Steroid Injection in Hip (2023)

In this article find out about all the common side effects of steroid injections and all the best available alternative injections to repair hip conditions. Doctors usually prescribe steroid drugs to the hip (buttock) mainly because of their anti-inflammatory effects. These drugs are very effective in reducing pain and inflammation. A steroid injection comprises two main ingredients. One is a steroid (cortisone) that reduces inflammation and the other is a numbing agent that helps reduce pain.

Some of the conditions of the hip joint pain in which administration of steroid injections is beneficial are;

  • Osteoarthritis of the hip
  • Injury or trauma to the hip
  • Bursitis
  • Misuse or overuse of hip joint

You should take cortisol injections after determining the severity of your inflammatory condition. Sterile conditions are mandatory for the administration of injections. However, anesthesia is usually not required as it is a painless procedure.

Cortisol injections are very effective for the treatment of inflammation. Steroids are effectively used for the treatment of acute inflammation but not chronic ones. Some orthopedic doctors also prescribe hyaluronic acid injections for the treatment of chronic inflammation if the inflammation lasts for more than 8 weeks.

(Video) Why I Recommend Steroid Injections for Knee and Hip Pain

In this article, you will get appropriate information about every aspect of hip joint injection which everyone should know before getting the procedure done.

How do they work?

The main function of steroid injections is to reduce swelling and redness at the inflammation site and therefore decrease the severity of your inflammation(1). They do so by decreasing the activity of your body’s natural defense system against any infection or illness.

When infectious agents enter your body, your immune system recognizes them as harmful foreign agents. Your immune cells migrate to the site of infection and try to eliminate the infectious agent. In doing so, they produce the chemicals that cause the blood to move out of blood vessels into the soft tissues at the site of infection, which is the cause of the swelling. So, the inflammation you see at the site is due to the activity of the immune system against the agent (pathogen).

The administration of steroids decreases the activity of the immune system. As a result, the immune cells do not migrate in significant numbers to the site of infection. It also prevents the blood from moving out of the vasculature and keeps the blood within the vascular compartment. As the immune response is reduced, the inflammatory reaction is also decreased.

Method of administration

Doctors usually perform a steroid injection as an outpatient procedure, therefore you do not need to be hospitalized for this purpose. A special type of X-ray known as fluoroscopy(2) is used to see an image of the inside of the hip. This allows the doctor to place the needle properly without damaging a nerve or any other structure.

You lie on the table in such a position so that your doctor may access the hip joint. After cleaning the skin, the doctor applies a local anesthetic agent. Using fluoroscopy, a needle is inserted into your joint. Afterward, the doctor injects small amounts of dye to see the exact area where steroids should be injected.

Often, some soreness is felt at the site of injection, but then it vanishes gradually. How long a steroid lasts varies in different people. However, you can expect it to provide pain relief for weeks or months.

(Video) Hip injection - Dr. Sara Baird

Benefits of steroid injection

Doctors usually use local steroid injections because they have plenty of benefits and they are less likely to cause significant side effects. The main benefit of steroid injections is a reduction in the inflammatory response in joints so that your hip joint can work properly.

The administration of cortisol injections has some important advantages in the treatment of inflammatory conditions, these include;

  • Instant pain reduction(3)
  • Reduction in swelling and redness
  • High success rate
  • Resolution of inflammation

NSAIDs and physiotherapy are usually known as the first lines of treatment against inflammatory conditions. However, if you are suffering from acute inflammatory conditions and there is no improvement in your condition with these medications, you should go for steroid injections. And if your total hip is damaged during a trauma, you need to undergo hip replacement therapy.

Side effects of steroid injections

Steroid injections are useful in treating inflammatory conditions but there are side effects as well. However, most people have steroid injections without any side effects. Some of the significant side effects include:

Steroid injections decrease the activity of the immune system(4). The immune system normally protects the body against harmful agents. When the immune system does not remain efficient as it should be, your body becomes prone to developing various infectious diseases because the immune system is not there to fight against the infectious agent.

