Cortisone injection for trochanteric bursitis?

Posted by ellerbracke @ellerbracke, Thu, Feb 14 2:10pm

I’m exactly 5 months past a very successful right TKR. Things were going great, back to normal life and exercise routine, and then I developed right side hip pain about 2 months ago. Most painful at night, and at rest. Diagnosed as trochanteric bursitis. Had this once before 2 years ago, received cortisone injection. All that did was cause initial numbness, significant pain for 36 hours, and then no improvement. This time I’m opting for PT and exercises to begin with. Wondering if my non-benefit of the past cortisone is common, or not? I may have to resort this if I can’t get rid of the pain on my own.

@ellerbracke If the cortisone did not help it may not have gotten to the actual site. I had a number of cortisone injections for hip bursitis that did not help beyond initially. I did some research and discovered that there is such a thing, "guided" injections, where they inject using an x-ray to pinpoint where.
I went to a doctor in Boston, I don't really recall what made me choose him, and he said he did not need to do it that way. I was overweight and he asked me if any of the doctors had used a long needle. I did not believe any had, so that was how he proceeded. His explanation was very gentle, he said that patients with a little extra padding needed a longer needle to get to the site better. Sure enough, he was right. I went to him three times for cortisone injections and he hit the spot every time. I have lost the extra padding so I now use a doctor closer to home.
If you do not have any "extra padding" it could still just be that the doctor did not hit the spot well enough. Good luck with this.
JK

@contentandwell

@ellerbracke If the cortisone did not help it may not have gotten to the actual site. I had a number of cortisone injections for hip bursitis that did not help beyond initially. I did some research and discovered that there is such a thing, "guided" injections, where they inject using an x-ray to pinpoint where.
I went to a doctor in Boston, I don't really recall what made me choose him, and he said he did not need to do it that way. I was overweight and he asked me if any of the doctors had used a long needle. I did not believe any had, so that was how he proceeded. His explanation was very gentle, he said that patients with a little extra padding needed a longer needle to get to the site better. Sure enough, he was right. I went to him three times for cortisone injections and he hit the spot every time. I have lost the extra padding so I now use a doctor closer to home.
If you do not have any "extra padding" it could still just be that the doctor did not hit the spot well enough. Good luck with this.
JK

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Had several cortisone shots for my trochanteric bursitis, each one provided temporary relief. Mine came after a hip resurfacing. Finally had a revision of the hip to THR.

JK: No “padding” at all……. will keep guided shot in mind. Had that several years ago in spinal area for Sciatica. I’m just hesitant since during the past 15 months I also had 2 cortisone injections in the knee, one pre-arthroscopic surgery, one post, and neither one lasted more than 3 days – ergo TKR. Hip was X-rayed, no arthritis or other visible issue.

@ellerbracke

JK: No “padding” at all……. will keep guided shot in mind. Had that several years ago in spinal area for Sciatica. I’m just hesitant since during the past 15 months I also had 2 cortisone injections in the knee, one pre-arthroscopic surgery, one post, and neither one lasted more than 3 days – ergo TKR. Hip was X-rayed, no arthritis or other visible issue.

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@ellerbracke My hip problems are strictly bursitis and I have read that hip replacements can make that worse! Sometimes they are OK, and other times, like the last few nights, I can't sleep on either side. It's been quite a while since I had a cortisone injection, if this continues I will go for one again. I am tempted to go back to Boston since that doctor always hit it right on target. I no longer have the extra padding but even without it, doctors can miss.
JK

Liked by lioness

@ellerbracke I’m almost 6-1/2 weeks post right TKR, and within days of quitting my cane, at about 2-1/2 weeks, my right hip became extremely painful. It hurt all day and all night. I woke up in pain multiple times a night. Heat and/or ice helped a little first thing in the morning, but it was downhill from there. I took 1600 mgs per day of Ibuprofen. No relief at all. My new knee is almost pain free, but the hip pain was ruining everything.

I had my 6 week post op TKR visit today and told my ortho about the hip. He put his finger near my hip and kind of to the outside of my thigh. He pushed his finger deep into my skin and I almost jumped off the exam table. He said it’s classic trochanteric bursitis.

I took him up on his offer to give me an injection. When he gave me the shot, I had several seconds of pain in my hip. Then I got a pain down the top part of the top of my thigh. I mentioned the thigh pain and he said that was because he got the shot in just the right spot.

He said after the numbing agent wears off later today, I can expect to have pain for the next day or two. Then he said “then the pain should stop and hopefully not come back”. Here’s hoping. 🤞

I have had many injections over the years, all for shoulders or knees. This is the first I’ve had in my hip. Over the years I think at least 95% of the shots I received gave me good results.

I should know in a few days if this shot worked. I will keep you posted. My overall experiences with steroid injections have been very good. I hope you find the relief I know you badly need. Hang in there.

@connie1559

@ellerbracke I’m almost 6-1/2 weeks post right TKR, and within days of quitting my cane, at about 2-1/2 weeks, my right hip became extremely painful. It hurt all day and all night. I woke up in pain multiple times a night. Heat and/or ice helped a little first thing in the morning, but it was downhill from there. I took 1600 mgs per day of Ibuprofen. No relief at all. My new knee is almost pain free, but the hip pain was ruining everything.

I had my 6 week post op TKR visit today and told my ortho about the hip. He put his finger near my hip and kind of to the outside of my thigh. He pushed his finger deep into my skin and I almost jumped off the exam table. He said it’s classic trochanteric bursitis.

I took him up on his offer to give me an injection. When he gave me the shot, I had several seconds of pain in my hip. Then I got a pain down the top part of the top of my thigh. I mentioned the thigh pain and he said that was because he got the shot in just the right spot.

He said after the numbing agent wears off later today, I can expect to have pain for the next day or two. Then he said “then the pain should stop and hopefully not come back”. Here’s hoping. 🤞

I have had many injections over the years, all for shoulders or knees. This is the first I’ve had in my hip. Over the years I think at least 95% of the shots I received gave me good results.

I should know in a few days if this shot worked. I will keep you posted. My overall experiences with steroid injections have been very good. I hope you find the relief I know you badly need. Hang in there.

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@connie1559 I hope the injections do work for you. They always have for me, when the doctor got to the right spot. I never had pain down my thigh though, nor afterward.
The times a doctor did not get to the right spot, the doctor who did hit it correctly said it was probably because they should have used a longer needle — I was overweight. He said that patients with a little extra padding needed a longer needle! I thought he expressed that pretty tactfully. He never missed. Now that I don't have that padding though I am going local (he was in Boston) and hopefully this doctor will hit the spot. I am having the cortisone shots in both hips in about a week and a half.
JK

Update: since the last 3 cortisone injections in various body parts did not help, I opted for some PT instead to deal with the hip area pain. My excellent go-to PT was not convinced that it is strictly (or only) the trochanter bursa that is involved, he thinks it is more likely the tendons and muscles just behind and toward the butt are involved. So for the past 3 weeks I’ve been doing specific stretching and strenghtening exercises for that (Hurrah! Just what I wanted! More exercises!), and it seems to ease up. Just annoying that when the knee is finally quite good, something else crops up. Wish I was 60 again, no aches or pains, other than self-induced by overdoing things!

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