Study: Steroid injection reduces pain, aids mobility with hip osteoarthritis

April 6 (UPI) -- A steroid injection provides "significantly" more pain relief for people with hip osteoarthritis than other options, including exercise, weight loss and opioid drugs, for up to four months, a study published Wednesday by the BMJ found.

Patients who received a single injection of the corticosteroid triamcinolone, administered directly into the hip, with a local anesthetic, saw a 1.4-point improvement, on average, on a zero-to-10-point pain rating scale, the data showed.

The patients reported this improvement at follow-up evaluations two weeks, two months and four months after receiving their injections, the researchers said.

In addition, 67% of study participants given the injectable steroid said they were not limited in their normal, day-to-day activities because of hip pain, according to the researchers.

However, one patient treated with the steroid who previously underwent heart-valve replacement surgery with a bioprosthetic device developed an infection on the interior surface of the heart and died four months later, they said.

The remainder of the side effects reported following steroid treatment generally were mild or moderate and resolved on their own, the researchers said.

"Those receiving the steroid injection had significantly reduced pain levels, as well as improved ability to function," study co-author Dr. Zoe Paskins told UPI in an email.

"A steroid and local anesthetic injection offers an alternative to oral pain relief," said Paskins, a rheumatologist at Keele University in England.

Osteoarthritis is a degenerative joint disease that is caused by a breakdown of joint cartilage and underlying bone, according to the Centers for Disease Control and Prevention.

The agency estimates that 54 million adults nationally have been diagnosed with some form of arthritis, with the hip the affected joint in about one-third of them.

The condition can cause disabling pain, as well as trouble walking, the CDC says.

As a result, about 500,000 people in the United States undergo hip replacement surgery each year, based on recent research, with about one-third of them receiving potentially addictive prescription opioid pain drugs, according to the American Association of Hip and Knee Surgeons.

Steroids are anti-inflammatory drugs that can be injected directly into a joint, via a procedure known as intra-articular injection, to reduce pain and swelling, Paskins and her colleagues said.

For this study, the researchers assessed pain levels in 199 English adults -- average age 63 years -- with hip osteoarthritis.

All of the study participants received education about exercise approaches to relieve pain and the benefits of weight loss, which current guidelines in England describe as "best care" for the condition, the researchers said.

In addition, 66 of the participants received one ultrasound-guided injection of the steroid triamcinolone with a local anesthetic, administered directly to the hip, while 66 were given the local anesthetic alone, according to the researchers.

Participants were not told which injection they received, the researchers said.

At six months, 58% of participants given triamcinolone said they were satisfied with their care and treatment compared with 34% of those who received exercise and weight-loss education, the data showed.

Although two-thirds of those treated with the steroid injection said they were not limited in their normal activities due to hip pain, only 45% of those who were counseled on exercise and weight loss did so, the researchers said.

The findings "offer important choice to patients, who often believe their treatment options are limited," they said.