Hip pain is a common complaint that can be caused by a wide variety of problems. The precise location of your hip pain can provide valuable clues about the underlying cause. For this reason, the medical examination represents a fundamental pillar for the correct diagnosis and the consequent establishment of the appropriate treatment.
The hip is the area on each side of the pelvis. The pelvis bone is made up of 3 sections:
Ilium. The broad, flaring portion of the pelvis.
Pubis. The lower, rear part of the pelvis.
Ischium. One of the bones that helps form the hip.
The hip joint is a ball-and-socket joint that allows motion and gives stability needed to bear body weight.
The socket area (acetabulum) is inside the pelvis. The ball part of this joint is the top of the thighbone (femur). It joins with the acetabulum to form the hip joint.
The hip is one of the most stable joints in the body. But because it bears your body weight, it is more likely to develop arthritis because of the extra pressure. Hip pain may be caused by injury to muscles, tendons, or the small fluid-filled sacs (bursae) that cushion and lubricate joints.
Healthy Hip – The spaces between the acetabulum (socket) and the head of the femur (ball) are preserved
Hip with Osteoarthritis – The spaces between the acetabulum (socket) and the head of the femur (ball) are diminished, allowing both bones to stick together.
What are common hip problems?
You have about 160 bursae around your body. Bursae provide a cushion between bones and soft tissues. They prevent bones from rubbing against tendons and muscles. Bursitis can affect any of the bursae in your body.
Trochanteric bursitis is hip pain caused by inflammation of the fluid-filled sac, or bursa, on the outer edge of your hip. Bursitis is the leading cause of hip pain. Trochanteric bursitis affects the outer point of the thighbone, the femur, at the edge of the hip. This bony point is called the greater trochanter. Another bursa called the iliopsoas bursa is on the inside of the hip. Inflammation of the iliopsoas bursa causes pain in the groin.Repetitive activities like climbing stairs or surgery to the hip can cause the bursa to become inflamed. Many doctors now call trochanteric bursitis “greater trochanteric pain syndrome.”
The main symptom of trochanteric bursitis is pain in the outer part of the hip. You may feel soreness when you press on the outside of your hip or lie on that side. The hip pain will get worse with activities such as walking or climbing stairs. Pain can also spread, or radiate, down your thigh.
Osteoarthritis is a degenerative type of arthritis that occurs most often in people 50 years of age and older, though it may occur in younger people, too.
In osteoarthritis, the cartilage in the hip joint gradually wears away over time. As the cartilage wears away, it becomes frayed and rough, and the protective joint space between the bones decreases. This can result in bone rubbing on bone. To make up for the lost cartilage, the damaged bones may start to grow outward and form bone spurs (osteophytes). Osteoarthritis develops slowly and the pain it causes worsens over time.
Osteoarthritis has no single specific cause, but there are certain factors that may make you more likely to develop the disease, including:
- Increasing age
- Family history of osteoarthritis
- Previous injury to the hip joint
You can still develop osteoarthritis even if you don’t have any of the risk factors listed above.
The most common symptom of hip osteoarthritis is pain. This hip pain develops slowly and worsens over time, although sudden onset is also possible. Pain and stiffness may be worse in the morning, or after sitting or resting for a while. Over time, painful symptoms may occur more frequently, including during rest or at night. Additional symptoms may include:
- Pain in your groin or thigh that radiates to your buttocks or your knee
- Pain that flares up with vigorous activity
- Stiffness in the hip joint that makes it difficult to walk or bend
- “Locking” or “sticking” of the joint, and a grinding noise (crepitus) during movement caused by loose fragments of cartilage and other tissue interfering with the smooth motion of the hip
- Decreased range of motion in the hip that affects the ability to walk and may cause a limp
- Increased joint pain with rainy weather
3D CT scan of the hip with osteoarthritis
Comparative image of a normal bursa and an inflamed bursa (bursitis)
How can we help you?
At Regenecare Pain Clinic we aim to improve the quality of life of our patients, freeing them from the pain that afflicts them and preventing future complications. We base our treatments on Regenerative Medicine, but we also carry out the rest of the conventional treatments according to the needs of each of our patients for the management of their pain. We have developed a comprehensive method of care for our patients, based on wellness goals, with close monitoring and always seeing the patient as a whole and not just as a disease.
