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Hip joint injection

Cortisone shot - hip; Hip injection; Intra-articular steroid injections - hip

A hip joint injection is a shot of medicine into the hip joint. The medicine can help relieve pain and inflammation. It can also help diagnose the source of hip pain.

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Description

For this procedure, a health care provider inserts a needle in the hip area and injects medicine into the hip joint. In most cases, the provider uses a real-time x-ray (fluoroscopy) or ultrasound to see where to place the needle in the joint.

You may be given medicine to help you relax.

For the procedure:

• You will lie on the x-ray table, and your hip area will be cleaned.
• A numbing medicine will be applied to the injection site.
• A small needle will be guided into the joint area while the provider watches the placement on the x-ray screen.
• Once the needle is in the right spot, a small amount of contrast dye is injected so the provider can see where the medicine will be placed.
• The medicine (usually a combination of a local anesthetic and a steroid) is slowly injected into the joint.

After the injection, you will remain on the table for another 5 to 10 minutes. Your provider will then ask you to move the hip to see if it is still painful. You may have pain relief almost immediately. The hip joint will become more painful afterwards when the numbing medicine has worn off. It may be a few days before you notice any pain relief from the steroids that were given.

Why the Procedure Is Performed

Hip joint injection is done to reduce hip pain caused by problems in the bones or cartilage of your hip joint. The hip pain is often caused by:

• Bursitis
• Arthritis
• Labral tear (a tear in the cartilage that is attached to the rim of the hip socket bone)
• Injury to the hip joint or surrounding area
• Overuse or strain from running or other activities

A hip joint injection can also help diagnose hip pain. If the shot does not relieve pain within a few days, then the hip joint may not be the source of hip pain.

Risks

Risks are rare, but may include:

• Bruising
• Swelling
• Skin irritation
• Allergic reaction to medicine
• Infection
• Bleeding in the joint
• Weakness in the leg

Before the Procedure

Tell your provider about:

• Any health problems
• Any allergies 
• Medicines you take, including over-the-counter medicines
• Any blood thinner medicines, such as aspirin, warfarin (Coumadin), dabigatran (Pradaxa), apixaban (Eliquis), rivaroxaban (Xarelto), or clopidogrel (Plavix)

Plan ahead to have someone drive you home after the procedure.

After the Procedure

After the injection, follow any specific instructions your provider gives you. These may include:

• Applying ice on your hip if you have swelling or pain (wrap the ice in a towel to protect your skin)
• Avoiding strenuous activity the day of the procedure
• Taking pain medicines as directed

You may resume most normal activities the next day.

Outlook (Prognosis)

Most people feel less pain after a hip injection.

• You may notice reduced pain 15 to 20 minutes after the injection.
• Pain may return in 4 to 6 hours as the numbing medicine wears off.
• As the steroid medicine begins to take effect 2 to 7 days later, your hip joint should feel less painful.

You may need more than one injection. How long the shot lasts varies from person to person, and depends on the cause of the pain. For some, it can last weeks or months.

References

American College of Rheumatology website. Joint injections (joint aspirations). rheumatology.org/patients/joint-injections-joint-aspirations. Updated February 2022. Accessed January 13, 2023.

Foye PM, Stitik TP, Shah VP, Sajid N, Gnana JS, Bachoura PJ. Hip osteoarthritis. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 55.

Naredo E, Möller I. Aspiration and injection of joints and periarticular tissue and intralesional therapy. In: Hochberg MC, Gravallese EM, Smolen JS, van der Heijde D, Weinblatt ME, Weisman MH, eds. Rheumatology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 31.

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Review Date: 12/12/2022  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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