Why would someone have a hip injection? Hip joint injections relieve pain from joint diseases such as arthritis. Hip arthritis is among the most common causes of hip or groin pain. Other causes of hip pain include impingement of the hip or iliopsoas tendonitis. A steroid injection for the hip can be helpful. Find out if you’re a candidate for an ultrasound hip injection.

hip impingement

What are the options for ultrasound hip injections?  

We use several different ultrasound hip injections for pain. The most common substance injected is cortisone. Other substances injected are hyaluronic acid or platelet-rich plasma (PRP).

Cortisone injection hip

Recent evidence suggests that a steroid injection in the hip joint provides short-term relief of symptoms of hip arthritis. For example, one study in the UK found that a cortisone shot into the hip joint directed by ultrasound improved pain for four months compared to simple education. However, there is some concern regarding long-term damage to cartilage, particularly with repeated injections. Also, we believe you should avoid a cortisone injection up to 6 months before a hip replacement due to the increased risk of infection. So, overall, we don’t think cortisone injections are an excellent hip injection for arthritis. However, cortisone injections may help those people with severe hip pain.

Hyaluronic acid injections in the hip

Although hyaluronic acid and PRP injections are effective in knee arthritis, there is mixed evidence for their effectiveness in hip arthritis.

One type of hyaluronic acid with high molecular weight, Durolane, is effective in hip arthritis for 6-12 months. On the other hand, PRP injections have mixed results in hip arthritis and still need more evidence. Nevertheless, these injections are helpful for longer-term relief; perhaps hyaluronic acid is more favoured.

A new type of PRP called Nstride PRP is marketed as a longer-acting PRP due to a higher concentration of platelets and white cells. However, there is no evidence that this type of PRP is better or more effective than hyaluronic acid or PRP as a hip injection for pain. It is also much more expensive.

Can a hip joint injection tell you the cause of pain?

Apart from pain, another reason to inject cortisone into the hip joint is to give more information about the likely cause of hip pain.

Sometimes, it might be challenging to know that the cause of hip or groin pain comes from the hip joint. There are many causes of hip and groin pain in active people. An injection into the joint under ultrasound can give the exact pain source greater certainty. If injection into the hip joint improves pain, then the source of the pain is the joint and not the surrounding muscles, tendons, or ligaments. This positive result of an injection gives greater diagnostic certainty and may help treatment.

Hip ultrasound injection: Does guidance matter? 

Generally, we do injections into joints with or without imaging. Usually, image guidance is done with ultrasound or X-ray.

Evidence suggests that a hip joint injection without imaging is only accurate in 50% of cases. However, using ultrasound improves accuracy by close to 100%. Furthermore, ultrasound hip injection is much cheaper and does not expose the patient to radiation like X-ray. Also, most patients prefer ultrasound to X-ray injections if they can choose.

It would be best to find a practitioner who has experience with ultrasound hip injections and uses the latest ultrasound technology. In addition, hip ultrasound injection requires expertise and a clean room to avoid complications such as joint infection. Therefore, you should research before having a hip ultrasound injection for pain. If you have an ultrasound-guided injection, these are the four questions you should ask. 

 

Other frequently asked questions about ultrasound hip joint injections:

Can you drive after a hip injection?

Generally, we suggest you avoid driving directly after a hip joint injection. However, driving is often allowed the next day if you can move without pain.

Are you put to sleep for a hip joint injection? 

No. Generally, you don’t need to be put to sleep if you have an ultrasound-guided hip joint injection. However, injections done with X-ray guidance are ususally done with sedation or, in some cases, general anaesthetic.

How soon can I exercise after a cortisone injection in the hip?

Generally, we recommend you rest your hip for a few days. You should avoid excess walking within 72 hours after a hip joint injection. After seven days, you can resume more intense exercise, such as cycling and crosstraining. Generally, after ten days, you can continue running. P

X-ray guided hip injection: Is it better than ultrasound hip injection? 

No. Both X-ray and ultrasound-guided hip injections have equal accuracy. However, an X-ray-guided hip injection exposes patients to radiation and is much more expensive. Also, studies suggest patients are much more likely to favour an ultrasound over an X-ray-guided hip injection.

What do I wear for a hip joint injection? 

We suggest you wear loose pants and underwear for a hip joint injection. As sterility is paramount, you must keep your clothing away from the injection site. 

Final word from Sportdoctorlondon about ultrasound hip joint injections for pain relief

Hip joint injections for pain are generally invasive, so clinical reasoning is essential. We do hip joint injections to improve pain or give more information about the source of pain. Ultrasound hip injeciton is preferred over X-ray guidance as the injection is cheaper and has no radiation. Before an injection, you need to do your homework: use a doctor with experience in ultrasound-guided injections.

Other hip and groin conditions:

Dr Masci is a specialist sports doctor in London. 

He specialises in muscle, tendon and joint injuries.

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