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Hip

HIP

Causes of Hip Pain

263x252Any source of inflammation may cause pain in the hip area, whether it be acute or chronic, and the most common causes of chronic hip pain are Arthritis, Bursitis, Muscle strain, and Nerve irritation.

The hip joint attaches the leg to the torso of the body. In the hip joint, the head of the thighbone (femur) swivels in a socket, called the acetabulum, that is made up of pelvic bones. While many causes of hip pain can arise from the joint itself, there are numerous structures surrounding the hip that can also be the source of pain.

Pain can arise from structures that are within the hip joint or from structures surrounding the hip. The hip joint is a potential space, meaning that there is a minimal amount of fluid inside it to allow the femoral head to glide in the socket of the acetabulum.

Any illness or injury that causes inflammation will cause this space to fill with fluid or blood, which stretches the hip capsule and results in pain.

The femoral head and the acetabulum are lined with articular cartilage that allows the bones to move within the joint with less friction. Also, the socket area of the acetabulum is covered with tough cartilage called the labrum. Just like any other joint cartilage, these areas can wear away or tear and become the source of pain. This condition is known as Arthritis and is the most common cause of hip pain.

There are thick bands of tissue that surround the hip joint, forming a capsule. These help maintain joint stability, especially with movement.

Movement at the hip joint is possible due to the muscles that surround the hip and their tendons that attach across the hip joint, allowing motion in different directions. Aside from controlling movement, these muscles act in concert to maintain joint stability. There are large bursas (closed fluid-filled sacs) that surround areas of the hip and allow the muscles and tendons to glide more easily over bony prominences. Any of these structures can become inflamed.

A tendon is a tough yet flexible band of fibrous tissue. The tendon is the structure in your body that connects your muscles to the bones. The skeletal muscles in your body are responsible for moving your bones, thus enabling you to walk, jump, lift, and move in many ways. When a muscle contracts it pulls on a bone to cause movements. The structure that transmits the force of the muscle contraction to the bone is called a tendon. Tendons come in many shapes and sizes. Some are very small, like the ones that cause movements of your fingers, and some are much larger, such as your Achilles tendon, in your heel.

When functioning normally, these tendons glide easily and smoothly as the muscle contracts. Sometimes the tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating. If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful. This is called Tendonitis, and literally means inflammation of the tendon. Tendonitis is most often an overuse injury. Often people begin a new activity or exercise that causes the tendon to become irritated. Tendon problems are most common in the 40-60 year old age range. Tendons are not as elastic and forgiving as in younger individuals, yet bodies are still exerting with the same force.

Pain from other sources can be referred to the hip, meaning that while the hip hurts, the problem may potentially originate elsewhere. For example, inflammation of the Sciatic Nerve as it arises from the spinal cord in the back can cause hip pain.

Sprains are due to ligament injuries, while strains occur because of damage to muscles and tendons. Because of the amount of force required to walk or jump, the hip joint is required to support many times the weight of the body. The muscles, bursas, and ligaments are designed to shield the joint from these forces. When these structures are inflamed, the hip cannot function and pain will occur.

Hip pain often arises from overuse injuries in which muscles, tendons, and ligaments can become inflamed. These injuries may be due to routine daily activities that may cause undue stress on the hip joint or because of one specific strenuous event. Overuse may also cause gradual wearing away of the cartilage in the hip joint, causing arthritis.

Another surrounding structure that can be involved with the development of hip pain is the Iliotibial Band, which stretches from the crest of the pelvis down the outside part of the thigh to the knee. This band of tissue may become inflamed and cause hip pain, knee pain, or both. This is a type of overuse injury that has a gradual onset associated with tightness of the muscle groups that surround the knee and hip. Piriformis Syndrome, in which the piriformis muscle irritates the sciatic nerve in the buttock, can also cause significant posterior hip pain.

