Hip or Trochanertic Bursa Injection

Screen Shot 2019-02-18 at 1.29.55 PM.png
Screen Shot 2019-02-18 at 1.27.06 PM.png


The hip is a complex joint consistent of bones, joint in between, ligaments that hold the structure together and multiple muscles around the joint which allow the joint to move within available range of motion. 

There are different areas within this complex structure that could be painful. The hip joint can be painful due to arthritis or labral tear of fracture. The Bursa can get inflamed due to injury, sports, leg length differences, scoliosis, and sometimes for no apparent reason. Joint pain often on weight baring / walking and is described as groin or butt pain. The bursa pain is often on the outside of the hip, painful to pressure or rolling over it at night. Hip bursitis is the most common bursitis in body.

Procedural Treatment

Non surgical treatment for hip or bursa pain includes physical therapy, use of anti-inflammatory medications, and at times localized injections of steroid, PRP or stem cells.

Risks Associated with Procedure


It is important to know the risks associated with any medical or surgical treatment. There are a few risks associated with caudal epidural steroid injections but they tend to be rare.

The potential risks of injection treatments include:


  • Allergic reaction to meds

  • Infection

  • Bleeding

  • Nerve Injury

  • Temporary increase in pain

  • Osteoporotic bone fracture

  • Avascular necrosis(if steroid used)

  • High blood sugar levels(if steroid used)

  • Transient vaginal spotting

  • Transient facial flushing (if steroid used)

  • A transient decrease in immunity

  • Stomach ulcers

  • Severe arthritis of the hips

  • Avascular necrosis of joints(if steroid used)

  • Cataracts (if steroid used)

  • Increased appetite

  • Agitation and irritability

  • Negative effect on bone density and fractures (if steroid used)

  • Lack of benefit


Prepare for your Procedure:


  • Certain medications have to be held or before elective procedures or patient has to accept a slight increased risk of bleeding with TPI procedure

  • Do not hold such medication on your own. Consult your Primary Care Physician (or Cardiologist) before stopping those medications. Ask your PCP if it is safe to stop the medication. Continue to take all other medications, especially your Blood Pressure medications.

  • Please let us know if you have had fevers, antibiotic treatment, any illness, or hospitalization within the last 4 weeks. You must be healthy and off all antibiotics on the day of the procedure

A sample of medications that have to be held includes:


  1. Aggrenox® (dipyridamole)

  2. Coumadin® (warfarin)

  3. Effient® (prasugrel)

  4. Fragmin® (dalteparin)

  5. Heparin

  6. Eliquis ® (apixaban).

  7. Lovenox® (enoxaparin)

  8. Plavix® (clopidogrel),

  9. Pradaxa® (dabigatran)

  10. Ticlid® (ticlopidine)


Right after the Procedure


  • You will be observed for 15-30 minutes.

  • A nurse will check your vitals and review the discharge instructions with you and will answer any questions you may have. A responsible adult must be present to drive you home after discharge.

  • You will leave with a pain log and a copy of the discharge instruction which contains Emergency contact numbers. Please do not discard your discharge instructions.

Discharge Instructions


  • Take band aid off tomorrow.

  • Ice area the night of the procedure.

  • May take Tylenol or Motrin if you have some soreness.

Call your doctor if you develop these symptoms. YOU MAY BE DIRECTED TO ER:


  • Sudden weakness or shortness of breath

  • Fever over 101°F within 5 days after procedure

  • Persistent redness, increased localized pain, or discharge from the site of injection.

  • Possible allergic reaction within 5 days of the procedure

  • Significant increased pain not responding to ice, NSAIDS and pain meds or associated with fever