Bursa Injections

Indications: 
Bursae are fluid-filled sacs that provide a cushion between bones, tendons and/or muscles in different areas in your body usually found around a joint. When irritated, they can produce pain around the specific area that they reside. By placing a local anesthetic mixed with a steroid, which is a strong anti-inflammatory, in the bursa that is inflamed, this can decrease the irritation which decreases your pain. Some common locations of bursae include:

• Subacromial and subdeltoid bursae:  Shoulder pain
• Ischial tuberosity bursa:  Buttock pain especially when you sit
• Greater trochanter bursa:  Hip pain
• Pes Anserine bursa:  Knee pain

 
Contraindications/Reasons why you may not have your injection today:

• Bleeding disorders/low platelet counts
• Medications that thin your blood (please review this section)
• Current infection
• No driver
• Your symptoms have changed and/or improved
• Patient refusal
• Procedure not approved by your insurance
• Poorly controlled high blood pressure that may be giving you symptoms
• Poorly controlled diabetes
• Certain types of glaucoma
• Poorly controlled bipolar disorder
• Allergies to the any of the medications that is being used

 
Potential side effects/risks of the procedure:

• Increased pain
• Temporary numbness at the site of the injection
• Numbness in lower extremities that is short lived
• Infection
• Bleeding
• Allergic reaction
• Cramping in lower extremities
• Mood changes
• Flushed face/extremities
• Headaches
• Worsening of high blood pressure
• Increasing of blood sugars if you have diabetes
• Water retention
• Chronic steroids can cause weight gain
• Seizures
• Stroke
• Nerve injury

 
Procedure:
During the procedure, you will be in the best position to be able to safely and most comfortably perform the injection. At times, an X-ray and/or ultrasound machine may be used to identify the area of the bursa more specifically. After the area on your skin is marked, your skin is cleaned with an antiseptic solution, typically betadine unless you are allergic. The skin may be numbed with a local anesthetic which is typically the most painful part of the procedure as this medicine has a tendency to burn when it is injected. After this point, you should only feel pressure. If anything is too painful for you, please tell your provider as more numbing medicine can be given at any time. When the needle is in the bursa sac, a solution containing both a local anesthetic and steroid is slowly injected. You may experience increased pain/pressure in that specific area which is to be expected. However, if at any time the pain is too intense, please tell your provider to slow down your injection. After the medication is injected, the needle is removed and the procedure is completed.

Typical length of the procedure: 
5 minutes.  Expect to be at the clinic no more than 15 minutes after you have been checked in by the medical assistant into the preoperative area.  If this is your first time at our clinic, you will likely be at the clinic for at least one hour.  Please plan accordingly.

How long do you expect pain relief: 
It is difficult to determine how long and how much pain relief you may experience. It varies depending on multiple factors. Some patients do not gain any relief from the procedure and some may have permanent relief. If you experience relief right after this procedure, this can be diagnostic that your pain is coming from the specific bursa that was injected today.