Comparison of Pain With Ultrasound-Guided Intra-Articular Hip Injections With and Without Prior Subcutaneous Local...

Area of Science:

• Musculoskeletal Medicine
• Pain Management
• Injection Techniques

Background:

• Intra-articular hip steroid injections are common for pain relief.
• The necessity of a preceding subcutaneous local anesthesia (LA) injection for pain reduction during hip injections is debated.

Purpose of the Study:

• To compare pain levels associated with intra-articular hip steroid injections.
• To determine if a prior subcutaneous local anesthesia injection reduces pain during the procedure.

Main Methods:

• A randomized prospective study was conducted.
• Forty-one adult patients undergoing their first ultrasound-guided hip injection were enrolled.
• Patients were randomized to receive the hip injection with or without a prior subcutaneous lidocaine injection, with pain assessed using the Visual Analog Scale (VAS).

Main Results:

• No significant difference in baseline pain scores was observed between groups.
• The mean VAS score for the subcutaneous lidocaine injection itself was 20.4.
• There was no statistically significant difference in VAS scores for the intra-articular hip injection between the group that received prior subcutaneous LA and the group that did not (P = 0.232).

Conclusions:

• A subcutaneous lidocaine injection prior to an intra-articular hip steroid injection does not significantly decrease the pain experienced during the intra-articular injection.
• Clinicians may consider performing intra-articular hip injections using a 22-gauge spinal needle without the need for an additional subcutaneous local anesthesia injection.