The Trochanteric Bursa is a sac on the outside part of the hip that serves to protect muscles and tendons as they cross the greater trochanter (a bony prominence on the femur). Trochanteric Bursitis describes the inflammation of this bursa. The bursa may become inflamed for a variety of reasons, often due to minor trauma or overuse

“Traditional” Treatment Options

Despite its durability, the hip joint isn’t indestructible. With age and use, the cartilage can wear down or become damaged and the resultant arthritis can be overwhelming. The muscles, tendons, and surrounding structures in the hip can get overused and succumb to the chronic inflammation. Traditionally, Rest, Physical Therapy, Steroid Injections, Non-Steriodal Anti-inflammatory Drugs (NSAID’s), and Opiates have been the mainstay of treatment. And some of these can be very helpful–specifically rest and physical therapy can help and is always worth trying. However, often your body is overwhelmed by the degree of degeneration in the joint and/or the accompanying inflammation, and is not able to repair itself on its own.

The problem with some of these treatments (namely NSAID’s, Steriods, and Opiates) is that they often allow a quick return to the activities that caused the injury in the first place. This often leads to continued additional micro-trauma to the ligaments and tendons, and a chronic mechanical shearing (lateral sliding) on the joint surface, which will accelerate the loss of cartilage causing worsening arthritis.

Hip Replacement Surgery is often necessary when the hip joint has reached a point when painful symptoms can no longer be controlled with non-operative treatments. In a hip replacement procedure, your surgeon removes the damaged joint surface and replaces it with an artificial implant. This is the second most common joint replacement surgery after knee replacements. This is an option that should only be entertained as a last resort. There is no “turning back” once you’ve undergone one of these highly invasive procedures, especially if less than optimal results are achieved. It is a painful procedure that requires hospital stays ranging from 4–9 days, post-surgical complications can occur, and revisions are sometimes necessary. Next, there is a prolonged period of immobilization, followed by an extended period of rehabilitation. If and when pain is satisfactorily achieved, invariably you will never have the function or mobility that you used to experience, and you will have to give up many activities that you used to enjoy doing. This is why most people try to stave off having a hip replacement surgery performed for as long as possible, or try to avoid them altogether.

A Better Option is Available

Utah Stem Cells offers a much better treatment option than these “traditional” non-surgical and surgical treatment options. One common theme you will notice among all the causes of hip pain described above is the inflammation involved with these structures, which directly contributes to the pain. Utah Stem Cells specializes in an advanced form of Prolotherapy, called Stem Cell Prolotherapy, which is a relatively unfamiliar and under-utilized non-surgical treatment for musculoskeletal disorders.

This form of treatment combats this chronic inflammation by promoting a healing cascade directly targeted to the needed areas. Prolotherapy has been practiced for over 80 years by a small but growing group of physicians with excellent results.

Healthy ligaments and tendons are strong and tight, yet flexible enough to allow for proper joint movement and function. After an injury, the ligament or tendon will be compromised worn-out rubber band that has been left in the sun. The previous supple, flexible and strong tissue will become stiff, inflexible, weakened, and unable

to perform the function of keeping the joint in a bio-mechanically correct position throughout the range of motion.

Arthritic changes in joints were once thought to be irreversible, but now we can regenerate cartilage and other damaged tissue.

Ligaments and tendons are different from other tissues such as muscle and bone because they have a very limited supply of blood and oxygen. This means the key nutrients required to repair an injured ligament or tendon are usually not available to fully heal these tissues even after a minor injury. Prolotherapy (proliferative therapy) injections can repair the weakened sites and produce healthy new ligament and tendon tissue. This results in the strengthening and stabilization of the joint and permanent pain relief.

Prolotherapy stimulates the body to repair the painful injured area(s) when the body’s natural healing process is not able to do the job on its own. Prolotherapy is an accurate injection of a non-toxic substance into the injured tissue, which causes a temporary and purposeful therapeutic inflammation. The resultant inflammation initiates a beneficial healing cascade causing an increase in blood supply, growth factors, and stem cells. This eventually produces an increase in collagen that essentially grows stronger tissues and cartilage.