Understanding the Basics of Bursa Injections

Finding relief becomes a priority when discomfort lingers and hampers your everyday activities. Bursa injections are a pain treatment option for those suffering from chronic joint pain. The therapeutic procedure is known for its efficacy in reducing joint inflammation and pain.

In This Article:

What is a Bursa?

A bursa is a small fluid-filled sac that provides cushioning between bones and tendons or muscles around a joint. When a bursa becomes inflamed, the condition is known as bursitis, and it can lead to joint pain and restricted movement.

Inflammation of the bursa causes a painful condition called bursitis. The most common locations for bursitis are in the shoulder, elbow, and hip. But it is also possible to suffer from bursitis in the knee, heel, and the base of the big toe. Bursitis often occurs near joints that perform frequent repetitive motion.

Treatment of bursitis typically involves resting the affected joint and protecting it from further trauma. Bursitis pain usually disappears within a few weeks with treatment, but recurrent bursitis flare-ups are common.

What is a Bursa Injection?

A bursa injection is a specialized procedure designed for the targeted relief of inflammation within the bursa of a joint. The procedure is a minimally invasive treatment involving the delivery of anti-inflammatory medication directly into the affected bursa to help alleviate pain and swelling. The injection is often performed with ultrasound guidance (fluoroscopy) to enhance the accuracy of medication delivery.

The injection is typically a blend of a corticosteroid and a local anesthetic, often providing immediate pain relief with long-term reduction in inflammation to help provide pain relief.

Who Benefits from Bursa Injections?

Bursa injections may benefit individuals who suffer from the discomfort and limitations of bursitis due to repetitive movements or prolonged pressure that irritates a joint. The injection can be beneficial when physical therapy or oral medications haven’t provided relief from the pain.

A bursa injection can be beneficial for those with bursitis in high-movement areas such as:

  • Hip (trochanteric) bursitis is a condition that affects runners, cyclists, or those who have had hip fracture surgery or suffer from greater trochanteric pain syndrome. The injection may help relieve inflammation around the greater trochanter bursa.
  • Shoulder (subacromial) bursitis is common in individuals who perform repetitive overhead movements, like painters or baseball players.
  • Elbow (olecranon) bursitis is the pain experienced by individuals who lean on their elbows frequently, likely causing inflammation in the olecranon bursa or having sustained an elbow injury.
  • Knee (pre-patellar) bursitis is a condition experienced by athletes or those who kneel often for their profession. The injections may also help with pain associated with movements along the femur and surrounding tissues.

If non-surgical treatments haven’t adequately relieved the pain, a bursa injection could provide interim relief while seeking other treatment options.

How to Prepare for a Bursa Injection

As you gear up for a bursa injection, there are several steps you’ll want to take to ensure you’re ready for the procedure. Adequate preparation can help mitigate any nerves and streamline the process, letting you focus on the relief that awaits. Here’s how to prepare effectively:

  • Medical History Review: Disclose your full medical history, including any allergies, medications, or medical conditions, to your healthcare provider. Doing so allows them to anticipate potential interactions with treatments, identify abnormalities, and provide a safe, custom procedure.
  • Medication Management: Discuss any medications you’re currently taking, especially blood thinners or anti-inflammatory drugs, as you may need to adjust or halt these prior to the injection to reduce the risk of bleeding.
  • Fasting: Usually, there’s no need to fast before a bursal injection, but always confirm with your doctor in case they have specific instructions.
  • Clothing: Wear loose-fitting clothing on the day of the procedure, especially if the injection site is likely to be in an area that could stir up friction with your attire. Comfort is key and will provide easy access for the doctor.
  • Transportation Plans: Even though the injection is quick and non-surgical, you might experience temporary numbness, discomfort, or tenderness afterward. Plan on having someone drive you home.
  • Aftercare Arrangements: Depending on the injection site, your doctor may advise applying a dressing at the site and potentially prescribe a regimen for gently flushing the area to prevent discharge or infection. Arrangements for assistance during recovery may be necessary, especially if your mobility is affected by pain or tenderness.

Adhering to these guidelines will help contribute to a more favorable treatment outcome. Always follow any additional or specific instructions your healthcare provider gives, as personal medical needs can vary.

What Happens During the Bursa Injection Process?

Precision and care are top priorities during the bursa injection process to relieve and minimize discomfort. If you’re considering this treatment, knowing what to expect can ease your mind as the appointment approaches.

