Hip pain often interferes with daily movements like walking, standing, or sleeping. The discomfort frequently stems from inflammation or structural damage within and around the joint. Common culprits include osteoarthritis, where the protective cartilage wears down, and soft tissue issues like bursitis or tendinitis affecting the surrounding structures. When conservative treatments such as physical therapy and oral medications fail to provide adequate relief, injections offer a focused, non-surgical path. These targeted procedures deliver powerful relief directly to the source of the pain and sometimes act as a diagnostic tool to pinpoint the exact cause of the discomfort.
Anti-Inflammatory Injections (Corticosteroids)
The most widely used injection for hip pain involves a combination of a potent anti-inflammatory medication, known as a corticosteroid, and a local anesthetic. Corticosteroids like methylprednisolone or triamcinolone mimic the action of cortisol, a hormone naturally produced by the body, to suppress the immune system’s inflammatory response. When injected, these agents interrupt the inflammatory cascade, providing powerful reduction in localized inflammation and significant short-term pain relief, particularly in cases of hip osteoarthritis (OA) or trochanteric bursitis.
For hip OA, the injection is delivered directly into the joint space (intra-articularly), often targeting the inflamed synovial lining. Conversely, for conditions like trochanteric bursitis—inflammation of the fluid-filled sac on the outer hip—the medication is injected into the affected bursa.
The immediate relief a patient feels is due to the local anesthetic, which numbs the area within minutes. This temporary effect wears off within a few hours, and the corticosteroid component may take between two to seven days to become fully effective. While highly effective for managing acute flare-ups, these injections are not a permanent solution, as the benefit often diminishes in the medium to long term. Due to potential side effects on local tissues, including possible cartilage damage with repeated use, healthcare providers generally limit the number of injections to two or three per year into the same joint.
Lubricating Injections (Viscosupplementation)
Another category of injections focuses on improving the mechanical function of the hip joint, primarily for the management of osteoarthritis. This treatment, known as viscosupplementation, involves injecting a gel-like substance called hyaluronic acid (HA) into the joint space. Hyaluronic acid is a naturally occurring molecule that is a major component of healthy synovial fluid, providing both lubrication and shock-absorbing properties.
In an osteoarthritic hip, the concentration and quality of the natural HA decrease significantly, compromising the fluid’s viscosity and elasticity. Injecting an exogenous HA preparation aims to restore these viscoelastic properties, allowing the joint surfaces to glide more smoothly and cushioning the impact of movement. This action mechanically reduces friction between the bones, decreasing pain and improving mobility.
Unlike corticosteroids, which primarily suppress inflammation, viscosupplementation focuses on restoring the joint’s biological environment and mechanics. While the initial pain relief may not be as rapid as with a steroid injection, the effect of HA is often longer-lasting, potentially extending for several months. For some patients with mild to moderate hip OA, this treatment may help to delay the need for joint replacement surgery.
Regenerative Injections (PRP and Stem Cells)
A newer, non-traditional approach to treating chronic hip pain involves regenerative medicine, which uses the body’s own healing mechanisms to repair damaged tissue.
Platelet-Rich Plasma (PRP)
Platelet-Rich Plasma (PRP) is created by drawing a small amount of the patient’s blood and processing it in a centrifuge. This process concentrates the platelets, which contain a high volume of growth factors, into a small volume of plasma. The concentrated PRP is then injected into the injured area, such as a damaged tendon, ligament, or arthritic joint. The growth factors released by the activated platelets signal the body’s cells to initiate a healing response, promoting tissue repair and regeneration. This approach is favored for chronic conditions where natural healing has stalled, offering a potential path to tissue restoration rather than just symptom management.
Cellular and Stem Cell Therapies
Cellular or stem cell therapies represent an advanced application of regenerative medicine, often utilizing mesenchymal stem cells (MSCs) harvested from the patient’s bone marrow or fat tissue. These cells possess the ability to differentiate into various cell types, including cartilage and bone. They also release signaling molecules that reduce inflammation and modulate the immune system. Although these procedures are cutting-edge and may not be universally covered by insurance, they are being explored for their potential to slow the progression of cartilage loss and promote a robust healing environment in the hip.
Procedure and Recovery
Regardless of the substance being injected, the procedure for a hip injection follows a standardized protocol to ensure accuracy. Due to the deep location of the hip joint beneath muscle and soft tissue, the use of image guidance, such as fluoroscopy (real-time X-ray) or ultrasound, is mandatory. This imaging ensures the needle is placed precisely into the target area, whether it is the intra-articular joint space or a specific bursa.
Before the injection, the skin is thoroughly cleaned, and a local anesthetic is applied to numb the injection site. During the procedure, a small amount of contrast dye may be injected first to confirm the needle’s exact placement on the imaging screen. The patient may feel a sensation of pressure or fullness as the medication is delivered, but the pain is minimal.
Following the injection, patients are advised to rest for the remainder of the day and avoid any strenuous activity for at least 24 hours. Patients should monitor the injection site for any signs of infection, although this is a rare complication. A temporary increase in pain, sometimes called a “steroid flare” after a corticosteroid injection, may occur in the first day or two, which can be managed with ice wrapped in a towel.