Guided Hip Injections
A guided hip injection involves injecting a small quantity of local anaesthetic and anti-inflammatory steroid into your hip joint. The procedure is performed in the operating theatre using an X-ray machine to guide the needle.
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Why have a Guided Hip Injection?
The hip joint is common a source of pain in the groin and thigh or even around the knee. More common causes for the pain are problems such as:
- osteoarthritis (wear and tear)
- synovitis ( inflammation in the lining of the joint)
- abnormalities of the hip labrum (specialised supporting rim of the hip joint)
Occasionally problems in other areas – particularly the lower spine, sacroiliac joint, pubic bone joint or the knee can produce very similar pains.
An injection into the hip joint can be used help diagnosis and to differentiate between pain of hip origin and pain arising from elsewhere. The injection can give significant symptomatic relief – particularly in early arthritis or minor tears of the hip labrum.
What happens if my surgeon decides that I need a hip injection?
On the day of your injection you can eat and drink.
You should take all of your medication as normal unless your consultant states otherwise.
Upon arriving at the hospital you will be reviewed by a nurse and your consultant.
The spinal anaesthesia involves injecting a small amount of anaesthetic into the fluid surrounding the spinal cord in the lower back. This induces a short acting loss of sensation (numbness) in your lower limbs which allows the operation to take place pain free. The feeling returns to your legs after a few hours, after the operation has been completed.
Your consultant will explain the procedure again to you. You will need to sign a consent form and your hip will be marked. Any questions should be directed to the consultant at this time.
What does a hip injection involve?
The hip injection is performed in the operating theatre under a local anaesthetic and usually takes ten minutes.
You will be lying on your back for the procedure. The skin over the hip is cleaned with antiseptic and local anaesthetic is injected to anaesthetise the area. A needle is then passed into your hip joint under the guidance of an X-ray machine. A small amount of dye is injected to confirm the correct position of the needle. The hip is then injected with anaesthetic and anti-inflammatory steroid. A small dressing will be applied to the injection site.
What happens after the injection?
You need to remain in the hospital for at least thirty minutes after the procedure. Provided there is no evidence of any allergies, leg problems or weakness you will be allowed home. You must not drive yourself home or go home alone on public transport. Ideally you should arrange for someone to collect you following the procedure
You should avoid excessive exercise or heavy work for the first few days. The dressing can be removed the next day. You should continue to take any pain killers if your symptoms have not improved. Diabetic patients should closely monitor their blood sugar measurements over the first few days.
Your surgeon usually will review you approximately six weeks after your injection. You should monitor any improvement in your symptoms and it is worthwhile keeping a diary noting down any changes in your symptoms. This can be discussed with your surgeon at the follow up appointment.
Risks of a hip injection and side effects
These are all very rare but include the following:
- Thigh Numbness and/or weakness to the leg. This is usually temporary and due to the local anaesthetic injection affecting the nerves supplying the skin and muscles of your thigh.
- Bruising at the injection site
- Allergy to the injected medication
- Skin discolouration at the injection site.
If you are a diabetic and take insulin, it is important to monitor your blood glucose closely for the first few days after the injection as the injected steroid may temporarily increase your sugar levels.
How long does it take to work?
If the hip joint is the source of your symptoms, you may notice an improvement in your symptoms within 15 -30 minutes as the local anaesthetic numbs the joint.
The steroid part of the injection usually takes several days to work. Your symptoms may occasionally become worse for 24-48 hours after the injection, before the steroid starts to work.
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