Top 5 Injections To Help Out Hip Pain

In this video I’m going to tell you about the top five injections that you can try to help out your hip pain. My name is Dr. David Middaugh, and I’m a specialist physical therapist at El Paso Manual Physical Therapy. And this channel is dedicated to helping people stay healthy, active and mobile, while avoiding unnecessary surgery, injections and pain medications. Please consider subscribing to our channel so that you don’t miss out on any of the helpful videos we post every single week.

So let’s start with number one. The most commonly done injection for hip problems is cortisone injections, otherwise known as steroid injections to these types of injections typically offer pretty quick relief within days, you should begin to feel a reduction in pain. And that pain relief is estimated to last anywhere from two to four months as long as they hit the right tissues.

Hitting the right tissues can be tricky since the hip joint is deep within a bunch of muscles. injections for hip problems typically need to be done under some sort of guided imaging like fluoroscopy. Fluoroscopy is basically an x ray so they can see that the needle is going into the hip joint.

Now you do need to be careful with cortisone or steroid injections into the hip because you’re limited to three per year because cortisone or steroids are known to break down connective tissue in the body connective tissue are things like cartilage, ligaments, and tendons. And if you’re diabetic, it can also be harmful because it can cause your blood sugar to spike quite a bit. So make sure you check with your doctor and see if a steroid injection is right for your hip pain.

The cost of a steroid injection is anywhere from 100 to $300. And it really depends on how experienced your doctor is at doing these kinds of injections because some won’t even offer it. Number two is highly erotic acid. And there’s many different names different types of injectable products that a doctor might offer you if they offer highly erotic acid.

They’ll typically refer to this as a lubricating agent that they inject into your hip joint to help the fluid inside the joint to re-lubricate the cartilage surfaces and allow for more freedom of motion and hopefully less pain in your hip joints.

Now the research is not conclusive on whether or not this actually helps you. And they’re still experimenting with the number of injections that you might need to feel an effect from these types of products. The estimated cost is anywhere from $500 to $1,500 per injection, you may also need fluoroscopy guided injections. So there may be more equipment than just a typical injection as are done in the knee joint. And these are estimated to give anywhere from six to nine months of pain relief.

Number three is platelet rich plasma injections otherwise known as PRP injections. The reason for the name, platelet rich plasma is because plasma is taken out of your blood. And that’s full of platelets. It’s a chemical that’s inside of blood. It’s one of the components of blood that’s injected into the hip joint. The way that they develop this is they take blood from your body, and they put it in what’s called the centrifuge.

It’s one of those things that spins your blood really fast. And after they spin it enough, the blood starts to separate into the plasma and the red blood cells and other things as well. And so they take just the plasma which is rich in platelets, those platelets are then injected into your hip joint with the hopes that it’s going to promote healing of the cartilage inside the hip joint. And this tends to be a more expensive procedure.

And it’s anywhere from 1000 to $2,000. And it’s typically not covered by insurance. And I forgot to mention this but the only injection that’s typically covered by insurance is going to be the cortisone or steroid injections. Everything else I’m mentioning here on this list is typically not covered by insurance. So you’d be footing the bill out of pocket, a relief from a platelet rich plasma or PRP injection is expected to last about six months.

Number four on the list is prolotherapy injections. Now, this is a dextrose of glucose or basically a sugar-based injection that’s put into the joint and is actually supposed to stimulate a little bit of irritation in hopes that it’ll tighten things up. And the reason why these injections are done are for instability in joints. So this typically is not going to be done for something like hip arthritis, but maybe done for more like something like hip tendinitis, or some sort of cartilage damage that affects the stability of the joint, like a hip labrum tear.

These are more rarely seen as this type of injection is very experimental, but it tends to be a bit more affordable coming in at about 300 to $600 per treatment. The relief from these types of injections is expected to be about four to six months. Number five is stem cell injections. Now of course this is highly talked about in the media when it comes to regenerative medicine or healing Naturally, the stem cells are harvested in different ways.

The most common, the one that you’ll probably run into, if you go to a medical facility that does stem cell injections is it’ll be harvested from your own bone marrow or even fat cells. Once that’s harvested from your own body, then that’s centrifuge that’s been around, so they can separate out the stem cells. And then those stem cells are injected into your hip joint, in the hopes that it’s going to promote healing. And the way that it’s supposed to promote healing is the cells.

The stem cells are undifferentiated cells, meaning they’re the basic cells that can eventually become a cartilage cell or a bone cell or a blood cell, it can become any type of cell. But we don’t have a solid method to make sure that it becomes a cartilage cell and truly regenerates the cartilage on the hip surfaces. And in my experience, as a physical therapist, I run into patients that have tried stem cell therapy, and I’ve seen about a 50-50 improvement versus no change.