We seek to avoid or at least delay surgeries since we have evidence and experience that our treatments give excellent results.
Regenerative therapy is an alternative treatment option for Hip pain patients. Minimally invasive procedures like stem cell and platelet-rich plasma therapies involve an outpatient procedure performed under local anesthesia in our clinic, using the patient’s own adult stem cells or patient´s own blood (PRP) to help the hip heal.
Stem cells are found throughout the body and have the potential to become any type of cell, including those found in cartilage. They can help the body regenerate tissue by stimulating healing and reducing the painful effects of osteoarthritis. And furthermore, researchers believe adult stem cells can repair and replace cartilage as well as other tissue damaged by arthritis. In the same way, this treatment prolongs the longevity of the joint.
Stromal Vascular Fraction Extraction for Stem Cells separation
Platelet Rich Plasma (PRP)
The human blood contains red and white bloods cells, platelets and plasma. PRP refers to blood plasma that contains a large concentration of platelets. Platelets contain the necessary bioactive proteins and growth factors to repair and regenerate human tissue. PRP injections produce regeneration and repair of damaged tissues. At Regenecare Pain Management Clinic we obtain great results of pain relief and improvement of function with our PRP treatment protocol.
Platelets agglutinate on damaged tissue to repair it, in addition, they produce the chemoattraction of other repair and growth factors that allow damaged tissue to heal.
Steroids are powerful anti-inflammatories that, when injected directly into the pain site, greatly reduce inflammation and thus pain. In the particular case of the hip, steroid injections fulfill a diagnostic function and a therapeutic function. This means that the injection, in addition to treating the pain, allows us to identify if the pain really comes from the hip since hip pain can sometimes be referred and come from another anatomical site. Steroid injections generally help relieve pain and swelling and make movement easier. The benefits can last for several months and the side effects are minimal with proper administration.
All Injections are performed under ultrasound guidance
Hip replacement surgery is usually necessary when the hip joint is worn or damaged so that your mobility is reduced and you are in pain even while resting. During hip replacement, a surgeon removes the damaged sections of your hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function. Osteoarthritic damage is the most common reason to need hip replacement.
Some patients still have limitations after total hip surgery in activities like walking, climbing steps and getting in and out of a car.
Seven percent of patients with moderate limitations and 20% of patients with severe limitations before their first surgery still had severe limitations, after five years.
Among those having revision surgery or a second hip replacement, 13% had moderate limitations and 30% with severe limitations reported severe limitations after five years – So 70% were doing well.
At Regenecare our objective is the comprehensive well-being of our patients, therefore, although we base our treatments on Regenerative Medicine and consider surgery the last of our therapeutic options, we have the orthopaedic surgery department that, if necessary, will offer the best surgical option for our patients.
At Regenecare we see surgery as an excellent therapeutic option, as long as it is strictly necessary and we have previously exhausted all conservative alternatives.
Role of Regenerative Therapies
Any treatment or procedure’s success should be based on a patient’s needs rather than merely figures and statistics. Hip replacement surgery has proven successful for many aged between 60-80 years old, but…
What about those at that age but are still reasonably active?
What about the young who still want to walk, compete, and go to the gym?
What about those who are not fit for surgery or who don’t want it?
Regenerative Treatments (stem cell therapy and PRP therapy) offer patients another option, widening the spectrum of choice with no risks or side effects. Regenerative Hip Treatments may be able to provide pain relief for many of those unhappy to go ahead with surgery.
Autologous Hip Stem Cell Treatment for Hip Osteoarthritis is a minimally invasive procedure. Adult Stem Cells are taken from your body and injected into the Hip under a local anaesthetic.
Once injected into your HIP, the Stem Cells initiate a healing process that is assisted with a platelet-rich plasma concentrate (PRP) extracted from your blood. Your PRP is rich in growth factors that allow the stem cells to thrive and self-repair tissue and has an instant anti-inflammatory effect.
Stem Cell Therapy provides a Walk-in Walk-out clinic-based treatment with very low-risk involved, avoiding hospitalisation, the general risk of surgery and offering another alternative to hip replacement when possible.
Am I a good candidate for Regenerative Treatments?