Bursitis is an inflammation of the bursa, sacs of fluid which decrease friction between the moving parts in the body. Treatment options to reduce the pain and swelling of shoulder and hip bursitis have long included cortisone injections. Cortisone injections are also used for another injury called a triangular fibrocartilage complex (TFCC) tear. You may wonder if there are more advanced options than cortisone injections to decrease the recovery time for shoulder or hip bursitis or triangular fibrocartilage complex (TFCC) tears.
Tendons attach muscles to bones, and ligaments connect bones to bones. Bursae are sacs of fluid that decrease friction as tendons, ligaments, muscles, and skin slip past each other. With overuse and repetitive motions, bursae can become inflamed, especially at the hip and shoulder. Conventional medical treatment for bursitis is cortisone injections.
The outer membrane of the bursa produces the synovial fluid inside the bursa sac. Synovial fluid is a viscous, slippery lubricating fluid. Healthy bursae are thin and allow materials such as blood cells and bacteria to enter and leave the sac.
When the synovial membrane becomes inflamed, it will thicken and produce extra fluid. If the bursitis is due to trauma, bacteria can enter the bursa and cause an infection called septic arthritis.
Bursitis is commonly from friction or trauma. Frequently, when the bursa becomes inflamed, the overlying tendon will as well.
The subacromial bursa is one of the largest bursae in the body and is found under the acromion, at the top of the shoulder blade. This compact space accommodates the rotator cuff muscles, tendons, and the subacromial bursa.
Raising the arm above the head exacerbates the pain of shoulder bursitis. The pain sometimes radiates down the outside of the arm. Arm and shoulder weakness may occur because of decreased movement and exercise.
A slight amount of swelling can lead to symptoms, including pain and inflammation. Cortisone injections for the treatment of shoulder bursitis should decrease inflammation and speed up recovery time. However, cortisone injections are not without their risks.
Symptoms of shoulder bursitis may include pain with the following:
The shoulder bursa could become inflamed after any of the following:
Trochanteric hip bursitis causes pain at the outer curve of the upper thigh. It is common in runners and ballet dancers. It may radiate to the buttock, groin, knee, and lower back. A large bursa overlying the top of the thigh bone (femur) becomes inflamed.
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Symptoms of trochanteric or hip bursitis include pain with the following:
The trochanteric bursa can become inflamed after any of the following:
Iliopsoas bursitis: The iliopsoas bursa is near the groin. Bursitis of the iliopsoas bursa causes pain in the front of the hip instead of the outer curve. The pain slowly worsens.
Ischiogluteal bursitis: Ischiogluteal bursitis is an inflammation of the bursa that lies between the ischial bone and the insertion of the hamstring muscle to the bone. It commonly occurs after a trauma or from sitting on a hard surface for a prolonged period.
If not adequately treated, acute bursitis may become a chronic problem. If the bursa is not infected, start with RICE.
Nonsurgical treatments for bursitis are directed towards decreasing the inflammation in the bursa. They may include any of the following:
The triangular fibrocartilage complex (TFCC) is made of tough fibrous tissue and cartilage and supports the joints between the two forearm bones, the radius and the ulna. The TFCC plays an essential role in moving the wrist, rotating the forearm, and supporting the forearm when gripping an object.
There are two types of TFCC tears.
Symptoms of TFCC tears may include the following:
Cortisone injections for the treatment of shoulder or hip bursitis or TFCC tears may decrease inflammation and speed up recovery time. There are risks associated with cortisone injections, including risk for infections, allergic relations, bleeding, and tendon rupture.
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.