At the site of administration of the injection, you will see flare-ups within 24 hours. It usually settles by itself without taking any medicine within a day or two. You can also use painkillers such as paracetamol to get rid of it. You may see discoloration of skin at the site of administration, and rarely there are chances of development of infection.

Repeated use of cortisol injections can cause prolonged pain known as a cortisone flare. This is due to the crystal formation of steroids leading to swelling and infection, which is more worse and painful than the infection that is being treated.

(Video) How joint injections for hip pain work | BMI Healthcare

Corticosteroids can elevate your blood glucose levels(5) in addition to reducing inflammation. If you have diabetes, you should consult your doctor before having a cortisone injection, and monitor your blood pressure and blood sugar levels regularly.

Steroids can also interfere with your other metabolic processes such as fat metabolism. This frequently results in weight gain. They can also interfere with the menstruation cycle (periods) in women(6).

Preventive measures after steroid injections

For a day or two, cover your injection site. If you have a cortisone injection in your hip, limit your walking and other movements. But after about 10 days to 2 weeks, you should start a gentle range of motion exercises.

If you feel pain or soreness at the injection site, you can use ice packs to reduce the pain. Avoid using heating pads for at least 2 to 3 days after injection, and also do not use a bathtub or hot tub. However, It’s fine to take a shower.

Monitor the injection site for a few days for any signs of infection, such as persistent discomfort, redness, and swelling that lasts longer than 48 hours. If you notice any of these symptoms then report them to your doctor.

Follow-up signs of infection, such as persistent discomfort, redness, source of pain, and swelling that last longer than 48 hours. If you notice any of these symptoms then report them to your doctor.

Conclusion

Steroid injection into the hip is the last-line medical treatment for your hip pain. However, you should be very careful about the medical treatment you are taking for your illness. You need to consult your doctor about whether you need a steroid injection or not. In addition, you should also keep in mind the possible benefits as well as adverse effects of the injection into the hip. Take care of yourself and take preventive measures after a steroid shot. This would be a step ahead in managing your healthy lifestyle and avoiding diseases.

(Video) Ultrasound-Guided Hip Injection

FAQs

Is a steroid injection in the hip painful?

After injection in the hip, you will feel a little discomfort with a slight burning sensation and achiness. You can also use a local anesthetic at the area of injection to make it numb, which reduces the pain. But the condition is temporary and will not interfere with your routine activities.

How long does a steroid injection into the hip last?

The main function of steroids is to reduce inflammation. They will quickly relieve the inflammation in the hip and have a positive effect on reducing the pain. However, the effect of the injection may last for as long as 6 weeks to 6 months. The steroid injections do not help cure the disease but can provide proper time for the rehabilitation process.

Can I walk after a cortisone injection in my hip?

Yes, you can walk after the steroid injection in the hip, but it is beneficial to take the rest after the shot. It is safe to take painkillers such as ibuprofen and naproxen to reduce the pain. Routine activities are permitted but you should avoid heavy exercise because it may worsen the condition and can increase the inflammation.

What are the side effects of steroid injection in hip?

Steroid injections decrease the activity of the immune system. When the immune system does not remain efficient as it should be, your body becomes prone to developing various infectious diseases because the immune system is not there to fight against the infectious agent.

At the site of administration of the injection, you will see flare-ups within 24 hours. You may see discoloration of skin at the site of administration, and rarely there are chances of development of infection. Corticosteroids can elevate your blood glucose levels in addition to reducing inflammation.

Steroids can also interfere with your other metabolic processes such as fat metabolism. This frequently results in weight gain. They can also interfere with the menstruation cycle (periods) in women.

How long should you rest after a cortisone injection in the hip?

After the steroid injection in hip, you should rest for at least 24 hours, because it helps in the rehabilitation process such as reducing the inflammation and pain. Daily activities are permitted, but you should avoid heavy exercise because it can aggravate the condition.

