What role do corticosteroid injections play in the management of bursitis, and when should they be considered?

Role of corticosteroid injections in bursitis management: Corticosteroid injections are considered a second-line treatment option for non-septic bursitis when conservative management (such as rest, ice, activity modification, and simple analgesia) has failed to control symptoms or if recurrent bursitis is suspected.

When to consider corticosteroid injections: They should only be considered after excluding septic bursitis, which requires bursal aspiration and Gram staining/culture to rule out infection. Corticosteroid injections must not be given if infection is suspected due to the risk of worsening infection and complications.

Additional considerations: The procedure should be performed by clinicians with relevant expertise and experience to minimise risks such as infection, skin atrophy, and chronic pain. Routine use of corticosteroid injections is not recommended due to lack of high-quality evidence supporting their efficacy and potential risks.