Summary:
The shoulder and the hip are common places to experience bursitis, inflammation of the bursa.
Bursitis can be the result of shortened muscles and too much pressure on the structures that are in or passing through the bursa.
Cortisone injections, sometimes used to relieve pain, actually breakdown tissues such as muscle, tendon and bone. For this reason steroids have limited usefulness when studied.
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Transcript:
Dr. Heather Tick: Why shouldn’t I get a second steroid injection for my bursitis? There are a few structures in the body that we call bursa. Bursa are little sacs with a tiny little bit of fluid in them that are designed to allow tendons and muscles to slide over each other. Two very common ones that run into trouble: are ones in the shoulder, or the ones in the hip. And when they run into trouble, we call it bursitis. But sometimes, that’s not actually the most accurate title for it.
Bursitis implies that there’s inflammation because –itis, at the end of a word means inflammation. Sometimes the problem is not primarily inflammation though. It’s a problem of shortened muscles putting too much pressure on the structures in or through the bursa. And sometimes in the hip in particular, there are certain muscles that are too tight and they cause pressure on the bursa. Working with a chiropractor, a sports physician, a physical therapist, trainer or massage therapist who understands how to recognize what all the muscles around the bursa are doing and can help really recognize whether the bursa is just an innocent bystander.
Sometimes people do get relief from injections of steroid into the bursa but sometimes they don’t. If you’ve had relief from the first one, that’s good but then you need to find out what is the root cause of the problem because it isn’t acceptable to keep having steroid injections. Injections of cortisone actually breakdown our tissues. It can breakdown muscle and tendon and it’s not very good for our bones either. It can make people who are diabetic or pre-diabetic have trouble controlling their blood sugar. And for some people it can also make them feel very stressed and agitated because cortisone is related to our stress hormones and some people react psychologically very badly to them. So I don’t recommend steroid injections unless we’re absolutely certain that that’s the only thing that will help. I think having a physical treatment like acupuncture for example, would be a good first step.