(Video) What to Expect During a Hip Injection (Cortisone Shot) | Seaview Orthopaedic & Medical Associates

What should I do after the hip injection?

You may experience a slight burning sensation and soreness at the site of injection for about 24 to 28 hours. Ice is the best cure. Apply the ice pack for about 20 minutes after every 2 to 3 hours at the site of injection to reduce the swelling and pain. Heating the site of injection should be avoided for about 72 hours.

References

  1. Fadale, P. D., & Wiggins, M. E. (1994). Corticosteroid Injections: Their Use and Abuse. JAAOS – Journal of the American Academy of Orthopaedic Surgeons, 2(3), 133–140. https://journals.lww.com/jaaos/Abstract/1994/05000/Corticosteroid_Injections__Their_Use_and_Abuse.1.aspx
  2. Graf, D. N., Thallinger, A., Zubler, V., & Sutter, R. (2022). Intraarticular Steroid Injection in Hip and Knee with Fluoroscopic Guidance: Reassessing Safety. Radiology. https://doi.org/10.1148/radiol.210668
  3. van Middelkoop, M., Arden, N. K., Atchia, I., Birrell, F., Chao, J., Rezende, M. U., Lambert, R. G. W., Ravaud, P., Bijlsma, J. W., Doherty, M., Dziedzic, K. S., Lohmander, L. S., McAlindon, T. E., Zhang, W., & Bierma-Zeinstra, S. M. A. (2016). The OA Trial Bank: meta-analysis of individual patient data from knee and hip osteoarthritis trials show that patients with severe pain exhibit greater benefit from intra-articular glucocorticoids. Osteoarthritis and Cartilage, 24(7), 1143–1152. https://doi.org/10.1016/j.joca.2016.01.983
  4. Regan, P., Elkhalifa, S., & Barratt, P. (2021). The systemic immunosuppressive effects of peripheral corticosteroid injections: A narrative review of the evidence in the context of COVID‐19. Musculoskeletal Care.
  5. Choudhry, M. N., Malik, R. A., & Charalambous, C. P. (2016). Blood Glucose Levels Following Intra-Articular Steroid Injections in Patients with Diabetes. JBJS Reviews, 4(3). https://doi.org/10.2106/jbjs.rvw.o.00029
  6. Celebi, O. O., Song, S. A., Santeerapharp, A., Choksawad, K., & Franco, R. A. (2020). Assessment of side effects after serial intralesional steroid injections for idiopathic subglottic stenosis. European Archives of Oto-Rhino-Laryngology, 278(2), 445–450. https://doi.org/10.1007/s00405-020-06371-3

FAQs

What does a steroid injection do to the hip? ›

Pain and inflammation in the hip joint(s) are the main reason that doctors prescribe steroid injections. A steroid injection contains two main ingredients. The first is a steroid (cortisone) that helps reduce inflammation. The second is a numbing agent or anesthetic that reduces pain.

How long does it take for a steroid injection in the hip to work? ›

Most research concludes that steroid injections take between 3-5 days to work. However to be on the safe side we would normally encourage patients to have their injection ideally 7-10 days week before their event. This gives the maximum chance that the steroid will achieve maximum benefits.

Does a steroid injection in the hip hurt? ›

The most common side effect is intense pain and swelling in the joint where the injection was given. This usually gets better after a day or two. You may also get some bruising where the injection was given. This should go away after a few days.

How long should you rest after a cortisone injection in the hip? ›

When can you return to running and other sports after a steroid injection? If you have had a hip, knee or ankle/foot injection, we suggest you rest from running for at least 5-7 days.

What is the next step if steroid injection does not work? ›

When one (or several) injections fail to fix your problem, often the next recommended step is surgery. The majority of the people we work with are seeking pain relief for their back, knee, neck or shoulder WITHOUT the need for surgery and other procedures.

