Steroid Injection In Hip
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
- 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.
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.
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.
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.
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.
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.
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.
- 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
- 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
- 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
- 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.
- 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
- 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