of injections for spinal pain.

In the past, I have had epidurals for pain as well as nerve blocks and just simple steroid injections but I was never quite sure what the difference was.

An article on the Very Well site explains that an epidural steroid injection is a cortisone injection used to treat inflammation around the spine. Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland. Cortisone is released from the adrenal gland when your body is under stress. Natural cortisone is released into the bloodstream and is relatively short-acting.

An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. They say that the best reason to have an epidural steroid injection is not for the relief of back pain, but rather for the relief of leg pain caused by spinal nerve compression, like sciatica, leg pain caused by nerve irritation. They also say that ‘back pain is not a good reason to have an epidural injection’. 

The difference between the nerve block and the epidural is where they put the needle. The nerve block injection usually also contains a steroid to decrease inflammation and pain. The injection is similar to a transforaminal epidural steroid injection, but in a selective nerve root block, there is no attempt to have the medication enter the epidural space.

The differences between epidurals and the nerve blocks and facet joint injections is that facet joint injections are used for both diagnostic and therapeutic reasons in the treatment of degenerative or arthritic conditions. Along with the numbing medication, a facet joint injection also includes injecting time-release steroid (cortisone) into the facet joint to reduce inflammation, which can sometimes provide longer-term pain relief.

A trigger point injection which I have recently been offered is an anesthetic such as lidocaine (Xylocaine) or bupivacaine (Marcaine), a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine and are used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin.

But, all seem to include some kind of steroid medication for the pain, they are all put into different areas and some involve using x-ray guidance but to me, the actual drug they are using is the same, but of course this is just what I have read online and is not something have discussed with my pain consultant.