How painful is hip injection? ›

As a proven alternative to surgery, hip joint injections successfully reduce pain for patients. Following the procedure, however, you may have soreness for one to two days. It's recommended that you take it easy the day of the procedure, but return to your usual activities the following day.

Can I drive after a cortisone injection in my hip? ›

You may not drive for 12 hours after your injection. It is common to experience mild soreness at the injection site(s) for 24–48 hours. Ice is the best remedy. You may apply ice for 20 minutes at a time, several times a day, as needed.

What should I do after a cortisone shot in my hip? ›

After the cortisone shot
  1. Protect the injection area for a day or two. ...
  2. Apply ice to the injection site as needed to relieve pain. ...
  3. Not use a bathtub, hot tub or whirlpool for two days. ...
  4. Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.
20 May 2021

Are you put to sleep for a hip injection? ›

The injection is carried out in theatre under a quick general anaesthetic or sedation so that you do not feel pain while the injection is being performed. Please do not eat anything after midnight the night before. You may have sips of water for up to two hours before your admission time, if required.

Are hip injections worth it? ›

PRP and stem cell injections, while the thought is promising, have not been shown to predictably reduce the symptoms of hip arthritis or regrow cartilage. Further research is needed,” says Dr. Angerame. While hip injections seem harmless, there are some drawbacks when performed too close to surgery.

What do I wear for a hip injection? ›

There are not any particular preparations you need to make before you have a hip injection. It is advised that you wear comfortable, loose fitting clothes that allow easy access to the hip. Check with your doctor whether you will be able to drive following your joint injection.

What should you not do after a cortisone shot? ›

Some surgeons may give you permission to do anything you feel up to. Others have a specific protocol they want you to follow. As a general rule, patients advised receiving a steroid injection into a joint are cautioned against any heavy lifting or exercise.

Can I walk after hip steroid injection? ›

You'll be able to resume walking directly after the short recovery period in your doctor's office. In fact, walking after your steroid shot for inflammation helps to disperse the medicine and prevent stiffness in the hip at the injection site.

What happens if a hip injection doesn't work? ›

Generally, if the first shot doesn't work, we may inject the same area again after 6-8 weeks. However, if a second shot doesn't work, we don't recommend the third shot. But, you can have multiple cortisone shots in different parts of your body.

What is the best injection for hip pain? ›

Corticosteroid Injection

Corticosteroids are anti-inflammatory medications that may provide pain relief when injected directly into the hip joint. Corticosteroids reduce inflammation, which is part of the body's immune system response and causes pain and swelling.

Why is my pain worse after a cortisone injection? ›

Some patients may experience a “cortisone flare” after their injection. This happens when the cortisone crystallizes and causes pain for a day or two. The pain may be worse than what you were living with before the shot. This is not a dangerous side effect, but it is uncomfortable.

Are steroid injections successful? ›

Steroid injections are one of the most effective ways to decrease pain and improve function, yet they generally do not cure the illness. Some brief and typically minor pain at the time of the injection is common. In rare instances, the following side effects might occur: Infection.

Do steroid injections help hip arthritis? ›

These injections were associated with excess risk for rapid hip destruction. Patients with hip osteoarthritis sometimes receive intra-articular steroid injections to relieve pain, but some reports have suggested that these injections occasionally cause rapid destruction of the hip joint.

What does a hip injection feel like? ›

Once the hip joint is visualized, a numbing spray is applied over the skin to minimize the sensation of the needle entering the skin. A small caliber needle is then introduced into the joint. The patient may feel a sting for a few seconds.

Why does my hip hurt more after cortisone injection? ›

The corticosteroids in the injection are formulated as slow-release crystals to give you long-term pain relief. Pain relief usually lasts for several months. However, the presence of these crystals can irritate your joint, which is what creates the sensation of pain around the area of the shot.

How long does a hip injection procedure take? ›

A hip joint injection will take approximately 30-45 minutes.

What sedation is used for hip injections? ›

The injection can produce some discomfort. We therefore provide the option of an oral medication for sedation, such as Valium.

