Steroid Injections for Tendons & Bursae Epoch Medical Imaging, St Ives
Cortisone injections for tendons, bursae and soft tissue at Epoch Medical Imaging, St Ives. Ultrasound-guided precision. Serving the North Shore — Turramurra, Pymble, Gordon.
Cortisone for Tendinopathy: When Does It Help and When to Avoid?
Cortisone injections and tendinopathy have a nuanced relationship — and understanding when cortisone is helpful versus when it should be avoided is important for getting the best outcome.
When cortisone IS appropriate for tendinopathy:
– Short-term relief during a painful acute flare when pain is preventing engagement with rehabilitation
– Tendon sheath conditions (such as de Quervain’s tenosynovitis) — where inflammation of the tendon sheath, not the tendon itself, is the primary problem. Cortisone is highly effective here.
– As a one-time intervention to break a cycle of pain and allow physiotherapy to begin
– Rotator cuff tendinopathy — to reduce surrounding bursitis and facilitate rehabilitation
When cortisone should be used with caution or avoided:
– Chronic degenerative tendinopathy (such as mid-portion Achilles tendinopathy) — repeated cortisone injections into degenerative tendons may weaken the tendon and increase rupture risk
– Directly into the Achilles tendon substance — this is specifically avoided due to rupture risk
– When multiple previous injections at the same site have not provided lasting benefit — further injections are unlikely to be the answer
Bursa Injections: Shoulder, Hip, Knee & Elbow Bursitis
Bursae are small fluid-filled sacs that cushion tendons and bones at friction points throughout the body. When they become inflamed (bursitis), they cause localised, often severe pain. Cortisone injection directly into an inflamed bursa is one of the most effective and rapid treatments available.
Common bursa injection sites at Epoch Medical Imaging, St Ives:
– Subacromial bursa (shoulder): The most commonly injected bursa — providing excellent relief for shoulder bursitis and impingement syndrome
– Trochanteric bursa (hip): On the outer aspect of the hip — treating lateral hip pain, often called greater trochanteric pain syndrome
– Infrapatellar bursa (knee): Below the kneecap — treating anterior knee pain and swelling
– Prepatellar bursa (kneecap): Directly over the kneecap — treating “housemaid’s knee” type presentations
– Olecranon bursa (elbow): At the back of the elbow — treating swelling and pain at the elbow tip
– Retrocalcaneal bursa (heel): Behind the Achilles tendon attachment — treating heel bursitis
All bursa injections at Epoch Medical Imaging are performed under ultrasound guidance, confirming the needle is within the bursal sac before injecting.
De Quervain's, Trigger Finger & Plantar Fasciitis Steroid Injections
Several common, painful hand and foot conditions respond very well to precisely delivered cortisone injection — providing meaningful relief that allows return to normal activity.
De Quervain’s tenosynovitis:
– Inflammation of the tendon sheath around the thumb tendons at the wrist — causing pain with gripping, lifting, and thumb movement.
– Cortisone into the tendon sheath is the gold-standard non-surgical treatment, with high success rates when delivered accurately under ultrasound guidance.
Trigger finger (stenosing tenosynovitis):
– The flexor tendon of a finger becomes thickened, causing it to catch or lock as it moves through the tendon pulley.
– Cortisone into the tendon sheath — guided by ultrasound at Epoch Medical Imaging — reduces sheath inflammation and often resolves the triggering without surgical release.
Plantar fasciitis:
– Persistent heel pain from degeneration and inflammation at the plantar fascia origin on the heel bone.
– Cortisone injection under ultrasound guidance targets the periplantar area precisely — the injection is placed at the inflamed fascia origin, not into the fascia itself.
Ultrasound-Guided Tendon & Bursa Injection at Epoch
Ultrasound guidance is the standard for all tendon sheath and bursa injections at Epoch Medical Imaging — and its importance cannot be overstated for achieving optimal outcomes.
Why ultrasound guidance is particularly important for tendons and bursae:
– Tendon sheaths are small, delicate structures — an inaccurate injection into the tendon substance rather than the sheath can cause tendon damage.
– Bursae can be small and variably positioned — guidance confirms the bursa is distended with fluid (confirming needle placement within it) before injecting.
– For conditions such as de Quervain’s tenosynovitis, trigger finger, and plantar fasciitis, injection accuracy directly determines clinical outcome — an inaccurate injection dramatically reduces success rates.
What to expect at Epoch Medical Imaging, St Ives:
– The injection is performed by our specialist radiologist under real-time ultrasound visualisation.
– The target structure is identified and the needle is advanced under direct visualisation.
– Correct placement is confirmed before the medication is delivered.
– The procedure takes approximately 20 to 30 minutes including preparation and aftercare advice.
– You can drive yourself home for most peripheral injections — rest the area of the injection for the remainder of the day is recommended.
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Monday - Wednesday, Friday 08:00 AM - 05:00 PM
Thursday - 08:00 AM - 07:00 PM
Saturday - 08:30 AM - 1:00 PM