An intra-articular hip injection is the injection of a steroid medication along with a local anesthetic into the hip joint.
The steroid medication is a very powerful anti-inflammatory medication. Pathologic changes within the hip joint (i.e. arthritis, tendon tears, etc) often lead to inflammation. This inflammation is a primary cause of pain. An injection of steroid can substantially decrease this inflammation and thereby lead to a significant reduction in pain.
You will be placed on the procedure table. The injection site is sterilized with a strong antiseptic. The site to be injected is numbed with a local anesthetic, then a needle is directed to the target area. X-ray guidance is used to ensure proper placement and positioning of the needle. Contrast (x-ray dye) may be injected to be sure the needle is in the proper position. Once proper needle placement is confirmed, the steroid solution is slowly injected.
The injection can produce some discomfort. We therefore provide the option of an oral medication for sedation, such as Valium.
In addition, you cannot have anything to eat or drink within 6 hours of your appointment (clear liquids are allowed until 2 hours before the procedure). If you take medications for diabetes, these medications may need to be adjusted the morning of the procedure. Your primary care physician can help you with this adjustment.
If you received sedation do not drive or operate machinery for at least 24 hours after the procedure. You may return to work the next day following your procedure. You may resume your normal diet immediately. Do not engage in any strenuous activity for 24 hours. Do not take a bath, swim, or use a hot tub for 24 hours (you may take a shower). Call the office if you have any of the following: severe pain afterwards (different than your usual symptoms), redness/swelling/discharge at the injection site(s), or fevers/chills.
You may experience any of the following side effects up to 8 hours after the procedure:
These side effects can be normal. They are not dangerous, and will resolve on their own.
The complication rate for this procedure is very low. Whenever a needle enters the skin, bleeding, infection, or nerve damage can occur. Some other serious but extremely rare risks include paralysis and death. You may have an allergic reaction to any of the medications used. If you have a known allergy to any medications, especially x-ray contrast dye or local anesthetics, notify our staff before the procedure takes place.
The occurrence of complications is extremely low. If, however, you experience any of the following, a complication may have occurred. You should call our office and proceed immediately to the nearest Emergency Room for evaluation:
The steroid medication begins to take effect in one to two days after the procedure, at which point you should start to see some benefit. The steroid effect continues to increase with the peak effect occurs at about two weeks. Thereafter, the effect will stabilize and should last several weeks to months.
Typically, the pain relief experienced from this procedure lasts 3- 6 months, but there is significant variability from patient to patient and from one procedure to another. If and when the pain starts to return, this procedure can be repeated to try and attain some pain relief once again. Keep in mind that this injection may work very well for pain in certain areas, but may not help with others. This is normal. Areas of pain that do not respond may need other treatments, which you can discuss with your doctor.