Joint and Bursa Injections
Image-guided injections for arthritis and bursitis of the hip, knee, shoulder, and other joints, to calm pain and help you stay active.
Joint injections for arthritis
Osteoarthritis wears down the cartilage that cushions a joint, causing pain, stiffness, and swelling. An injection of a steroid, usually with numbing medicine, into the joint can calm inflammation and ease pain. National arthritis guidelines recommend steroid injections for knee and hip osteoarthritis, alongside exercise and weight management.1
The most common joint we treat for arthritis pain
Image guidance is especially important for this deep joint
For arthritis, frozen shoulder, and rotator cuff pain
We also treat other joints, such as the elbow, wrist, hand, ankle, and foot, when appropriate.
Bursa injections for bursitis
A bursa is a small, fluid-filled cushion that lets tendons and muscles glide over bone. When a bursa becomes inflamed (bursitis), it can cause sharp pain with movement or pressure.
Common examples include pain on the outside of the hip that makes it hard to lie on that side, shoulder pain when reaching overhead, and pain on the inner knee. A steroid injection into the bursa can calm the inflammation. In a randomized trial of outer hip pain, more people recovered by 3 months with an injection than with usual care alone.2
- Outer hip (trochanteric) bursitisPain on the side of the hip, worse lying on that side or climbing stairs
- Shoulder (subacromial) bursitisPain when reaching overhead or behind the back
- Knee (pes anserine) bursitisPain on the inner knee, below the joint line
How it works
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Exam and imaging
Your physician confirms which joint or bursa is causing pain and reviews any X-rays or MRI.
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Image guidance
Ultrasound or X-ray helps place the needle precisely, especially in deep joints like the hip.
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Medicine delivered
A steroid, usually with numbing medicine, is injected into the joint or bursa.
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Back to your day
Most people walk out and return to light activity right away.
- QuickMost injections take just a few minutes.
- PreciseImage guidance improves accuracy compared with injecting by feel alone.
- Works with therapyPain relief can make it easier to do the exercises that keep joints healthy.
- No downtimeYou can usually return to normal activities the same or next day.
What to expect
Before your injection
Tell us about your medications, especially blood thinners, and whether you have diabetes or an infection. Please don’t stop any medication on your own.
During your injection
The skin is cleaned and may be numbed. You’ll feel pressure and a brief sting. Image guidance takes only a moment longer.
After your injection
The numbing medicine may give quick relief that fades after a few hours. The steroid usually starts working in 2 to 7 days. Rest the area for a day and avoid heavy use for a few days.
Common questions
How long will an injection help?
Relief varies from a few weeks to several months. If injections help, they can be repeated, but we space them out, usually at least about 3 months apart, because frequent steroid injections can affect the joint and the rest of the body.
Will it cure my arthritis?
No. Injections calm pain and inflammation, but they don’t rebuild cartilage. They work best as part of a plan that includes exercise, weight management, and other treatments.1
What if injections stop helping my knee?
Other options include genicular nerve ablation, which can relieve knee arthritis pain for months, and referral to an orthopedic surgeon when joint replacement may be appropriate.
I have diabetes. Is that a problem?
Not usually, but steroids can raise blood sugar for a few days. Check your sugar more often after the injection.
Will insurance cover it?
Most plans cover joint and bursa injections. Our staff will check your benefits before your visit.
Talk with a specialist about joint pain
Our physicians will examine the painful joint and review your imaging to decide whether an injection, or another treatment, is the right next step.
New pain management patients need a referral. Your provider can fax it to 870-706-2428.
Risks
Possible side effects include a temporary increase in pain (a steroid flare) for a day or two, skin lightening or thinning at the injection site, facial flushing, temporary high blood sugar, bleeding, and infection (rare). Your physician will review the risks with you before your procedure. Individual results vary.
Sources
- Kolasinski SL, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2020;72(2):149-162. doi:10.1002/acr.24131
- Brinks A, et al. Corticosteroid injections for greater trochanteric pain syndrome: a randomized controlled trial in primary care. Ann Fam Med. 2011;9(3):226-234. doi:10.1370/afm.1232
Knee illustration: BruceBlaus, via Wikimedia Commons, CC BY-SA 4.0, resized. Hip and shoulder illustrations: Blausen.com staff, “Medical gallery of Blausen Medical 2014,” WikiJournal of Medicine, CC BY 3.0, resized.