HIP PAIN TREATMENT WARWICKSHIRE

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ABOUT HIP PAIN TREATMENT

Ultrasound helps visualize the muscles, tendons, ligaments, bones, joints and soft tissue of the hip region.  Ultrasound uses nonionizing radiation hence deemed as safety equipment for any age group including pregnant women. 

Diagnostic Ultrasound around the HIP region is able to identify:

  • Early arthritis changes.
  • Muscle or tendon tears.
  • Joint effusion.
  • Bursitis
  • Extra-articular cysts.

What are the limitations of the diagnostic Ultrasound in the hip region?

Like any other joints in the body, ultrasound cannot penetrate the bones, joints of the hip, therefore Intraarticular problems cannot be visualized on an ultrasound scan. Internal structures of the joints require either an MRI or CT scan.

hip pain treatment warwickshire
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Musculoskeletal issues?

If you are experiencing painful joints, muscles, tendons or ligaments please get in touch for a diagnostic scan and or treatment

Hip Conditions that we can diagnose and treat at our clinics:

Hip joint arthritis

Hip joint arthritis is one of the most common joint arthritis in the UK. Ultrasound-guided steroid injection to the hip joint is carried out as a diagnostic injection to confirm or rule out the source of pain and therapeutic injection for symptomatic relief.

There are various types of injections used for Hip joint symptoms.

Steroid Injections:

Steroid injections are very successful in controlling the hip joint symptoms. If you respond to the steroids, you may experience pain relief from 2-3 months to 18months. This depends on the severity of the problem, lifestyle, and other factors.

There is a limit on how many steroid injections can be given to the hip joint In a year.

Viscosupplementation / hyaluronic acid injections / gel injections :

Hyaluronic acid injections are particularly injected for those who are too young to have an operation or needed repeated injections There is no limit on the number of hyaluronic acid injections given to the hip joint. These injections help to enhance joint lubrication and work as a shock absorber. Hence, controls the worsening of arthritis and delays the hip surgery/ joint replacement.

Platelet Rich Plasma (PRP) Injections :

Plasma injections promote the natural healing process of damaged tissue. Plasma injections contain different growth factors concentrated 6-10 in comparison to the whole blood of the same volume. Thus enhances the natural healing process of joint cartilage. Plasma injections are made from the patients own blood, hence there is no limit on how many injections can be given in a year. Usually, a course of 3 injections is recommended.

What happens in the OA hip?

  • Inflammation of the soft tissue around the joint.
  • Joint and cartilage Wear and tear.
  • This leads to extra bony growth, called spurs/osteophytes.

Symptoms:

  • Groin pain.
  • Joint Stiffness, especially after a period of rest and in the morning.
  • Joint pain. Pain is worse with weight-bearing activities, such as walking, running, jogging, swimming, climbing, and daily weight-bearing activities.
  • Some times may experience referred pain into the knee joint.
  • Often difficult to cope with hobbies, such as gardening, tennis, bowling, cricket, golf, walking, and jogging.

Advantages of Ultrasound (US) Guided HIP joint injection:

  • Cost-effective.
  • The hip joint is injected accurately.
  • Easily performed in an outpatient clinic.
  • Unlike fluoroscopy, ultrasound has no radiation risk.
  • Metal implants: This does not interfere with ultrasound waves.
  • If present, joint effusion can be aspirated at the same time as a hip injection.

Other Indications for Ultrasound-Guided Hip joint injection :

  • Femoro-acetabular impingement.
  • Para labral cysts.
  • Iliopsoas Bursitis.

Trochanteric  Bursititis

Bursitis

There several types of burse around the hip joint region. Among these Trochanteric bursae is the most common and Ischial bursa is another relatively common bursa. These are diagnosed and treated in joint care clinics.

Trochanteric Bursitis: 

Bursa is a fluid-filled sac and works as a shock absorber and lubricant for the movement of the tendons and muscles adjacent to it. Inflamed bursa causes pain, swelling, and difficulty in walking and carrying out other weight-bearing activities.

Bursitis is an inflammation of the bursa.

The trochanteric bursa is located at the trouser pocket level. If you are experiencing the pain on the outside of the hip at the pocket level and unable to lie on your side, it concludes the possibility of  ‘Trochanteric bursitis’.

