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Injections for hip pain can provide short-term relief: but when suffering from hip pain, corticosteroid shots aren't recommended as a long-range solution.

If you suffer from greater trochanter pain syndrome (GTPS), a common source of hip pain caused by inflammation of the trochanteric bursa in the hip, you may find temporary relief from corticosteroid injections. The bursa is a fluid-filled sac that rests between the bone on the outside of the hip (the greater trochanter) and the tendon that passes over the bone. When the bursal sac becomes inflamed, each time the tendon has to move over the bone, pain results.


Corticosteroids, of which cortisone is one type, can reduce inflammation and therefore reduce the pain. However, in a study published in the October issue of the American Journal of Sports Medicine, researchers found that while cortisone injections were effective at relieving symptoms in the short term, their benefits decline over time. The researchers noted that after 15 months, a much greater majority of patients who treated their GTPS with home exercise programs or low-energy shock-wave treatments found relief than those who continued to get the injections only. Shock-wave therapy involves a machine that delivers energy pulses to the affected area.

Physiatrist David Fish, MD, with the UCLA Comprehensive Spine Center, says that injections should be used in conjunction with exercise or physical therapy. In serious cases, surgery can be done to remove the inflamed bursa or lengthen the tendon or even remove the part of the tendon that rubs against the bursa. Cortisone injections can also be effective in temporarily treating the discomfort caused by osteoarthritis, another common source of hip pain.

"If you're not a surgical candidate, then the injection is a possible option," Dr. Fish says. "It is part of a larger program with exercise. The problem is that only the stiffness can be helped by physical therapy, but the pain is not usually improved with exercise. Injections can be done, at most, four times per year or every 3 months. If you don't get benefit, then why keep doing the injection that has known complications, such as bleeding, infection and worsened pain?"

Hip pain can also be the result of fractures or an extension of low back pain or spinal problems, Dr. Fish says. To help diagnose your condition, he suggests sharing the details of your pain with your doctor, and be able to describe the type of pain you feel, how long you've had the problem, when you feel the pain (after physical activity, when you wake up in the morning, etc.,) and what helps to relieve the pain.


To help reduce hip pain:

* Lose weight to reduce strain on the hips and other joints.

* Swim and try other exercises that do not place much impact on the hip.

* Stop smoking.

* Talk with your doctor about non-steroidal anti-inflammatory drugs (NSAIDs) and other medications to relieve your symptoms, as well as hot-and-cold treatment and other home remedies.

* Rest and allow an acute attack of hip pain to subside.

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Publication:Healthy Years
Date:Jan 1, 2010
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