There are two major components to treating hip osteoarthritis. The first is taking away the inflammation from the joint to alleviate the pain; the other is to make sure we address the biomechanics to take the pressure off the hip so that the inflammation does not return.
When symptoms are persistent despite physical therapy, or if the symptoms are getting in the way of participating in physical therapy, there are a couple of different injections that one can employ. We can either be injecting steroids into the hip or hyaluronic acid into the hip.
Steroid Injections for Hip Osteoarthritis
Steroid injections in the hip should be done under fluoroscopic guidance because it is a relatively deep structure so the best way to get to the hip is to use an X-Ray to guide the needle in. When you put steroid into the hip, you’re not fixing the hip osteoarthritis and you’re also not masking the pain, you’re reducing the inflammation, ideally resetting the inflammatory clock back down to zero. This should allow someone to take more advantage of the physical therapy, to stretch, to strengthen, to really tweak the biomechanics so that ideally, the inflammation doesn’t recur.
Hyaluronic Acid Injections for Hip Osteoarthritis
The other kind of injection that can be done in the hip is hyaluronic acid. This is more commonly done for knee osteoarthritis, but it can be done in the hip as well. Hyaluronic acid is basically putting joint fluid back into the joint. You’re basically putting in a series of injections – either one three, four, or five injections depending on the brand used. You’re putting in this viscous substance in to lubricate the joint and to wash out the inflammatory proteins. Again with hyaluronic acid injections, you’re not fixing the hip osteoarthritis, the injections will wear off typically in about six months. So again, what we’re using the injections as more of a window of opportunity to stretch, to strengthen and address the whole chain of biomechanics so that at the end of the six months, we’re not sitting back and having to do it again.