A hip joint injection may be considered for patients with symptoms such as arthritis, injury or mechanical stress, hip, buttock, leg or low back pain. The injection can help relieve the pain, as well as help diagnose the direct cause of pain. Hip joint injections involve injecting medicine directly into the joint.
Diagnostic: By placing numbing medicine into the joint, the amount of immediate pain relief experienced will help confirm or deny the joint as a source of pain. If complete pain relief is achieved while the hip joint is numb it means this joint is likely to be the source of pain.
Pain Relief: Along with the numbing medication, steroid “cortisone” is also injected into these joints to reduce inflammation, which can often provide long-term pain relief.
An IV line may be started so that adequate relaxation medicine can be given, if needed.
The patient lies on their back on an x-ray table and the skin over the hip is well cleaned. The physician numbs a small area of skin with an anesthetic (a numbing medicine). The patient may feel a sting that will last for a few seconds. The physician uses X-ray guidance (fluoroscopy) to direct a very small needle into the joint. Several drops of contrast dye are then injected to confirm that the medicine only reaches the joint. A small mixture of anesthetic and steroid “cortisone” is then slowly injected into the joint. The injection itself only takes a few minutes, but the overall procedure will usually take between thirty and sixty minutes.
After the hip joint injection procedure, the patient typically remains resting on the table for a few minutes, and then is asked to move the area of usual discomfort to try to provoke the usual pain. Patients may or may not obtain pain relief in the first few hours after the injection, depending upon whether or not the joint that was injected is the main source of the patient’s pain. On occasion, the patient may feel numb or experience a slightly weak or odd feeling in the leg for a few hours after the injection. On the day of the injection, patients are advised to avoid driving and doing any strenuous activities.
On the day after the procedure, patients may return to their regular activities. When the pain has improved, it is advisable to start regular exercise and activities in moderation. Even if the pain relief is significant, it is still important to increase activities gradually over one to two weeks to avoid recurrence of pain. Injections are also commonly coupled with other treatments (medications, physical therapy, etc) in an attempt to either maximize the benefit or prolong the effects. You should consult with your doctor to develop a comprehensive care plan.
Patients may notice a slight increase in pain lasting for a few days as the numbing medicine wears off and the cortisone is just starting to take effect. If the area is uncomfortable in the first two to three days after the injection, applying ice or a cold pack to the general area of the injection site will typically provide pain relief and appear more beneficial than applying heat. If the hip joint that was treated is the source of the pain, the patient may begin to notice pain relief starting two to five days after the injection. If no improvement occurs within ten days after the injection, then the patient is unlikely to gain any pain relief from the injection and further diagnostic tests may be needed to accurately diagnose the patient’s pain.
Patients may continue to take their regular medications after the procedure, with the exception of limiting pain medicine within the first four to six hours after the injection, so that the diagnostic information obtained is accurate.
Patients may be referred for physical therapy or manual therapy after the injection while the numbing medicine is effective and/or over the next several weeks while the cortisone is working.
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