Procedures & Treatment Options
Joint, Bursa, &
Tendon Injections.
Joint, bursa, and tendon sheath injections are used to address musculoskeletal pain conditions affecting these structures. A formal clinical evaluation is needed to determine which injection, if any, is appropriate for any individual patient.
In Brief
What it is
Injections of medication directly into joints, bursa (fluid sacs near joints), or tendon sheaths to address pain and inflammation, used after appropriate clinical evaluation.
When it may be considered
In selected patients with joint pain, bursa-related pain, or tendon sheath inflammation when other conservative approaches have been tried and clinical evaluation supports their use.
What to expect
The target structure is identified by palpation or ultrasound guidance, and medication is injected. Procedures typically take 10-20 minutes. Patients are observed briefly and usually go home the same day.
Overview
Joint, Bursa, and Tendon Injections.
Joint Injections place medication directly into the joint space, used for joint pain, inflammation, or osteoarthritic changes.
Bursa Injections target bursae — fluid-filled sacs that reduce friction between tendons, muscles, and bones. Inflammation in a bursa (bursitis) causes pain that can be addressed with an injection.
Tendon Sheath Injections place medication in the fluid-filled sheath surrounding a tendon, used for tenosynovitis or tendon sheath inflammation.
Indications
When These Injections May Be Considered.
These injections may be considered for selected patients with:
- Joint pain or osteoarthritic changes
- Bursa inflammation (bursitis)
- Tendon sheath inflammation (tenosynovitis)
- Pain in these structures that has not responded adequately to conservative treatment
- Conditions where a clinical evaluation supports the use of injection therapy
The appropriate injection depends on which structure is causing pain and which has been identified on clinical examination and, when available, imaging.
Procedure
The Injection Procedure.
The target structure (joint, bursa, or tendon sheath) is identified by physical examination and, when appropriate, ultrasound guidance. Ultrasound guidance improves accuracy and helps ensure medication reaches the correct location.
Once the target is identified, medication is injected. The medication typically consists of local anesthetic and may include a corticosteroid or other medication depending on the clinical situation. The entire procedure usually takes 10-20 minutes. Patients are observed briefly and typically go home the same day.
Response
Response and Outcomes.
Response to these injections is variable. Some patients experience significant pain relief, while others experience minimal or no improvement. The timeline of relief also varies — some patients feel improvement quickly while others may take longer.
Many patients benefit from combining these injections with other treatments, particularly physical therapy, to address the underlying cause of pain and prevent recurrence. The goal is to reduce pain enough to allow more effective participation in rehabilitation and other conservative care.
Questions
Frequently Asked Questions.
What is the difference between a joint injection, bursa injection, and tendon sheath injection?
These are three different types of injections targeting different structures. A joint injection places medication directly into the joint space. A bursa injection targets a bursa (a fluid-filled sac that cushions areas where tendons, muscles, and bones rub together). A tendon sheath injection places medication in the fluid surrounding a tendon. The specific injection type depends on the structure causing pain.
What medication is injected?
The specific medication depends on the clinical situation and diagnosis. Options may include local anesthetic alone or local anesthetic combined with a corticosteroid or other medication. The choice is based on the patient's diagnosis, prior response to treatment, and medical history.
Is ultrasound guidance always used?
Ultrasound guidance improves the accuracy of the injection and helps ensure medication is placed in the correct location. Some injections can be performed by landmark palpation, while others benefit more from ultrasound visualization. The specific approach depends on the target structure and clinical situation.
How quickly will I feel relief?
Response time is variable. Some patients experience pain relief within hours or days, while others may take longer or may not experience significant relief. Response depends on the specific structure involved, severity of inflammation, chronicity of the condition, and individual factors.
Are these injections covered by insurance?
Insurance coverage varies and depends on the insurance plan, the specific indication, and the structure being injected. Patients should check with their insurance provider before proceeding.
How many injections will I need?
The number of injections recommended depends on the specific structure involved, prior response, and clinical evaluation. Some patients may benefit from a single injection, while others may be candidates for additional injections spaced over time.
Information
Important Information.
These injections are not appropriate for every patient or every condition. Response is variable and depends on the specific structure involved, severity of the condition, chronicity, and individual patient factors. These injections do not cure the underlying condition and are not guaranteed to provide pain relief.
A formal clinical evaluation is required to determine whether one of these injections is appropriate for any individual patient. This page is for general informational purposes only and does not constitute medical advice or create a physician-patient relationship.
Dr. Dardashti sees patients in Mission Hills, California, serving patients from the San Fernando Valley, Santa Clarita Valley, and surrounding Los Angeles communities.
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