What Is a Hip Injection?
Hip injections are a non-surgical approach utilized for those with chronic pain in their hips.
The hip joint corresponds to where the femur, or thigh bone, meets the pelvis. It is a sizable ball and socket joint that can support a great deal of weight.As a result, the joint is exposed to everyday wear and tear that increases the risk for the evolution of osteoarthritis (OA). As we age, the likelihood of osteoarthritis increases. There is significant morbidity and mortality associated with hip OA in the elderly.
Osteoarthritis represents the most prevalent type of arthritis, affecting an estimated 20 million individuals in the United States, and is characterized by the inflammation of bones and joints.
Symptoms of osteoarthritis include joint pain and swelling, decreased range of motion, crepitus (a clicking sound associated with movement of joints), and gelling (morning joint stiffness lasting less than 30 minutes).
Osteoarthritis leads to the degradation of the cartilage found within joints. Cartilage reduces friction in joints and absorbs shock. End-stage osteoarthritis is characterized by bone rubbing upon bone, which can be extremely painful.
X-rays of the hip are the best method for diagnosis of hip problems. X-rays of the hip may reveal loss of joint space, bony sclerosis, or cysts. No specific laboratory abnormalities are associated with hip OA.
Non-pharmacologic treatment of hip osteoarthritis includes education, rest, heat and cold therapy, weight loss, physical therapy, and occupational therapy.Pharmacologic treatment of hip OA may entail acetaminophen (Tylenol), oral non-steroidal anti-inflammatory drugs (NSAIDs), and tramadol (Ultram).
When the treatments mentioned above are not successful in reducing pain, hip injections may be utilized.
The medication injected into the hip joint is a mixture of a local anesthetic, like lidocaine, and an intermediate- to long-term acting corticosteroid, like triamcinolone or dexamathasone.
Corticosteroids are potent inhibitors of inflammation and can decrease or relieve the pain of hip osteoarthritis.
Hip injections can also be an alternative to surgery in patients not wanting hip replacement surgery or those patients with poorly controlled health issues.
The health issues, in fact, can disqualify them from consideration for hip replacement surgery.
How Is a Hip Injection Performed?
Hip injections are a short outpatient procedure that can decrease the inflammation and pain associated with hip osteoarthritis.Fluoroscopy is an X-ray procedure producing real-time images of joints.
It is commonly used during hip injections to ensure proper placement of the needle and avoidance of nerve injury.
Prior to the procedure, patients lie face-down on an X-ray table, and the skin over the hip area is disinfected.
During the procedure, sedatives will be administered for relaxation. Once the injection site has been prepared, a mixture of an anesthetic such as lidocaine and a corticosteroid (dexamethasone or triamcinolone) will be injected in the direction of the hip joint.
Hip injections can also play a role in the localization of the source of hip pain.For instance, total relief of pain shortly after a hip injection points to the hip joint itself as the cause of pain.
Potential risks of hip injections include allergic reaction, swelling, excessive bleeding, infections, thinning of the skin, and tendon rupture at the site of injection.
As a result, intra-articular corticosteroid injections (hip injection) should be performed no more than three times a year on the same joint.
Conditions Related to Hip Injections
Hip injections can provide relief from the pain from hip osteoarthritis when more conservative measures fail. They provide opportunities for increased mobility plus improved quality of life. Hip injections are also recommended to patients who are not candidates for hip surgery or want to avoid hip surgery.
Hip injections should not be given any more than three times in a 12-month period. Not adhering to these guidelines could undermine the bones and tendons in the hip joint, causing further injury. Competent physician oversight with the formulation of a long-term treatment plan is key in having positive outcomes in the case of hip osteoarthritis and injections.
Hip injections have been found to improve the pain of hip osteoarthritis. Besides pain relief, hip injections are also helpful as a diagnostic tool in locating the exact source of hip joint pain. It can be very beneficial for those who opt out of or are not candidates for hip replacement surgery and want an alternative or non-surgical approach for pain relief and regaining function. The procedure also decreases the number of patients requiring long-term opioid maintenance. Caution should be used with the frequency of hip injections as there can be serious side effects. Overall, a multidisciplinary approach should be instituted when treating hip osteoarthritis.