If medication and physical therapy don’t relieve pain caused by a hip labral tear, doctors may inject medication directly into the hip joint. This cannot repair a tear, but it may help to reduce inflammation and restore the smooth gliding motion of the “ball-and-socket” components of the joint, which include the acetabulum, a bowl-shaped indentation in the pelvis, and the rounded top of the thigh bone, called the femoral head.
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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. Doctors administer injections during 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 powerful anti-inflammatory medications that can provide pain relief when injected directly into the hip joint. Reduced swelling in the hip joint allows the acetabulum and femoral head to move more smoothly and without pain.
In addition to the corticosteroid, doctors typically inject a small amount of anesthetic, which provides short-lasting but immediate pain relief. This medicine wears off a few hours after the injection, at which time hip pain may return temporarily. The corticosteroid solution begins to work approximately two to three days later.
For some people, a corticosteroid injection can provide pain relief that lasts for months or years. Others may find the injection relieves pain only for a short time.
NYU Langone doctors typically recommend no more than two or three corticosteroid injections in the hip joint per year to minimize the risk of side effects, including damage to the cartilage. If corticosteroid injections are not effective in treating pain, your doctor works with you to find a different treatment approach.
Platelets are blood cells that help to form blood clots. Platelets extracted from your blood and injected into the hip joint may help this tissue to heal more quickly. Doctors take a small amount of your blood—typically from a vein in your arm—for this procedure and use a small machine called a centrifuge to spin the blood sample at very high speeds, extracting the platelets. This process takes about 15 minutes. The resulting platelet liquid, called plasma, is then injected into the hip joint.
Platelet-rich plasma helps speed healing by attracting specific types of cells to the site of injury. These cells encourage regrowth of healthy tissue and may improve the condition of a torn labrum, relieving pain.
Stem cells are unique in that they can develop into any type of cell—for example, cells that help repair damaged tissue. When injected into the hip joint, stem cells may encourage the damaged tissue to regrow and heal. Injections of stem cells also reduce inflammation in the joint. The exact way stem cells work is still being researched, but some people find that an injection of stem cells relieves pain and improves joint function.
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, the stem cells 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 lead to greater function—and less pain—in the hip joint. Our doctors recommend one stem cell injection per year at most. Sometimes, they only recommend that you receive this treatment once.
The site of injection may be swollen or tender for one or two days. Your doctor may recommend an over-the-counter pain reliever or anti-inflammatory medication or the application of an ice pack for 15 minutes at a time to relieve pain and reduce swelling.
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