  • Verification: Your healthcare provider will confirm the procedure details and the specific bursa requiring treatment based on your symptoms and diagnosis. For cases of lateral hip pain, trochanteric bursal injections may be considered.
  • Site Cleaning: The area around the bursa is thoroughly cleaned to avoid infection risks, following strict aseptic techniques.
  • Anesthetic Application: To make the process more comfortable, your provider will apply a local anesthetic to numb the area around the injection site.
  • Needle Insertion: Using a thin, sterilized needle, your provider inserts it through your skin and into the inflamed bursa sac. This step may involve ultrasound technology or fluoroscopy guidance to ensure precise placement—particularly useful for deep or less accessible bursae.
  • Contrast Dye and Medicine Injection: A contrast dye is typically injected to confirm accurate delivery to the bursa before injecting the medication. The intended medication, usually an anti-inflammatory steroid, is injected into the bursa using a prefilled syringe to reduce inflammation and pain. The mixture with a local anesthetic often provides immediate pain relief.

After the procedure, it is common to experience pressure or temporary discomfort at the injection site. If multiple bursae require treatment, your provider will repeat the steps with fresh, sterilized needles for each site.

The procedure is generally quick and efficient, often completed in 10 minutes or less. Afterward, you may receive ice or another form of cold therapy to manage any immediate swelling and receive instructions regarding aspiration care if needed.

Remember, every individual’s experience will be different, and your healthcare provider will guide you through every step and ensure your comfort throughout the process.

Managing Expectations and Recovery

Right after your bursa injection, immediate care is crucial to maximize the treatment’s effectiveness and to ensure a smooth recovery. Here’s what typically happens and what you should do:

  • Site Care: A small bandage is applied over the injection site or treated areas. Keeping this area dry for at least 24 hours is important to prevent infection.
  • Pain Assessment: Shortly after the procedure, you may be asked to rate your pain using a 0- to 10-point scale and compare it to the pain felt before the procedure. This assessment is used if experiencing a temporary increase in pain due to a potential steroid flare (the body’s reaction to the cortisone), a common side effect.
  • Functional Assessment: Your doctor may want you to perform movements or assume positions that previously would exacerbate your pain, providing a practical assessment of the injection’s immediate impact.
  • Steroid Effectiveness: It can take up to 7 days for the steroids, like triamcinolone, to reach their full effectiveness. Patients are advised to monitor their pain closely over the next few weeks to gauge the long-term effectiveness of the injection.

Following your healthcare provider’s instructions is key. Recovery tips generally include:

  • Avoid Stressful Activity: It’s best to avoid activities that stress the treated area for at least 24 hours.
  • Apply Ice: Use an ice pack wrapped in a towel to manage swelling and discomfort. This is particularly helpful if a steroid flare occurs.
  • Pain Management: Over-the-counter pain relievers or NSAIDs may be recommended, but it’s crucial to follow your doctor’s advice regarding medications, as they might suggest avoiding certain drugs that could interfere with the healing process.
  • Avoiding Submersion: Avoid baths, pools, or getting the injection site wet for two days, although you can generally shower after this period.
  • Activity Restrictions: Depending on the injection site, doctors may recommend curtailing strenuous activities using the affected body part for up to four weeks to allow for adequate tissue healing.

By following these guidelines, you encourage a more successful recovery from bursa injection therapy.

Long-Term Outcomes and Effectiveness

When considering the long-term outcomes and effectiveness of bursa injections, it’s important for the patient to set realistic expectations:

  • Pain and Swelling Relief: A successful bursa injection typically results in a significant decrease in pain and swelling in the targeted area, with some patients reporting immediate relief due to the anesthetic, such as bupivacaine.
  • Duration of Relief: Pain relief can vary greatly from one person to another. For instance, bursa hip injections often provide months of pain relief, though individual experiences differ, prompting some to seek additional treatments.
  • Efficacy Monitoring: Patients are asked to monitor their pain levels in the weeks following the injection, especially if the pain involves areas with significant movement, such as the shoulder, elbow, knee, and hip.
  • Potential Repeat Injections: As individual outcomes can vary, repeat injections may be an option, although care is taken to avoid administering near bony prominences too frequently to prevent complications.
  • Supplementary Treatments: Bursa injections often work best as part of a comprehensive treatment plan that may include manual therapies to reduce the irritation of the affected area.

Keep in mind while many find bursa injections to be a valuable component of their pain management strategy, the treatment may not work to the same degree for everyone. Discussing future care options with your healthcare provider is essential if your symptoms persist or return after initial relief.

Overall, the long-term benefits of bursa injections can be quite gratifying, leading to increased mobility and an enhanced quality of life.

