The truth is, there are a few answers to that, and all of them are fairly straightforward. The first is that very often, local injections treat a symptom, not a cause. Pain is often a symptom of something happening in a region, whether it is an overuse syndrome, minor tearing, or a tendon issue. While the majority of times injections are very helpful in alleviating swelling from these types of injuries and decreasing local irritation and pain from them, they are not a panacea for these conditions, but often used as a way to allow patients to recover from them in more comfort, and without the systemic side effects of some medications that we often experience.
So, in the case of an overuse syndrome like a hip flexor tightness or IT Band Syndrome (a common cause of trochanteric bursitis), the initial injection is designed to alleviate the pain caused by your muscle perceiving it is being “overworked” by daily activities until your body is able to build up enough strength to tolerate these activities. You are then often sent to therapy to do just that: build up local strength and endurance so that once the shot wears off the root cause of this irritation is gone!
What about tears and tendinitis though? Well, the body actually is very good at self repair, and these tissues are some of the best in the body at rebuilding as they have to do it often! However, in the early phases sometimes our body needs a “kick start” by being directed in which area it needs to repair, and exercise has been found to be an excellent mechanism for this. Using a specific muscle or tendon will often trigger the body’s natural response to exercise, which is to go into a post exercise repair, exactly what we needed to begin with! But for people with high levels of irritation, these exercises can be aggravating in the first place, which can frustrate patients who want to treat the pain! So, an injection can be a great way to help patients ease into this process!
Essentially, many injections are a great way to decrease or eliminate pain in the short term, but in many diagnoses they are not enough to address the root cause of your pain, which means that if this is the case the injection effect can eventually wear off and result in a return of pain (or an increase afterwards if your mechanism of injury has continued while your pain was lowered). Your physician’s goal is to look at diagnosis, not just pain, and determine if your condition needs more beyond just pain relief to stay addressed, and this is where you will often see your PT orders come in! We’re here to help you address the cause underlying your symptoms!