Chronic Hip Pain

The hips are the human body’s main engine and is crucial to all movement in day-to-day life. Something as simple as entering in or getting out of car or climbing up or down the stairs can be a painful and debilitating for someone who is suffering from chronic hip pain.

There are many components of the hip – joint, muscles, ligaments, tendons, bursa and any or each of them can be pain generators. Determining the correct cause is the key to getting the best treatment.

Q. What are the common causes of Chronic hip pain?
A. Osteoarthritis, an age-related wearing down of the cartilage, is one of the most common causes in older individuals. Once the cartilage wears down enough, it fails to cushion the joint, causing pain, inflammation, swelling, restricted movements, limping. 

Another common cause of hip pain in middle aged individuals is Avascular necrosis aka AVN of head of femur or thigh bone, and, may occur in people who are chronic alcoholics, or have taken steroid medications for a prolonged period, and lot of other reasons. In this condition, the blood supply to the part femur bone is compromised, becomes weakened and collapses, causing hip pain.

In younger, more active patients or athletes, hip impingement syndrome, trochanteric bursitis – that is when the bursa - a liquid-filled sac near the hip joint is inflamed or even muscle strains tend to be more common. Finally, strain in the buttock aka gluteal muscles can cause pain where they attach, this condition is known as gluteal tendinopathy.

It is important to know that sometimes pain can radiate to the hip and come from compressed nerves in the spine, arthritis in the spine, or from the sacroiliac joint.

Q. How do you treat various conditions causing Chronic Hip Pain?
A. The treatment of chronic hip pain depends on finding the precise cause of the pain and diagnosing it. 

Patients suffering from Hip Arthritis especially in early stages traditional treatments include lifestyle modification, rest, non-weight-bearing, analgesics - but taking these medications has its own potential for side effects particularly in elderly patients. 

 At IPSC we treat patients of early arthritis, tendinopathies, bursitis and selected patients with Avascular necrosis of hip or AVN with Regenerative therapy called as Platelet rich plasma (PRP) or bone marrow stem cells injection into the affected region. The effect can last longer when complemented with physical therapy or exercises to increase the strength of hip muscles. 

Q.How advanced stages of chronic hip pain is managed?
A.As the arthritis progresses, as is in advanced stages of arthritis - medications, injections and other conservative treatment options might not be as effective and then Hip replacement surgery is usually advised. Some of these patients may be unfit for surgery due to advanced age or complex medical comorbidities or surgery can be delayed because of a patient’s preference; so, all these patient’s chronic pain can be managed with a novel technique called Cooled radiofrequency lesioning or coolief. 

Q. What is Cooled radiofrequency lesioning or COOLIEF?
A. Coolief is a minimally invasive non-surgical day care treatment targeting nerves that transmit pain signals, done under local anaesthesia. An electrical current produced at the tip of needle by a radio wave is used to heat up a small area of nerve, thereby decreasing pain signals from that specific area. Patients will find significant improvement in pain and activity in 1-2 weeks’ time. The pain relief will last until the nerve regenerates, roughly about 18 to 24 months. 

Patients can undergo a repeat procedure safely. 

Not only Hip pain but many other musculoskeletal pains can be treated with Regenerative therapy and Cooled radiofrequency lesioning.


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