If you are suffering from hip pain and have been diagnosed with hip bursitis or tendonitis, you may want to consider other treatment options before committing to steroid injections.
What is Bursitis?
Bursitis refers to inflammation of the bursa. A bursa is a fluid-filled sac that provides cushioning between tendons and/or bones around your joints.
Although it is a common diagnosis, hip bursitis is an often inaccurate term used in the medical field. The majority of cases described as hip bursitis actually have no inflammation in the bursa. Muscle tears, tendon strains, and trigger points can all cause pain in this area,
The most common risk factor for pain in the outer hip area is overuse injuries (also referred to as repetitive stress injuries). Running and standing for long periods of time are common causes.
Symptoms of Hip Bursitis and Tendonitis
Hip bursitis and tendonitis is characterized by tenderness to touch over the bony prominence on the outer side of the hip. In acute stages, pain is often described as localized and sharp. However, chronic cases are felt as dull and aching pain.
You might experience pain with certain movements or positions. For instance, your hips may hurt when you are standing or bearing weight. This pain can be more noticeable as you shift your weight to stand on the affected leg. This pain may occur when you are walking, climbing up/down the stairs, running, prolonged standing, or cycling. You may also experience pain when there is simply too much pressure on your hips, like when you are trying to sleep on the affected side.
As we gain a deeper understanding of sensation and the causes of pain, the complexity of understanding the source of the problem is leading us to prefer the term greater trochanteric pain syndrome (GTPS) over bursitis.
Treatment of Greater Trochanteric Pain Syndrome (GTPS)
Cortisone injections became the standard treatment for GTPS based on the belief that the pain originated from inflammation of the hip bursa.
Is Steroid Injection Beneficial?
Yes, therapeutic steroids – sometimes referred to as corticosteroids or cortisone – are helpful in the treatment of a number of different conditions (such as hip bursitis). Therapeutic steroids are similar to the hormones your body releases to fight illnesses, injuries, and help reduce inflammation in the body. Your physician or specialist will inject a small amount of steroid to control pain and inflammation in a bursa, joint, tendon, or muscle. A local anesthetic is also commonly injected at the same time.
Side Effects to Steroid Injections
Although rare, there are a number of adverse effects associated with steroid injections that should be considered. Side effects of steroid injections can include:
- Mild allergic reaction
- Temporary increase in pain
- Blood sugar increase
More severe side effects may include weakening of tendons and ligaments due to multiple injections in one area over a short period of time. Achieving minimal relief after two injections is generally considered as a contraindication to having more injections.
Recent Options for Treatment of Greater Trochanteric Pain Syndrome (GTPS)
Evidence now suggests that GTPS pain arises in response to a muscle and tendon injury, not due to inflammation. Determining the underlying cause of GTPS pain opened the way to pursue alternative treatments to cortisone injections.
Recent studies explored dry needling as an alternative to cortisone injections to reduce pain and improve function in patients with GTPS.
Dry Needling as an Alternative Treatment for Hip Pain
Recent studies show that patients with GTPS can get similar results from dry needling as a corticosteroid injection. Because the outcomes were similar, dry needling may be a good option for those worried about the potential side effects and risks of a steroid injection, or those who want to try a lower-risk treatment. If you have been diagnosed with this condition, dry needling has evidence-based treatment options to help you recover.
Side Effects of Dry Needling
Dry needling is a generally well-tolerated procedure with very minor side effects, such as soreness and discomfort, which subside just within a few hours after the treatment. It has very few absolute contraindications.
Dry Needling in Austin, TX
For top-notch physical therapy services in Austin, Round Rock, Manor, Pflugerville, Cedar Park, Bee Cove, and Hutto, visit us at Endeavor Physical Therapy & Wellness. Dry needling is one of the many innovative treatment modalities we use to deliver the best patient outcomes for the vast range of musculoskeletal problems.