Pain Management Procedures
Ischial Bursa, Ischiofemoral, and Iliotibial Band Injections
Ischial Bursa, Ischiofemoral, and Iliotibial Band Injections
What do these injections target?
· Ischial bursa injection targets the cushion over the “sit bone” and may be used for focal pain made worse by prolonged sitting.
· Ischiofemoral injection targets the space between the ischium and femur when narrowing or irritation affects the quadratus femoris muscle and causes deep buttock or groin pain.
· Iliotibial band injection targets selected areas of irritation where the thick band along the outside of the thigh rubs over the hip or knee. Dr. Sadeghipour's list says “ischiotibial band”; APG should confirm that “iliotibial band” is intended.
When may they be recommended?
Each procedure requires a specific diagnosis based on the pain location, examination, and often imaging. These conditions can resemble hamstring tendinopathy, hip-joint disease, lumbar nerve pain, piriformis syndrome, or another source. Injections are usually considered when targeted activity changes, therapy, and medication have not provided enough relief.
What happens?
Ultrasound or fluoroscopy guides a needle to the selected bursa, tissue plane, or area around the painful structure. The clinician may inject local anesthetic and corticosteroid or another selected treatment. Needles are kept out of tendon fibers whenever possible.
What should I expect?
Temporary soreness or numbness may occur. Avoid pressure or strenuous loading as directed. Improvement may create an opportunity to correct strength, flexibility, or movement factors that contributed to the irritation.
Important risks
Risks include bleeding, infection, medication reaction, temporary blood-sugar elevation, tissue thinning, and tendon injury. Deep targets are close to major nerves and blood vessels, which is why imaging guidance and a precise diagnosis matter.
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.