Pain Management Procedures
Greater Trochanteric Bursa Injection
Greater Trochanteric Bursa Injection
What is it?
The greater trochanter is the bony point on the outside of the hip. A bursa and several gluteal tendons lie over it. Pain in this region is now often called greater trochanteric pain syndrome because bursitis, tendon irritation, tendon tears, and friction from the iliotibial band can overlap. A bursa injection places medication into the cushion between these tissues.
When may it be recommended?
It may be considered for persistent outer-hip pain that is tender to touch and worse with lying on that side, climbing stairs, or prolonged walking. Activity changes, strengthening, and treatment of gait or hip-mechanics problems are often tried first or continued with the injection.
What happens?
You lie on the unaffected side or your back. The painful area is identified, and ultrasound may guide the needle into the bursa while avoiding the gluteal tendons. Local anesthetic and corticosteroid are commonly injected.
What should I expect?
There may be soreness or a temporary pain flare for several days. Steroid benefit can take a few days. Pain reduction can help you participate in hip-abductor strengthening, which is important when tendon dysfunction is part of the problem.
Important risks
Risks include bleeding, infection, medication reaction, temporary blood-sugar elevation, skin or fat thinning, and tendon weakening with repeated steroid injections. If pain comes from a substantial gluteal tendon tear rather than the bursa, the response may be limited.
Preparing for your injection procedure…
Your instructions will depend on the procedure. Before any injection, tell the APG team if you:
Take aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, or another medicine or supplement that affects bleeding. Never stop a prescribed blood thinner unless the clinician who manages it and the procedure team tell you how to do so safely.
Have diabetes, glaucoma, a bleeding disorder, an active infection, fever, or recent antibiotic treatment.
Could be pregnant, have an allergy to contrast dye or local anesthetic, or have reacted to steroid injections before.
Use an implanted pacemaker, defibrillator, spinal cord stimulator, or other electrical device.
Some procedures require fasting, a medication adjustment, or a responsible adult to drive you home, especially when sedation is planned. Follow the instructions provided for your specific appointment.
After your injection procedure…
Most injections are outpatient procedures. Mild soreness, bruising, temporary numbness, or a brief increase in the usual pain can occur. Follow the activity and bandage instructions you receive. Steroid medicine may take several days to have an effect and can temporarily raise blood sugar.
Call the office promptly for increasing redness, drainage, fever, severe or rapidly worsening pain, or new numbness or weakness. Seek emergency care for trouble breathing, chest pain, sudden loss of bladder or bowel control, a severe new headache, loss of vision, stroke-like symptoms, or rapidly progressing weakness.
This information is for general education and does not replace medical advice, diagnosis, or treatment. Not every procedure is appropriate for every patient, and results vary. Your APG care team will review your symptoms, examination, imaging, medical history, medications, and prior treatment before recommending a plan. Coverage requirements also vary by insurance plan.