Cortisone Shot in the Hip: What to Expect

What are the two kinds of hip cortisone shots?

The word hip covers two separate targets, and the shot goes to whichever one is causing your pain.

Your exam decides which one you need. Groin pain that worsens with bending and rotating the hip points to the joint, while a tender spot on the outside of the hip that hurts when you lie on it points to the bursa and tendons. Getting the target right matters, because a joint injection will not help tendon pain on the outside of the hip, and the reverse is also true.

• Hip joint injection: the needle goes deep into the ball-and-socket joint to treat arthritis, labral tears or impingement pain felt mostly in the groin. Because the joint is deep, it is usually guided by ultrasound or a live X-ray called fluoroscopy.
• Bursa or tendon injection: the medicine goes on the outside of the hip, near the bony point, to treat what is usually called trochanteric bursitis. It is shallower and often done in the office, sometimes with ultrasound.

What happens during a hip injection?

Before the shot, tell your provider about every medicine you take, especially blood thinners such as aspirin, warfarin, apixaban, rivaroxaban or clopidogrel, and mention any allergies, diabetes or recent infections. MedlinePlus recommends discussing these ahead of time, since some may need to be adjusted. Wear loose, comfortable clothing, and eat normally unless told otherwise.

For a joint injection, you lie on a table while the skin is cleaned and numbed. MedlinePlus describes the provider guiding a thin needle into the joint while watching an X-ray or ultrasound screen, sometimes using a small amount of contrast dye to confirm placement, then slowly injecting a mix of local anesthetic and steroid.

The procedure takes a short time. You rest for a few minutes afterward, and your provider may ask you to move the hip to see how the pain has changed. Plan to have someone drive you home after a joint injection.

How will my hip feel after the shot?

The timeline tends to follow a pattern, according to MedlinePlus:

• Within 15 to 20 minutes: pain often eases as the numbing medicine takes effect.
• After 4 to 6 hours: pain may return as the numbing wears off.
• Days 1 to 2: some people have a short flare of increased pain before the steroid kicks in.
• Days 2 to 7: the steroid starts to work and the hip should feel less painful.
• Weeks to months: how long relief lasts varies widely from person to person.

What are the side effects and aftercare?

Most people go back to normal activities the next day, avoiding strenuous exercise on the day of the shot. Ice wrapped in a towel can help soreness at the injection site. Mild swelling, redness or a short-term flare of pain are the most common side effects.

Because a little steroid enters the bloodstream, people with diabetes may see blood sugar rise for a few days, so check it more often. OrthoInfo notes that steroids can weaken cartilage and tendons with repeated use, which is why most doctors limit how many shots you receive, often to 3 or 4 per year. Infection is rare, but call right away or seek urgent care for fever, increasing redness, warmth or swelling, or severe pain in the days after a shot.

MedlinePlus also lists irritation and discoloration of the skin at the injection site as possible side effects. These are uncommon, but mention any skin change at your next visit so it can be checked and noted before any future injection.

Why wait 3 months before hip replacement?

A joint injection places a needle and medicine directly into the space where a future implant would go. A 2023 meta-analysis in EFORT Open Reviews found that injections given less than 3 months before hip replacement were linked to a higher risk of infection around the new joint, while longer intervals did not show the same clear increase.

OrthoInfo likewise advises delaying replacement surgery for at least 3 months after a joint injection. If surgery is already on the calendar, let your surgeon know before anyone injects that hip, and keep a record of the date of every shot.

What does it mean if the cortisone shot didn't work?

A shot that did not help still provides useful information. Many joint injections are partly diagnostic. If the numbing medicine relieves pain right away, it strongly suggests the pain is coming from inside the joint. If a well-placed joint injection brings little or no relief, OrthoInfo explains that the pain may be coming from somewhere else, such as a tendon, a stress fracture or the lower back.

Write down how the hip felt in the first few hours after the shot, using a simple 0 to 10 pain score while doing something that usually hurts. That record helps your doctor interpret the result and plan the next step, whether that is physical therapy, a different injection, platelet-rich plasma, or a conversation about surgery.

OrthoInfo also notes that cortisone eases pain without fixing the underlying condition, and repeated shots may help less over time as arthritis progresses. When relief from each shot gets shorter, that pattern is itself useful information for planning what comes next.

How can I get the most out of a hip injection?

Use the relief as a window. For outside-of-hip tendon pain, OrthoInfo notes a bursa injection can give temporary relief for a few months, so use that time to start a strengthening program that addresses the tendons themselves. For arthritis, a shot can make therapy and walking easier while you decide on longer-term options.

If you are wondering whether an injection is right for your hip, or one did not help as expected, our team can review the details at the Saturday Hip Pain Clinic. Bring the dates and results of past injections and any imaging you have.

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