Hip Injections

What is a hip injection?

Your hip joint is the largest weight-bearing joint in the body. It is a sizable ball-and-socket joint that connects the lower body to the torso. The femur (thigh) bone is topped by the femoral head, a large bone that nestles into the acetabulum of the hip. The acetabulum is the “socket” part of the joint, lined with smooth cartilage to receive the femoral head and ease movement in the joint.

The hip joint is further stabilized by muscles, ligaments, and tendons that surround and enclose it. The femoral and sciatic nerves run along the front and back of the femur, respectively.

Because the hip joint has such a significant task in terms of movement, we place incredible pressure and wear on it. In addition to the possibility of injury, this constant use increases the risk of age-related deterioration (e.g., osteoarthritis).

Hip injections can provide relief from hip pain when more conservative measures fail. Medications, including a mixture of a local anesthetic, like lidocaine, and an intermediate- to long-term acting corticosteroid, like triamcinolone or dexamethasone, are injected directly into the hip joint. The anesthetic gives immediate pain relief, while corticosteroids are potent inhibitors of inflammation. This reduction of inflammation can also help relieve pain and pressure in the hip joint.

Hip injections are generally not recommended more than three times in a 12-month period. More frequent injections may undermine hip bone structure and weaken tendons in the hip joint, potentially causing further injury. Because of this, a long-term, comprehensive treatment plan that includes lifestyle changes and other treatments in addition to hip injections is key to successful hip pain relief.

How can a hip injection help me?

Osteoarthritis is the most common form of arthritis, affecting an estimated 20 million individuals in the United States. It makes sense that this is one of the most common causes of hip joint pain.

Osteoarthritis leads to the degradation of the smooth cartilage found within joints. Cartilage reduces friction in joints and absorbs shock. At its most extreme, end-stage osteoarthritis is characterized by bone rubbing upon bone, which can be extremely painful.

Symptoms of osteoarthritis include:

• Joint pain and swelling
• Decreased range of motion
• A clicking sound associated with movement of joints (crepitus)
• Morning joint stiffness that lasts less than 30 minutes (gelling)

X-rays of the hip are the best method for diagnosing hip problems. These X-rays may reveal loss of joint space, bony sclerosis, or cysts. This can help diagnose osteoarthritis or other conditions that can cause hip pain, including bursitis or fractures.

Treatment of hip joint pain usually begins with education, rest, heat and cold therapy, weight loss, physical therapy, and occupational therapy. After, over-the-counter and prescription medications, such as acetaminophen and oral non-steroidal anti-inflammatory drugs (NSAIDs), may help with pain.

However, when these treatments are not successful in reducing pain, hip injections may provide pain relief. Hip injections are a non-surgical, minimally invasive option for those with chronic pain in their hips. They’re also an alternative to surgery in patients who don’t want hip replacement surgery or those patients with poorly controlled health issues that prevent them from having surgery.

Hip injections may also be used to determine the source of pain. For instance, total relief of pain shortly after a hip injection points to the hip joint itself as the cause of pain. If pain is unrelieved, then the hip may not be the cause. Further investigation is needed to locate the cause in these cases.

How does the hip injection procedure work?

To start, your doctor will discuss all your options for treatment and evaluate whether or not the procedure could help with your pain. Once you’ve decided on a hip injection, they’ll book you for your appointment.

Hip injections are performed on an outpatient basis. On procedure day, you will lie face-down on an X-ray table. The skin over the hip area is disinfected. During the procedure, your doctor may offer sedation for your comfort.

When you are comfortable and the injection site is ready, a mixture of an anesthetic and a corticosteroid is injected into the hip joint. Your doctor will use fluoroscopy to guide the proper placement of the needle. Fluoroscopy is an X-ray procedure that produces real-time images of joints to make sure placement of the injection is correct and to avoid nerve injury.

The entire hip injection procedure, from signing-in to recovery, takes less than an hour.

Hip injection risks

As with all medical procedures, there are some risks associated with hip injections. Potential risks of hip injections include

• Allergic reaction
• Swelling
• Excessive bleeding
• Infections
• Thinning of the skin
• Tendon rupture at the site of injection

Proper placement of the injection and receiving injections no more than three times in a 12-month period can help protect the structures of the hip while offering pain relief. Work with a highly trained pain specialist as well to reduce your risks.

Hip injection recovery

Hip injection recovery is usually swift and many patients experience profound pain relief immediately thereafter.

Take it easy on the day of your procedure. If you receive sedation, a friend or family member should drive you home and settle you in for a day of rest. Avoid any strenuous activity for at least 24 hours. You can gradually return to your normal activities as it feels good for you. Most patients can resume their normal diet and medications but talk to your doctor if you have concerns.

You may find that after your procedure your hip feels a little sore. This is normal. If you do not experience pain relief after the first few days, or if the pain increases and is accompanied by fever, swelling, and redness at the injection site, call your doctor. This could be a sign of infection.