Hip Bursitis - Why cortisone is not enough?!

April 12, 2024

Cortisone injections can be useful for managing the symptoms of gluteus medius tendinopathy and bursitis (also known medically as greater trochanteric pain syndrome) by reducing inflammation in the bursa itself and helping reduce your pain levels. However, did you know that relying solely on cortisone injections may not be the best long-term management strategy?  

Here are the reasons why and further suggestions of how to maximise your rehab through engaging in Physiotherapy:  

• It doesn’t address the underlying cause: While cortisone injections can provide temporary relief by reducing inflammation and pain, they do not address the underlying biomechanical issues or contributing factors that led to the tendinopathy in the first place. Physiotherapy aims to identify and address these underlying causes, which may include muscle imbalances, poor movement patterns, or biomechanical dysfunctions. 
• Identifying contributing factors to your tendon story: Hormonal influences, cardiac medications, new activities endeavours, back pain, hip osteoarthritis and conditions like long COVID19 put you at higher risk of a tendon issue like greater trochanteric pain syndrome. Physiotherapists can help you sort through these individualised factors and work out an appropriate plan with you and your GP, if needed.  

• Risk of tendon weakening: Prolonged or repeated cortisone injections may weaken the tendon over time and increase the risk of tendon rupture. Physiotherapy interventions such as strengthening exercises, manual therapy, and corrective movement patterns aim to strengthen the tendon and surrounding muscles, reducing the risk of further injury. 
• Incomplete rehabilitation: Cortisone injections may provide short-term pain relief, which can lead individuals to neglect or delay engaging in necessary rehabilitation exercises. Physiotherapy focuses on comprehensive rehabilitation, including strengthening, flexibility, proprioception, and functional training, to optimize long-term outcomes and prevent future recurrences. These rehab plans can happen at home, using your local gym membership or you can join an OHL Group Physio class to complete your rehab in a supervised, responsive setting.  
• Risk of Side Effects: Cortisone injections carry potential side effects, including infection, tendon rupture, skin discoloration, and temporary flare-up of symptoms. Physiotherapy interventions are generally considered safe and have minimal risk of adverse effects when performed by qualified professionals. 

In summary, while cortisone injections can be a useful adjunct to physiotherapy in the management of gluteus medius tendinopathy and bursitis, they are typically not recommended as a standalone treatment due to their limited ability to address underlying causes, potential risks, and incomplete rehabilitation. A comprehensive physiotherapy approach that includes targeted exercises, manual therapy, and functional rehabilitation is often preferred for optimizing long-term outcomes and preventing recurrence.  

Get in touch to start your individualised assessment and physio-led rehabilitation program today by calling 9431 5955 or you can book with an OHL Physiotherapist via our Client Portal on our website.  

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