The hip joint is a large joint where the leg joins the pelvis. If this joint experiences arthritis, injury or mechanical stress, one may experience hip, buttock, leg or low back pain.  Hip joint injections may be considered for patients with these symptoms. The injection can help relieve the pain, as well as help diagnose the direct cause of the pain. The hip joint is a ball and socket joint located where the thigh bone meets the pelvis. The top of the thigh bone (the femur) is a round ball, which fits into the socket formed by a cavity in the pelvic bone. The ball is held in the socket by a grouping of ligaments that form a capsule around the joint. This capsule of ligaments contains synovial fluid which acts as a lubricant. There is cartilage between the two bones, which allows them to move against each other without causing friction.

Hip joint injections involve injecting medicine directly into the joint. Fluoroscopy (live x-ray) should be used in hip joint injections for guidance in properly targeting and placing the needle, and for avoiding nerve or other adverse effects. These injections can help diagnose the source of pain, as well as alleviate the discomfort:

• Diagnostic function: 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 function: Along with the numbing medication, time-release cortisone is also injected into these joints to reduce inflammation, which can often provide long term pain relief.

Hip Joint  Injection instructions:

On the day of the hip joint injections, patients are advised to avoid driving and doing any strenuous activities. The hip joint injection procedure includes the following steps:

• An assessment for amount and location of pain. Consent for treatment. A driver is preferred in case of numbness from the anesthetic or side effects.
• The patient lies face down on an x-ray table and the skin over the hip is well cleaned with surgical soap.
• 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 anti-inflammatory cortisone is then slowly injected into the joint.

The injection itself only takes a few minutes, but the overall procedure will usually take about 1 hour. After the hip joint injections procedure, the patient typically remains resting in a chair or bed for twenty to thirty 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. Post-injection pain levels help to confirm the source of the pain-generator. At the Pain Prevention Center, located in Chesterfield Missouri, we can provide these procedures in our state-of-the-art treatment room.

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 medicines 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.

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.