June 20, 2012
Hip Pain Causes, Risks & Treatments
Dr. Jeffrey Cummings, Tahoe Fracture and Orthopedic Medical Clinic
Dr. Jeffrey Cummings with Tahoe Fracture and Orthopedic Medical Clinic specializes in arthroscopy and sports medicine. He took some time to answer questions about common causes of hip pain, diagnosis and treatment options.
What are some of the common causes of hip pain?
Some of the most common causes of hip pain that I see are bursitis, femoral acetabular impingement and arthritis.
Who is at risk of developing hip pain?
Unfortunately, we all have a risk of developing pain in our joins and this can occur without any specific injury or incident. It may present very gradually with symptoms of pain localized in the groin area, people sometime experience pain in the buttock area and occasionally pain may radiate down the thigh. Symptoms typically are made worse with prolonged walking or hiking or flexing and rotating the hip. Some may also experience a loss of range of motion or painful range of motion. If the pain is localized laterally on the hip and it is sore to press the bony prominence (the greater trochanter) it is most like bursitis. The other symptoms may be concerning for arthritis or impingement.
When is it appropriate to see a physician for hip pain?
If the hip pain has been constant and consistent it should not be ignored. The hip joint is made up of a round ball and socket. Hip impingement occurs when people lose the spherical shape of the hip and the ball becomes more egg shaped. The egg shaped bone does not move in the round socket as well and can cause damage to the cartilage of the hip and well as the labrum. Over time, if left uncorrected, it may lead to hip arthritis. Arthritis is the loss of the cartilage covering of the bones in the joint, so when the hip joint is trying to move, instead of a nice smooth surface of cartilage to glide against it becomes bone rubbing against bone. Diagnosis is made with physical exam, X-rays and MRI.
What are treatment options available for hip pain?
Usually, bursitis can be relieved with activity modification, physical therapy, stretching and occasional cortisone injections – surgery is rarely required.
Hip impingement also starts with activity modification, physical therapy and cortisone injections. If these fail and pain persists, one of the techniques available to treat hip pain is hip arthroscopy. A hip arthroscopy is an out-patient procedure where a small video camera attached to a fiber optic lens is inserted into the hip joint to allow a surgeon to see without making a large incision. While not as common as arthroscopy of the knee and shoulder, hip arthroscopy is now used to evaluate and treat orthopedic problems in the hip joint and the space outside the hip joint known as the greater trochanteric bursa. The goal of the surgery it to correct the egg shaped ball and make it round again and to remove any other bony prominences that may impinge the motion of the hip.
For advanced arthritis (bone on bone), treatment starts with activity modification, medications, cortisone injections and sometimes the use of a cane or walker. When these conservative treatments fail, and the hip has interfered with the patient lifestyle a total hip replacement maybe the best option.
If you are experiencing constant hip pain, it is best that you call your physician or schedule an appointment with Dr. Cummings.
Dr. Cummings is Board Certified with the American Academy of Orthopedic Surgeons.
June 7, 2012
Pain in the…Shoulder?
Pain in the shoulder can have several causes, can be temporary or can require further work up for diagnosis and treatment. Ignoring pain in any joint can lead to further damage. If you are experiencing pain in the shoulder it is important to contact your physician for diagnosis and treatment. Listed below are some common causes of shoulder pain.
Tendon inflammation
Bursitis: Sometimes, excessive use of the shoulder leads to inflammation and swelling of the bursa between the rotator cuff and part of the shoulder blade known as the acromion. The result is a condition known as subacromial bursitis. Bursitis often occurs in association with rotator cuff tendinitis.
Tendonitis: A tendon is a cord that connects muscle to bone. Most tendinitis is a result of a wearing down of the tendon that occurs slowly over time, much like the wearing process on the sole of a shoe that eventually splits from overuse. Tendinitis can be acute or chronic.
Tendon tears
Splitting and tearing of tendons may result from acute injury or degenerative changes in the tendons due to advancing age, long-term overuse and wear and tear, or a sudden injury. These tears may be partial or may completely split the tendon into two pieces. In most cases of complete tears, the tendon is pulled away from its attachment to the bone. Rotator cuff and biceps tendon injuries are among the most common of these injuries.
Instability
Shoulder instability occurs when the head of the upper arm bone is forced out of the shoulder socket. This can happen as a result of a sudden injury or from overuse. Shoulder dislocations can be partial, with the ball of the upper arm coming just partially out of the socket, versus a complete dislocation where the ball comes all the way out of the socket. Repeated episodes dislocations lead to an increased risk of developing arthritis in the joint.
Arthritis
The most common type of arthritis in the shoulder is Osteoarthritis. Symptoms, such as swelling, pain, and stiffness, typically begin during middle age. Osteoarthritis can be related to sports or work injuries and chronic wear and tear. It develops slowly and the pain it causes worsens over time. Other types of arthritis can be related to rotator cuff tears, infection, or an inflammation of the joint lining.
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