What Is A Hip Injection?

The hip joint is a ball and socket type of joint that is one of the largest joints in the body. It connects the lower extremity to the pelvic girdle. The socket is formed by the acetabulum, which is part of the pelvis, and the ball is formed by the head of the femur which is the long bone of the lower extremity. The bony surfaces of the ball and socket are lined with articular cartilage that protects and cushions the bones and allows them to move smoothly. Synovium is a thin lining that covers the surface of the joint.

In a healthy hip, the synovium produces a small amount of fluid called synovial fluid that lubricates the joint and helps with movement. The hip joint is designed to be a stable, weight bearing joint. However, in order to achieve this stability, movement is sacrificed. Furthermore, even though the hip joint is designed with stability in mind, it is susceptible to osteoarthritis due to the extreme demands that are placed on it every day.

Osteoarthritis is a degenerative type of arthritis that commonly affects individuals over the age of 50. Osteoarthritis can affect any joint in the body but typically affects weight-bearing joints, including the hips. Osteoarthritis develops as the cartilage of the hip wears away, allowing the bones of the hip joint to rub against each other. Osteoarthritis can result in pain and stiffness of the joint, and can make everyday activities difficult.

hipbulletA hip injection is a type of procedure that can be used for diagnostic and pain relief purposes. In patients who have pain of an unknown origin, a hip injection can be used to confirm or deny if the pain is actually originating from within the hip. If a hip injection completely relieves a patient’s pain then it likely means that the hip joint is the source of pain. However, if a patient’s pain is not relieved by a hip injection, it likely means that the pain is originating from somewhere else in the body.

In patients who have chronic inflammation and pain due to osteoarthritis, disease, or injury of the hip, a hip injection can be used to provide lasting pain relief. A hip injection typically contains an anesthetic and sometimes a steroid. This combination of medication helps to provide effective, long-term pain relief.

While hip injections do not cure the problem or disease that is present in the hip joint, they offer an alternative option for pain control in patients who are presented with hip surgery as an option to control their pain. Additionally, they offer a pain management strategy for patients who are not suitable candidates for surgery.

How Is A Hip Injection Performed?

Pain-Doctor-Hip-Bursa-Steroid-Injection-Procedure-3A hip injection is performed in an outpatient setting, as it is fairly easy to administer. The patient will be put in a side-lying position with the affected hip facing upwards. The affected area is then cleaned with an iodine solution. Once the area is sanitized, a needle with the anesthetic and possibly a steroid is injected into the hip joint. Fluid buildup or pressure within the hip joint may be released during this procedure as it is performed with a medicated needle. This may also add to the pain relief that a patient experiences. Once the injection has been performed, the patient will be moved to a recovery room where they will be monitored for adverse reactions for one to two hours.

Following a hip injection, a patient may experience a slight increase in pain for a few days while the anesthetic wears off and the steroid starts to take effect. During this time, it is advised that patients apply ice to the tender area to help reduce discomfort. Most patients will notice full pain relief benefits within a week to ten days following the injection. A hip injection does not provide permanent relief for hip pain; however, it usually provides lasting pain relief that can last for a few months at a time. The physician may recommend a series of injections over a three-week period for optimal relief for some patients, depending on their medical history and condition.

After a hip injection, patients can resume normal activities the day following the procedure. Once the pain has subsided, patients are advised to start exercising in moderation. Even once the pain relief is significant, it is recommended that patients gradually increase their activities over a period of one to two weeks in order to avoid pain reoccurrence.

Pain-Doctor-Hip-Bursa-Steroid-Injection-Procedure-8As with any type of procedure that involves an injection, there are side effects, including:

  • Infection
  • Swelling
  • Skin discoloration
  • Thinning of the skin
  • Injection site tenderness
  • Bleeding
  • Insomnia
  • Allergic reactions
  • Tendon rupture

It is important that patients do not receive too many hip injections within a one-year period. If too many injections are performed, the bones and tendons surrounding the hip joint may weaken, resulting in further damage. A qualified physician will be able to assess a patient’s condition and medical history and determine a safe hip injection treatment schedule that will provide the most benefit to the patient.

Conditions Related To Hip Injections

Hip BursitisHip injections have been shown to provide effective pain relief for patients suffering from inflammation due to osteoarthritis, disease, and injury. Hip injections are often recommended for patients who are opposed to undergoing surgery for their hip pain, or for those patients who are not ideal candidates for surgery. Following a hip injection, patients usually report decreased pain, increased mobility, and improved quality of life.

Conclusion

Hip injections are an effective pain management technique that can be used in patients suffering from hip pain due to osteoarthritis, disease, and injury. This procedure has both diagnostic and treatment benefits and can provide physicians with accurate information about the origin of a patients’ pain. Hip injections are minimally invasive and carry few risks. Hip injections help patients avoid long-term narcotic use, surgery, and hip joint replacements. Patients are encouraged to discuss their hip pain symptoms with their physicians to determine if a hip injection would be suitable for their condition.

References

1. Bhagra A, Syed H, Reed DA, et al. Efficacy of musculoskeletal injections by primary care providers in the office: a retrospective cohort study. Int J Gen Med. 2013;6:237-43.
2. Cole BJ, Schumacher HR Jr. Injectable corticosteroids in modern practice. J Am Acad Orthop Surg. 2005;13(1):37-46.
3. Courtney P, Doherty M. Joint aspiration and injection. Best Pract Res Clin Rheumatol. 2005;19(3):345-69.
4. Cunnington J, Marshall N, Hide G, et al. A randomized, double-blind, controlled study of ultrasound-guided corticosteroid injection into the joint of patients with inflammatory arthritis. Arthritis Rheum. 2010;62(7):1862-9.
5. Lambert RGW, Hutchings EJ, Grace MGA, Jhangri GS. Conner Spady B, Maksymowich WP. Steroid Injection for osteoarthritis of the hip: a randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2007;56:2278–87.
6. Moore K, Dalley A. Lower limb. In: Clinically Oriented Anatomy. 4th ed. Baltimore: Lippincott Williams & Wilkins; 1999:504-613.
7. Tepper S, Hochberg MC. Factors associated with hip osteoarthritis: data from the First National Health and Nutrition Examination Survey (NHANES-I). Am J Epidemiol. 1993;137:1081–8.
8. Valat JP, Rozenberg S. Local corticosteroid injections for low back pain and sciatica. Joint Bone Spine. 2008;75(4):403-7.