Intra-articular Steroid Injections for the Hip

10th June 2007 at 14:03 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article discusses the usage of intra-articular steroid injections for the hip.

Intra-articular Steroid Injections for the Hip

Introduction

Intra-articular steroid injections are a prescribed line of treatment for relief from joint-pain. The steroids administered through the intra-articular injections are used to decrease the inflammatory reaction associated with osteoarthritis and rheumatoid arthritis.

Basically, the intra-articular steroid injections are administered with the aim of providing 2 to 6 weeks of pain relief for patients with hip osteoarthritis. However, the higher-dose steroids with or without joint lavage can provide pain relief for a period as long as 24 weeks.

Research Findings

Research indicates that the intra-articular steroid injections delivered for relief from the pain related to hip osteoarthritis can produce highly effective results as compared to the standard form of treatment.

As per a research report, patients who were administered intra-articular steroid injections showed a significant improvement in all the symptoms including pain, stiffness, physical function and global assessment as against those given the conventional form of treatment and medications.

Hip Osteoarthritis

Intra-articular steroid injections are extensively used for treating the pain associated with hip osteoarthritis. In addition, steroid infiltration into the arthritic joints is now a very common means of treating pain. This form of treatment is also done to differentiate pain in the hip from that in the low back or knee.

When administered with proper precautions and care, the intra-articular steroid injections can bring about a remarkable relief to patients' articular diseases. During the process, usually an aspiration of distended joints can lead to an immediate relief. Besides, it is especially useful when the procedure can actually facilitate physical therapy.

However, experts issue a specific warning pertaining to the use of intra-articular steroid injections for the hip. Since this is a deep seated joint which is difficult to enter, joint aspiration and injection should not be attempted in an out-patient setting.

Intra-articular steroid injections are frequently used as a part of the treatment plan for hip osteoarthritis. Steroid injections are often successfully used along with:

• Physical therapy
• Weight reduction programmes
• NSAIDs
• Topical and opioid analgesics
• Education

The intra-articular steroid injections are an effective remedy for decreasing pain and swelling quickly. In addition, patients may also opt for the intra-articular steroid injections to delay using steroid pills or arthritis drugs.

Types and Forms

There are various types of preparation of steroids that have a different duration of effect and action. The guiding principle which determines the effectiveness of each of these preparations is their solubility.

The insoluble preparations are known to have a longer duration of effect and are the most preferred. For the benefit of analysis, here we briefly list each one of the preparations of the intra-articular steroid injections.

1. Aristospan (Triamcinolone HEXACETANIDE) – These are the most soluble and preferred preparation for intra-articular injections. The duration of effect is usually 6 months.

2. Aristocort (Triamcinolone ACETONIDE) – Highly insoluble, this is the preparation normally preferred after the above. This particular preparation normally has a duration of 3 months.

3. Depo-medrol (Methylprednisolone acetate) – This is highly soluble and should only be used as a last resort. The duration of effect in this preparation is only 5 weeks.

The Procedure

In this section, we've listed the basic steps involved in using an intra-articular steroid injections for the hip.

1. Selection of preparation to be used for the injection is done, after careful consideration of the extent of the problem and patient history.
2. The steroid is injected into the joint
3. At the same time, a local anaesthetic (lidocaine 1%) is injected. This is to confirm whether the pain is relieved by the injection.
4. Once done, an iodinated contrast is injected to observe immediate distribution of the steroid and local anaesthetic and confirm which joints are being treated.

Specialists dealing with intra-articular steroid injections generally instruct their patients to maintain a simple diary of pain for at least a week's duration after the injection. The commonly recommended entry in the diary is pain vs. previously expected pain or same physical workload.

Conclusion

A majority of professionals in the field of pain management support the use of intra-articular steroid injections for the treatment of pain that arises due to osteoarthritis of the hip.

However, another section of experts indicate that the use of intra-articular steroid injections for the hip may accelerate arthritis progression or may even increase infections after subsequent total hip arthoplasty.

Appointments and more information

For appointments or further information about London Pain Consultants please Contact Us