Thursday, November 18, 2010

steroids for band geeks?

Yesterday I had my steroid shots at the sports medicine clinic. (no I don't play sports, I think the staff was slightly disappointed!) First, I had a complete evaluation with various motion tests done on my hips. Everything from knee to chest (ouch!) and left knee to right side of chest (double ouch!) plus some resistance tests thrown in for fun. After that and some chatting he decided to inject the bursa on the trochanter (side of hip) and also do an intra-articular injection (inside the joint.) First my hip was cleaned with iodine and alcohol and I was positioned on my back because the inra-articular injection was first. Next, a number was injected in to my joint. This burned and stung quite a bit. After that a very large needle was used to inject the steroid into my hip. This stung as the the needle went in and then there was pressure and discomfort as the steroid was injected which took about 45 seconds.
I have had a similar procedure done before in the OR with anesthesia. I think it may be that sports med likes to do it outpatient with ultrasound guidance no sedation and general ortho prefers OR sedation and flouroscopic (x-ray) guidance. There are definite pros and cons between the two procedures. The outpatient procedure is more painful but it only takes about 24 hours to recover from. I prefer the OR procedure because you aren't awake for the procedure but you do need to fast, have an IV and the anesthesia may leave you feeling off for a 3 days or so.
After that my bursa (fluid filled sac) was injected and I was flipped onto my right side and my hip was cleaned. Again, I felt the burning but it only took about 10 seconds to inject the medicine. Usually there is little discomfort after with a bursa injection. However, for about a few days or so after intra-articular I usually have a slight limp and some groin pain. This is due to having something (fluid) put in the joint that wasn't there before! Sometimes the steroid crystallizes which can be painful but frequent icing can usually help.

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