What Type of Hip Injection to Use for Pain Relief

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Last Updated On: March 27, 2024

Hip pain ranks among the prevalent musculoskeletal complaints affecting approximately 19% of individuals aged 65 years and older, with an estimated 27 million people impacted by this condition. 

In addition to non-surgical treatments like low-impact exercises, physical therapy, weight reduction, and hot/cold therapy, orthopedic injections with substances such as hyaluronic acids, corticosteroids, and platelet-rich plasma provide short-term relief and complement other non-operative approaches.

Hip injection for pain relief is a common treatment for hip osteoarthritis. It is important to understand how hip osteoarthritis injections work, what is the proper technique for administering them, how long the relief lasts, and what are the latest findings on their effectiveness and safety. Popular orthopedic HA injections in the hip can provide relief, but it’s crucial to have a thorough knowledge of this therapeutic option.

Help your patients seeking effective treatment options for hip osteoarthritis pain by delving into insights from this article.

Key Takeaways

• Therapeutic injections are available for osteoarthritis of the hip when other medical treatments are not advisable or fail to alleviate pain.
• Hyaluronic acid injections aim to improve synovial fluid viscosity, enhancing joint lubrication and function, potentially offering long-lasting pain relief.
• Intra-articular injections of HA is a promising therapy that should be more researched, but already shown significant results.
• A radiology technologist in the health care team is very important during this procedure since it involves fluoroscopy.

Indications for Hip Joint Injections for Pain Relief

Injections for hip pain management are intended for purposes such as alleviating pain, conducting diagnostic evaluations to identify the source of pain, and performing joint aspiration. Corticosteroid injections are a common way to reduce inflammation and ease pain directly in the hip joint. But there are also innovative injection treatments that help damaged soft tissue heal. Although these injections, such as hyaluronic acid, platelet rich plasma, and stem cells, are not FDA-approved for this specific application yet, several studies showed their efficacy.

How Do Hip Osteoarthritis Injections Work?

Osteoarthritis is a progressive joint disease characterized by changes in articular cartilage, subchondral bone, ligaments, periarticular muscles, and capsule. It can decrease a person’s quality of life due to pain and reduced mobility, impacting their mental and social well-being. 

While oral pharmacological therapies like non-selective non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors provide pain relief, they come with systemic side effects. Intra-articular injections, such as corticosteroids, deliver therapeutic agents to the affected joint immediately but also cause potential complications. Recent research has focused on alternative injectable therapies, including viscosupplementation, which involves intra-articular injection of hyaluronic acid (HA). DUROLANE® and HYALGAN® are proven to be good options for intra-articular hyaluronic acid injections in the treatment of hip pain.

Injection Procedure: How to Administer

Speaking of steroid injections, they are typically administered under ultrasound guidance for precision and accuracy.

When it comes to viscosupplementation, fluoroscopy enables patient comfort, safety and proper needle access, so a radiologic technologist’s role is exceptionally important in helping the operator perform a procedure.The patient is positioned comfortably in a supine position with the lower extremity either in a neutral position or slightly internally rotated. Small weights may be applied lateral to both feet to limit motion and maintain a neutral leg position. After marking the skin at the proposed entry site and administering local anesthesia, a 23-gauge 3.5-inch spinal needle is used to access the femoroacetabular joint under intermittent fluoroscopy guidance to ensure precise needle placement and intra-articular injection.

How Long Does HA Last Once Injected?

40 studies were included in the analysis from an initial search of 3,265 studies, with data from a total of 3,350 patients and nearly all of them showed a reduction in mean pain at 1 month, 3 months and 6 months follow-up, as well as at the endpoint, and an improvement in mean patient-reported function was also seen at these timepoints. 

It should be emphasized that follow-up appointments are crucial to monitor the effectiveness of injections and determine further treatment options.

Conclusion

Intra-articular hip joint injection, especially viscosupplementation, is a promising therapeutic intervention for hip osteoarthritis, providing pain relief and functional improvement in patients who for some reasons need to avoid surgery or oral medications. While current evidence suggests its efficacy, ongoing research is needed in order to specify optimal dosing regimens, duration of efficacy, and long-term safety. If you’re interested in including orthopedic injections for hip pain treatment, explore our wide product selection, which is available at wholesale prices.

FAQ

What Is the Best Injection for Hip Pain?

DUROLANE® and HYALGAN® are considered suitable options for intra-articular hyaluronic acid injections in the treatment of hip pain.

Is Hyaluronic Acid Good for Hip Osteoarthritis?

Due to varieties among studies regarding the dosage, type, and frequency of HA injections, as well as the duration of follow-up, further research is needed to establish the efficacy of hyaluronic acid injections for hip osteoarthritis.

What is the Best Thing to Take for Hip Osteoarthritis?

There is no universal hip osteoarthritis cure, but every potential candidate may benefit from various options, including acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs which include aspirin, ibuprofen, and naproxen), and therapeutic injections such as corticosteroids or hyaluronic acid.

Does Hyaluronic Acid Repair Cartilage?

Hyaluronic acid (HA) is a polysaccharide composed of alternating d-glucuronic acid and N-acetylglucosamine, which are naturally present in cartilage and synovial fluid. In comparison to other polysaccharides, HA affects the regulation of cartilage function and repair of cartilage damage in many ways.

What are the Side Effects of Hyaluronic Acid Hip Injection for Pain Relief?

Healthcare professionals should thoroughly review the patient’s prior imaging to assess for any aberrant or variant anatomy before proceeding with any medical interventions or procedures.

Side effects of HA injections in the hip are rare and include exacerbation of baseline pain, especially the night of the procedure (related to bland synovitis), allergic reaction, small vessel injury.

Are There Any Limitations of Viscosupplementation?

The contraindications for therapeutic hip joint injections include:

• Septic arthritis
• Cellulitis at or near the skin entrance of the injection needle
• Bacteremia
• Acute fracture
• Anaphylaxis/allergy to injected therapeutic agents

References:

• da Costa BR, Reichenbach S, Keller N, Nartey L, Wandel S, Jüni P, Trelle S. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. Lancet. 2017 Jul 08;390(10090):e21-e33.
• Zhu, J.B., Lim, A.J.C., McCaskie, A.W., & Khanduja, V. (2023). Viscosupplementation is Effective for the Treatment of Osteoarthritis in the Hip: A Systematic Review. Journal of Arthroplasty, November 22, DOI: https://doi.org/10.1016/j.arthro.2023.11.010.
• Tafti D, Schultz D. Hip Joint Injection. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559023/
• Wang, M., Deng, Z., Guo, Y., & Xu, P. (2022). Designing functional hyaluronic acid-based hydrogels for cartilage tissue engineering. Mater Today Bio, 17, 100495. https://doi.org/10.1016/j.mtbio.2022.100495
• Dawson, J., Linsell, L., Zondervan, K., Rose, P., Randall, T., Carr, A., & Fitzpatrick, R. (2004). Epidemiology of hip and knee pain and its impact on overall health status in older adults. Rheumatology (Oxford), 43(4), 497-504. doi: 10.1093/rheumatology/keh086.