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Diagnosis & Evaluation

Find Out If Your Hip Joint Is Really the Problem

What is a diagnostic hip injection and what does it show?

A diagnostic hip injection places a numbing medicine directly into the hip joint under ultrasound or X-ray guidance. If your usual pain drops sharply over the next few hours, the joint is very likely the source. If it does not, the pain is probably coming from the spine, a tendon or nerve, which changes the treatment plan.

Some hip pain refuses to give up its source. When the exam and imaging point in two directions, a diagnostic injection acts as a test: the joint is numbed for a few hours and you report how you feel. It is one of the most useful steps before deciding on hip arthroscopy or replacement.

Written and medically reviewed by Dr. Stride, MD, board-certified orthopedic surgeon
Last reviewed October 2026
Dr. Stride reviewing hip X-rays with a patient in the Memorial City office

At a glance

Also called
hip joint numbing injection, intra-articular hip injection, lidocaine hip test, hip block
After your visit
Follow-up
Ask about this treatment →(713) 555-0168

Is Diagnostic Hip Injection right for you?

Usually a good fit if

  • Patients with both lower back arthritis and hip arthritis on imaging
  • Groin or buttock pain where the exam is mixed
  • Anyone considering hip surgery who wants confidence the joint is the pain source
  • Athletes with a small labral tear on MRI and unclear symptoms
  • Pain that continues after a prior hip or spine procedure

Another option may be better if

  • Active skin infection over the hip or a current joint infection
  • Pain you cannot reproduce during the day, since there is nothing to compare before and after

What happens, step by step

  1. Before the injection

    You rate your pain and do a few moves that normally hurt, such as a squat, stepping up or the FADIR test. Dr. Stride records those numbers so the response can be measured fairly.

  2. Guided needle placement

    The skin is numbed and a thin needle is guided into the front of the joint using ultrasound or low-dose X-ray (fluoroscopy). Image guidance matters, since a needle placed by feel alone misses the joint more often.

  3. Medicine into the joint

    A local anesthetic such as lidocaine or bupivacaine is injected. A corticosteroid is often added so the test can also give longer relief if the joint is the source.

  4. Testing the response

    About 15 to 30 minutes later, you repeat the painful moves in the office. You then keep a simple pain diary for the next 4 to 6 hours, ideally doing the activities that usually bother you.

The hip-spine connection

Could it start in your back?

When the hip and the back could both be to blame, a numbing injection into the joint helps show whether the hip is the real source.

Is it your hip or your back? →

What happens after the visit

First 30 minutes

Dr. Stride rechecks your hip and records how much the pain changed with the same moves.

Rest of the day

The leg can feel slightly weak or numb for a few hours, so plan for a ride home and skip strenuous activity.

Evening

Pain often returns as the numbing medicine wears off. That is expected and is part of the test.

2 to 7 days

If a steroid was included, relief may build again over several days and can last weeks to months.

Follow-up

Your pain diary is reviewed together. Strong relief points to the joint, and little relief shifts the focus to the spine, tendons or nerves.

“Before I recommend any hip operation, I want to be sure the joint is the problem. A numbing injection is a simple, honest test, and the answer protects you from a surgery that would not have helped. Sometimes the most welcome news from this test is that your hip is fine.”

Dr. Stride, MD

Frequently asked questions

Does a hip joint injection hurt?

Most people feel a brief sting from the numbing medicine and some pressure as the joint fills. Because the needle is guided by imaging, the procedure is usually quick, often under 10 minutes. Mild soreness at the site for a day or two is common.

What does it mean if a hip injection did not help?

Little or no relief after a well-placed numbing injection suggests the pain is coming from outside the joint. Common sources are the lower back, the sacroiliac joint, the gluteal tendons or a nerve. Dr. Stride uses that result to point treatment in the right direction.

Can you drive after a diagnostic hip injection?

It is safest to have someone drive you home. The numbing medicine can briefly weaken the thigh muscles or change how the leg feels. Most people return to normal activity the next day.

Is a diagnostic injection the same as a cortisone shot?

They overlap but have different goals. A diagnostic injection is mainly a test using numbing medicine, while a cortisone shot aims for longer relief. Many hip injections combine both, so the same visit answers a question and may also ease your pain.

Related treatments

Injections

Cortisone Hip Injection

A cortisone hip injection places a corticosteroid and numbing medicine directly into the hip joint, guided by ultrasound or X-ray.

Read more →Diagnosis

Hip Exam & Gait Analysis

A hip exam with an orthopedic hip specialist is a hands-on check of range of motion, labral and impingement signs, tendon strength and walking pattern.

Read more →Preservation

Hip Arthroscopy

Hip arthroscopy is an outpatient surgery that uses a small camera and slim instruments, placed through two or three small incisions, to treat problems inside the hip joint.

Read more →Replacement

Total Hip Replacement

Total hip replacement replaces the worn ball and socket of an arthritic hip with a metal, ceramic and medical-grade plastic implant.

Read more →Compare

Cortisone vs PRP

Cortisone and PRP hip injections work differently.

See the comparison →

Hip pain this can help with

Hip pain · Front of hip

Pain in the Front of the Hip and Groin

Front of hip and groin pain usually comes from inside the hip joint itself.

Causes & treatment →Hip pain · Back of hip

Pain in the Back of the Hip and Buttock

Pain in the back of the hip and buttock most often comes from the lower back, such as a pinched nerve or sciatica, or from the sacroiliac joint.

Causes & treatment →Hip pain · symptom

Is It Your Hip or Your Back?

Hip joint pain is usually felt in the groin or front of the thigh and flares with putting on socks or getting out of a car.

Causes & treatment →
From the Hip Health Library

Questions patients ask about this

All guides →
Dr. Stride reviewing hip X-rays with a patient in the Memorial City office
Treatment & Recovery

Cortisone Shot in the Hip: What to Expect

A hip cortisone shot combines a numbing medicine with a steroid.

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Hip Pain but the X-Ray Shows Nothing: What Next?

A normal hip X-ray means your bones look intact, but it does not rule out a problem.

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Pain & Warning Signs

Hip Pain Radiating Down Your Leg: Is It Your Hip or Sciatica?

Hip pain that radiates down the leg can come from the hip joint or from a pinched nerve in the lower back.

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SourcesReferences used for this page2

Medically reviewed by Dr. Stride, MD against current guidance from these sources. Last reviewed October 2026. How we write and review content

  1. Hip joint injection (opens in a new tab) MedlinePlus
  2. Symposium: evidence for the use of intra-articular cortisone or hyaluronic acid injection in the hip (opens in a new tab) Journal of Hip Preservation Surgery (peer-reviewed review)
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