Therapeutic Injections for Hip Impingement Syndrome
If medication and physical therapy don’t relieve pain caused by hip impingement syndrome, doctors may inject medication directly into the hip joint. Injections don't address the structural cause of symptoms, but they may help to reduce inflammation and restore the smooth, gliding motion of the ball-and-socket components of the joint.
Our specialists use corticosteroids to ease pain, as well as newer types of injections such as platelet-rich plasma or stem cells, which may encourage healing in damaged soft tissues. Your doctor can discuss whether you are a candidate for these experimental injections, which are not approved by the U.S. Food and Drug Administration (FDA) to treat hip impingement syndrome.
Our doctors are specially trained to administer these injections. They use live ultrasound guidance—an imaging technique that uses high-frequency sound waves to create pictures of the inside of the body—or X-rays to ensure that injections are placed precisely within the hip joint.
Your doctor first injects a local anesthetic to numb the skin above the hip, so you won’t feel any pain during the therapeutic injection into the joint. Injections are outpatient procedures that take place in a doctor’s office or in a radiology suite at NYU Langone.
Most people return home or go back to work an hour or two after receiving an injection.
Corticosteroids are anti-inflammatory medications that may provide pain relief when injected directly into the hip joint. Corticosteroids reduce inflammation, which is part of the body’s immune system response and causes pain and swelling.
Typically, doctors inject a small amount of anesthetic in addition to corticosteroids to provide short-lasting but immediate pain relief. This anesthetic wears off a few hours after the injection, at which time hip pain may return. The corticosteroid solution begins to work two to three days later.
For some people, a corticosteroid injection provides pain relief that lasts for many months; in others, the injection isn’t effective. Most people experience some pain relief, lasting for a few weeks or months.
Doctors recommend no more than a total of two or three corticosteroid injections in the hip joint. If used too frequently, corticosteroids may cause side effects, including weakening of soft tissues in the hip and skin discoloration at the injection site.
Platelet-Rich Plasma Injection
Doctors may inject a natural substance called platelet-rich plasma into the hip joint to help injured tissue heal more quickly. Platelet-rich plasma is composed of blood cells called platelets that are taken from your own blood. Platelets release substances called growth factors that stimulate healing.
In this procedure, a doctor takes a small amount of your blood from a vein in your arm and uses a machine, called a centrifuge, to separate the platelets and growth factors from other blood components. This process takes about 15 minutes.
The doctor then injects this platelet-rich liquid, called plasma, directly into the hip joint. Our doctors use ultrasound guidance to ensure precision.
People often experience pain relief and improved function within two to six weeks.
Stem Cell Injection
Stem cells are unique in that they can develop into any type of cell—such as those that help repair damaged tissue. When injected into an impinged hip joint, stem cells may encourage the damaged cartilage to regrow and heal.
Injections of stem cells also reduce inflammation. Exactly how they do this is still being researched, but some people find that an injection of stem cells relieves pain and swelling and may help speed recovery.
Our doctors obtain these stem cells from your body, typically from bone marrow in your pelvic bone, using a syringe. The area is thoroughly numbed before the stem cells are extracted, but the procedure may cause mild discomfort.
After the stem cells are separated from blood and other substances in the bone marrow, they are injected directly into the hip joint. Stem cell therapy does not produce results right away. However, over time the regenerative effect of stem cells may help damaged tissue to heal fully.
Most people experience improved function and relief from pain after two to six weeks.
What to Expect After Injections
Doctors recommend avoiding anti-inflammatory drugs, such as ibuprofen, for four to six weeks after treatment, while the injury heals. This is because the platelet-rich plasma or stem cell injection stimulates the body’s inflammatory response, an important part of healing, and anti-inflammatory drugs inhibit this response.
If the site of injection is sore or swollen in the days after treatment, doctors recommend taking over-the-counter acetaminophen and applying an ice pack for 15 minutes at a time, 3 times a day.
You should also avoid strenuous activities using the hip for four weeks after the injection. This gives the injured tissue time to heal. Your doctor can provide you with crutches to help you move around.