How much is a cortisone shot in the hip? ›

Cortisone injections for pain treatment cost around $100 per shot.

What is the difference between a steroid shot and a cortisone shot? ›

Many people are curious about what differentiates a steroid injection from a cortisone shot. When discussing steroid and cortisone injections for orthopedic related conditions, the two terms are referring to the same injection product.

Can I exercise after cortisone shot in hip? ›

As a general rule, patients advised receiving a steroid injection into a joint are cautioned against any heavy lifting or exercise. But after 10 days to two weeks, they are encouraged to start gentle range-of-motion exercises and to remain active as tolerated.

Can I drive home after hip injection? ›

Unless you received IV sedation, you can drive yourself home. You may want to apply ice to the injected area, and avoid strenuous activity. Call your physician if you experience any severe pain, redness/swelling/ discharge at the injection site, or fever/chills.

What happens when you get a hip injection? ›

Description. For this procedure, a health care provider inserts a needle in the hip and injects medicine into the joint. In most cases, the provider uses a real-time x-ray (fluoroscopy) or ultrasound to see where to place the needle in the joint. You may be given medicine to help you relax.

How often can you get hip injections? ›

If it is not terribly helpful, I would not encourage repeated injections. On the other hand, if it works well, a limited number of injections (up to three or four per year is a common limit) may reduce pain and improve function and quality of life.

What can you not do after a cortisone shot in the hip? ›

No baths or soaking the injection site for 24 hours after the procedure. It is fine to take a shower. After the procedure, you may take your routine medicines and any prescribed pain medicines.

Are hip injections worth it? ›

PRP and stem cell injections, while the thought is promising, have not been shown to predictably reduce the symptoms of hip arthritis or regrow cartilage. Further research is needed,” says Dr. Angerame. While hip injections seem harmless, there are some drawbacks when performed too close to surgery.

Do steroid injections help hip arthritis? ›

These injections were associated with excess risk for rapid hip destruction. Patients with hip osteoarthritis sometimes receive intra-articular steroid injections to relieve pain, but some reports have suggested that these injections occasionally cause rapid destruction of the hip joint.

Why does my hip hurt more after cortisone injection? ›

The corticosteroids in the injection are formulated as slow-release crystals to give you long-term pain relief. Pain relief usually lasts for several months. However, the presence of these crystals can irritate your joint, which is what creates the sensation of pain around the area of the shot.

Can I drive after cortisone injection in hip? ›

You may not drive for 12 hours after your injection. It is common to experience mild soreness at the injection site(s) for 24–48 hours. Ice is the best remedy. You may apply ice for 20 minutes at a time, several times a day, as needed.

What is the difference between a steroid shot and a cortisone shot? ›

Many people are curious about what differentiates a steroid injection from a cortisone shot. When discussing steroid and cortisone injections for orthopedic related conditions, the two terms are referring to the same injection product.

What is the downside of cortisone shots? ›

The Downsides

According to the National Institutes of Health, the side effects from cortisone shots include: Dizziness or headaches. Skin issues, including dryness, thinness, acne, dry skin, and red or purple blotches. Fatigue and trouble sleeping.

Are you put to sleep for a hip injection? ›

The injection is carried out in theatre under a quick general anaesthetic or sedation so that you do not feel pain while the injection is being performed. Please do not eat anything after midnight the night before. You may have sips of water for up to two hours before your admission time, if required.

Is hip injection risky? ›

Conclusions: Hip injection is safe provided a strict aseptic protocol is maintained. The time period of pain relief with hip injection is limited (average 2 months). For diagnostic purposes injections with local anaesthetic only is recommended.

What happens if a hip injection doesn't work? ›

Generally, if the first shot doesn't work, we may inject the same area again after 6-8 weeks. However, if a second shot doesn't work, we don't recommend the third shot. But, you can have multiple cortisone shots in different parts of your body.

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