Really no, I have not seen any patients that have said that stem cell treatments have hurt them. But I have met some that said it was no difference. They felt the same before versus after. And then I had other patients say that they did feel a significant improvement from having stem cell treatments done. Now the length of time to expect relief is unknown, it seems to be variable depending on the individual.

But doctors that do stem cell treatments do recommend that patients come back every so often to get another stem cell treatment done to extend the relief. Now this, of course is not covered by insurance, and it can cost anywhere from $4,000 to $6,000 per treatment. So let me break down my overall opinion about these different injections, these five injections that I’ve covered, and talk about what might be best for you in your specific situation.

Now, if you’re looking for pain relief, immediate pain relief, cortisone or steroid injections are probably going to be your go to injection. So you might talk to your doctor about that. And you need to of course, remember that a cortisone injection is pain medication that’s got an anti inflammatory component in it, that is not healing your hip, it’s not causing any healing. It’s simply just to deal with the pain and inflammation.

So the effects of it are going to be short term or temporary, other a lot longer than taking medication by mouth. But they’re still going to end eventually. And they’re not truly fixing the root problem, hyaluronic acid injections and PRP or platelet rich plasma injections, as well as stem cell injections all might be beneficial there can up and coming. So they may be beneficial later on as we learn more about the effects of these.

But currently, we don’t have enough information to know for certain that they’re going to help you out in your hip problem. Those three types of injections are typically done for more chronic problems like hip osteo arthritis, where you’re looking to regenerate tissues inside the hip joints. Now if you’re not dealing with hip arthritis or some degenerative problem in your hip, and if it’s more, it’s more of an instability problem, especially if you’re the very flexible type.

Like you’re the type of person that at one point could put your foot behind your head. Or maybe you still can, but you’re having hip pain from that, then a prolotherapy injection could be something that could benefit your specific hip problem.

Now, let me tell you about the cons of some of these injections. That number one thing I want to impart on you through this video is that none of these injections are addressing the root problem of your hip issue. Typically, there’s some sort of mechanical problem. A muscle imbalance is something that we often look at I as a physical therapist will look at the muscle strength on one side of the hip joint versus the other side of the hip joint.

Typically the hip flexors versus the hip extensors or the glute muscles. And there’s usually an imbalance between the two, which requires strengthening in the weaker muscle. There may be some mobility problems in the hip joint that need to be addressed. And it’s also important to look at the lower back as well as the knee and the ankle and foot because they all contribute to motions or lack of motion in the hip joints.

Now getting an injection, whether it’s a steroid injection, prolotherapy injection, or stem cells, or any of the other ones that I mentioned, just does not address your strength or mobility directly in the joints. And they also aren’t looking at the joints above and below the body parts above and below the hip joints.

That could be contributing factors major contributing factors to your specific problem. Some other cons are some of these procedures are quite expensive, and you’re looking at really just short term pain relief, spending quite a bit of money for that short term pain relief, which might be worth it for you.

I don’t want to discount that because for some people getting a good night’s rest for just a week or even a few weeks is very, very valuable to them and paying $1,000 or three or $4,000, to get an injection that can get them that kind of rest might be well worth it. And don’t be fooled.

Also, if you get some pain relief from any of these injections, make sure that you begin to treat that underlying problem, because it is possible to fall into the belief that you’ve solved your hip problem, when really you’re just masking the pain temporarily. But you need to solve that hip problem for the long term.

Even when it comes to stem cells. If you did have a positive outcome from a stem cell treatments, and you possibly have put down new cartilage cells in your hip joint, those cartilage cells are going to wear down over time, if you still have that underlying muscle imbalance that’s causing too much pressure to the hip joint.

Now, overall, the cost that you’d spend on any of these injections is going to be much less than the cost of something like a hip replacement, and it’s going to be much less invasive. Of course, hip replacement costs are upwards of $40,000.

Now often they’re covered by insurance, you might still have a copay or deductible to pay, but they are quite expensive, especially if you’re paying out of pocket. And then going through a round of physical therapy costs anywhere from two to $3,000, if you’re paying out of pocket, and often that’s covered by by insurance as well.

Now, if you’re looking for a physical therapist for your hip problem, make sure that you find a specialist somebody who knows how to help people that are looking to avoid surgery. Avoid injections and pain medications. Because by and large, most physical therapists are excellent at helping people right after having a hip surgery, or other surgeries.

What they’re not as good at typically because it requires extra training is helping people avoid surgery. I personally am a manual physical therapist and here in the office, we rarely see anybody that’s had surgery because it’s just not our specialty. We’d rather other clinics in the area handle people that have had surgery. If you’re looking for more help with your specific hip problem.

I’ve got many videos for different kinds of hip issues like hip labrum tears, hip tendinitis, hip bursitis hip arthritis. I’ve got playlists with tons of videos in them. They’re all linked down the description below. So go check those out before you leave. Thanks so much for watching, and I’ll see you in the next video. Bye