Potential Risks and Complications

Despite bursa injections being widely considered safe, they do come with potential risks and complications you should consider:

  • Pain and Bruising: The injection site may be tender, bruised, or exhibit localized friction for a few days post-procedure.
  • Swelling: Some individuals might experience swelling around the treated area, partially due to the volume of fluids injected.
  • Allergic Reactions: On rare occasions, allergic reactions to medications such as bupivacaine or the contrast dye can occur.
  • Skin Issues: Irritation, discoloration, skin dimpling, and other abnormalities can sometimes manifest at the injection site.
  • Infection: Although rare, there’s a risk of infection.
  • Bleeding: Individuals on blood thinners may have an increased risk of bleeding in the bursa, joint, or tendon.
  • Nerve or Tissue Damage: Very rarely, the needle could damage nearby nerves or soft tissue, so ultrasound guidance is often used to ensure proper injection placement.
  • Elevated Blood Sugar: Diabetic patients might notice a temporary rise in blood glucose levels following the cortisone injection.
  • Facial Flushing: A transient flushed appearance may occur as a bodily reaction post-injection, often related to cortisone absorption.
  • Steroid Flare: A temporary worsening of joint pain, known as a steroid flare, can be managed with ice and anti-inflammatory medication.

These complications may vary depending on the injection site and the individual’s health profile. To minimize risks, a thorough pre-procedure review of the patient’s medical history, lab values, and current medications is performed.

Your healthcare provider will inform you of these potential risks before you consent to the injection, ensuring you’re fully aware of the procedure. Understanding these possible complications helps you make a more informed decision and prepare for the treatment with the proper safety considerations in mind.

The Healing Advantages of Bursal Injections

The advantages of bursa injections are substantial for those battling joint discomfort. Some of the healing benefits include:

  • Quick Pain Relief. Many patients enjoy immediate relief from pain and swelling thanks to the local anesthetic, which can improve daily functioning soon after the procedure.
  • Reduction in Inflammation. The injected steroid helps decrease inflammation, offering long-lasting relief for weeks or even months.
  • Minimally Invasive. Bursa injections are a non-surgical option, lowering the risks compared to more invasive treatments and reducing recovery time.
  • Diagnostic Tool. A successful bursa injection can also serve as a diagnostic indicator, confirming that inflammation within the bursa is the pain source.
  • The treatment can be easily administered in an outpatient setting, making it an accessible option for many looking for relief without the complexities of surgery.

On the flip side, there are a few considerations:

  • Repeat Injections: Some may require additional injections, which could increase the risk of side effects over time.
  • Not a Cure-All: While injections address symptoms, managing any underlying conditions for long-term relief is important.

Subsequently, bursa injections can be an effective part of a broader treatment plan tailored to a patient’s needs. The procedure is often recommended for those who haven’t found relief with more conservative therapies.


What is the difference between a bursa and a joint injection?

A bursa injection targets the fluid-filled sac cushioning your joints to reduce inflammation. In contrast, a joint injection is administered directly into a joint to ease pain and swelling within the joint.

How long does a bursal injection take?

A bursal injection is typically a quick procedure, often completed in less than 10 minutes, allowing patients to return home shortly after the injection.

Is a bursa injection painful?

You may feel some pressure or minor discomfort during a bursa injection, but the pain is usually minimal due to the local anesthetic used to numb the injection area.

How long can I expect the relief to last?

Relief from a bursa injection can last several months but varies between individuals. Some may experience shorter or longer periods of symptom improvement.

Can bursa injections be repeated, and if so, how often?

Yes, bursa injections can be repeated but generally should be spaced at least three months apart to minimize potential tissue damage.

What are my restrictions after the procedure?

Post-procedure, avoid strenuous activities for at least 24 hours. Keep the injection site dry and take it easy, giving the area time to heal. Follow your doctor’s specific instructions on activity levels.

What is a trochanteric bursa injection?

A trochanteric bursa injection is a treatment aimed at reducing inflammation and pain in the bursa at the outer point of the hip, providing relief for individuals with hip bursitis.


In the journey towards wellness and pain relief, bursa injections can be a swift and effective means to help alleviate the discomfort of bursitis. The injection can help those suffering from chronic joint pain and want a solution that restores daily functioning. However, the injections are not a long-term solution for managing chronic pain conditions. It is important to treat the underlying cause of the pain for sustained improvement.

The potential benefits of a bursa injection include a return to regular activities, a decreased dependency on oral medications, and improved daily quality of life.

Novus Spine & Pain Center

Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with chronic pain with numerous therapies, including bursa injections. By using a comprehensive approach and cutting-edge therapies, we work together with patients to restore function and regain an active lifestyle while minimizing the need for opiates.

For your convenience, you may schedule an appointment online, request a call back, or call our office at 863-583-4445.


Bursitis (Mayo Clinic)
Shoulder Injection (Mayo Clinic)
Bursa Injection (Cleveland Clinic)
Therapeutic Injections for Bursitis & Tendinitis (NYU Langone Health)
What is a hip bursa injection? (Alberta Health Services)
Steroid injections – tendon, bursa, joint (Medline Plus)
Bursa Injections (NY Spine Medicine)