We get many emails from patients suffering from hip bursitis. Many of them have already had cortisone, many are recommended to cortisone injections. The question then they ask, is which one do you provide and think would be best for me?
Corticosteroids, like cortisone, are powerful anti-inflammatory substances. They are designed not to relive pain by repairing an injury, but rather they are designed to reduce inflammation to lessen a patient’s level of discomfort.
Cortisone also masks the pain, which gives people a sense of false security. Cortisone is often reached for in patients suffering from inflammation of a bursa (bursitis), a tendon (tendonitis), and a joint (arthritis). Painful foot conditions such as plantar fasciitis, rotator cuff tendinitis and many other conditions may be treated with cortisone injections as well.
Do you even have bursitis? Did you get cortisone for nothing?
Trochanteric bursitis has been used as a general term to describe pain around the greater trochanteric region of the hip. Doctors in one study speculated that that trochanteric bursitis may not however have an inflammatory component and that accordingly, bursal inflammation has no role in lateral hip pain.1
In agreement with this research, we will often see patients with a diagnosis of bursitis and as this study suggests they do not have it at all. The pain generator is coming from a ligament. This is usually discovered following a physical examination.
Platelet-rich Plasma (PRP) Treatment More Effective than Cortisone for Severe Hip Bursitis
A report from the American Academy of Orthopaedic Surgeons says that Platelet-rich plasma injections are significantly more effective and durable than cortisone injections for the treatment of severe chronic hip bursitis.
In the study, “Platelet-Rich Plasma (PRP) More Effective than Cortisone for Severe Chronic Hip Bursitis,” 40 patients were selected for the study and randomly divided into two groups: one group was treated with a single injection of 40 milligrams (mg) of methylprednisolone, and the second group, a single injection of PRP.
Results were recorded to assesses a patient’s functionality before and after hip treatment; and to measure pain, stiffness and functional limitation. According to the study authors, PRP injections are significantly more effective and durable than cortisone injections for the treatment of severe chronic hip bursitis.2
Other studies have shown that the long-term use of cortisone (i.e., repeated injections over a period of months or years) can cause degeneration of tendon tissue or cartilage if injected into the tendon itself.
With that said, although we don’t like to do repeat injections of steroids or cortisone, sometimes doing it once is a very good diagnostic tool to see where the problem is occurring. By using cortisone, we can isolate an area by figuring out where cortisone is working the best. That area is where we focus our other tissue-building techniques.
PRP (Platelet Rich Plasma) Therapy works on a totally different platform than cortisone
PRP (Platelet Rich Plasma) Therapy works on a totally different platform than cortisone. While cortisone inhibits inflammation, PRP initiates a collection of harmonious healing actions. The platelets stimulate proteins which encourage cellular growth and tissue regeneration. By concentrating the number of platelets normally found in an injured area, you’re basically boosting this healing mechanism at the same time. It attracts stem cells which eventually grow into healthy joints, tendons, or ligaments.
Simply put, PRP injection allows a quick and focused action to the area of injury, which allows it to heal more effectively and rapidly.
Requiring only a small amount of blood from the patient, a trained professional can, with the help of a centrifuge, create a highly concentrated platelet rich plasma, which is then injected into the patient’s injured tissue. This injection “jump-starts” the healing process.
A recent study presented at the International Meeting on the use of Autologous Growth Factors in Orthopedics and Sports Medicine found patients receiving cortisone showed a 40% improvement compared to PRP, which demonstrated a 75% improvement at 12 months. The study concluded that PRP injections reduced pain and increased function significantly, exceeding the effect of corticosteroid injection.3