Over the years we have seen our fair share of people who come in with a diagnosis of bone on bone hips. These patients have pain, they have instability which causes walking difficulties and balance difficulties. They also come in claiming that they have been told that they only have one treatment option. Hip replacement. With the recommendation to hip replacement comes a pain management plan to help this patient get to the the surgery in as much comfort as possible. This plan may include cortisone, sometimes anti-inflammatory medications, sometimes strong painkillers.
At Washington University School of Medicine, Departments of Orthopaedic Surgery and Neurology and Physical Therapy, surgeons and therapists wanted to examine patients who had hip osteoarthritis and back pain. The hip-spine complex can be a tricky and complex area to diagnose. Finding the true source or sources generating a patient’s pain can be equally complex. (more…)
The search for an answer to hip osteoarthritis pain usually starts with an MRI. For many patients this is the wrong start. Why? Because the MRI has a notorious habit of sending patients to surgery they do not need. This includes arthroscopy for hip labrum and cartilage damage.
Platelet-Rich Plasma therapy is part of a group of treatments that come under the term “regenerative medicine.” Regenerative medicine is the science that studies the regeneration of biological tissues obtained through the use of the patient’s own cells. In regards to the growth factors in platelet-rich plasma (PRP) obtained from the withdrawal of the patient’s blood, concentrating the platelets represents a safe, economical, easy to prepare, and easy to inject source of growth factors, such as in patients with hip osteoarthritis.
Trochanteric bursitis has been used as a general term to describe pain around the greater trochanteric region of the hip. “Bursitis,” is still a popular diagnosis for lateral hip pain.
Doctors at the Center for Hip Surgery in the United Kingdom however speculated that that trochanteric bursitis may not be a real diagnosis and in their study, pain normally attributed to bursitis was coming from a weakening of the hip tendons.1
In agreement with this research, we will often see patients with a diagnosis of bursitis, and, as this study suggests they do not have it at all. What we find is pain being generated by problems of the hip, pelvic, and low back ligaments in addition to the tendons This is usually discovered following a physical examination.