Symptoms of Trochanteric Bursitis:

  • Pain over outside of the hip, thigh, and back of the hip.
  • Unable to lie on the side for any length of period.
  • Pain is often worse with activities, such as climbing stairs, getting up from a chair, getting out of the car.
  • Pain is worse when you palpate on the outer side of the hip at a pocket level.

What causes the Trochanteric Bursitis?

  • Weak hip muscles.
  • After a hip replacement.
  • After a knee replacement.
  • Fall: on to the side of the hip or
  • Overuse: long-standing job, walking, climbing.
  • Deposition of the calcifications in the gluteal tendons.
  • Tight ITB/TFL/Hamstring /quadriceps and other lower limb muscles.
  • H/o Inflammatory arthritis : Ex: Rheumatoid, psoriasis arthritis, Gout.
  • Poor posture: leg length difference, scoliosis, arthritis of the hip, lumbar spine, SI joint.

How to prevent recurring trochanteric bursitis following an ultrasound-guided injection:

Though the prevention of the bursitis is not always easy, the following steps prevent worsening of bursal inflammation:

  • Strengthen hip muscles.
  • Stretches to the leg muscles.
  • Avoid repetitive activities that strain the hip.
  • Correct the leg length differences, if noted.
  • Loose weight – in the case of overweight.

Ischial Bursitis

Bursitis

There several types of burse around the hip joint region. Among these Trochanteric bursae is the most common and Ischial bursa is another relatively common bursa. These are diagnosed and treated in joint care clinics.

It is an inflammation of the bursa, which is located over the ischium, part of the pelvic bone. The common complaint is the worsening of pain with sitting, especially on a hard surface.

Symptoms of Ischial Bursitis:

  • Worsening of pain with hamstring stretches.
  • While Climbing stairs.
  • Squatting
  • Karate, Martial arts, kickboxing,
  • Prolonged sitting.

How to prevent recurring ischial bursitis following an Ultrasound-guided injection:

Though the prevention of the bursitis is not always easy, the following steps prevent worsening of bursal inflammation:

  • Strengthen hip muscles.
  • Loose weight – in the case of overweight.
  • Prevent over-stretching of the hamstrings.
  • Avoid prolonged sitting, especially on hard surfaces.
  • Avoid repetitive activities that strain hamstring muscles.

Our in house clinical consultation combined with Diagnostic Ultrasound can detect bursitis problems. Also, a diagnostic ultrasound scan helps to detect tendon quality, possible tears, fluid accumulation, calcific deposits, bony spurs or collection of blood in case of a fall/ trauma to the side of the hip.

Ultrasound also helps to guide the needle to the trochanteric or ischial bursa, to inject steroid, plasma or hyaluronic acid /viscosupplementation accurately.  Ultrasound-guided injections are particularly useful for deeper and small structures.

 Why do I need an Ultrasound-guided injection?

  • If you need repeated injections.
  • Avoids accidental injection into the tendons.
  • Accurate injection offers prolonged pain relief.
  • The trochanteric/ischial bursa is a deep, thin structure In between the tendons, often difficult to inject accurately without guidance.
  • When landmark guided injection is failed to treat the symptoms. Ex, No relief from a landmark guided injection.

FREQUENTLY ASKED QUESTIONS ABOUT ULTRASOUND GUIDED INJECTIONS

How long does an ultrasound guided injection take?

This will vary dependant on the area and other factors, but an assessment, scan & ultrasound-guided injection will generally take around 60 minutes. Ultrasound guided injection alone is done in a few seconds. Injection alone is carried out in few seconds.

Are ultrasound guided injections painful?

Discomfort from the needle insertion can be minimised by using the local anaesthesia using a very fine small needle. Ram is an experienced and carried out more than 30,000 Ultrasound guided injections sofar. He routinely treats complex patients and patients with needle phobia, through the technique he developed through his experience.

What is an ultrasound guided cortisone / Steroid / Corticosteroid injection?

Cortisone injection is also known as Corticosteroid injection  or steroid injection. This is a strong anti-inflammatory medication is used for many of the inflammatory and arthritis conditions to control pain, swelling, stiffness and improve function. Corticosteroid injections are NOT the same used by body builders use. Corticosteroid injections do not cause weight gain.  To find out more please visit our ultrasound-guided steroid injections page from the 'Types of Guided injection' menu on the top.

Always, consider having the Steroid injections under ultrasound guidance for accuracy. 

What is an ultrasound guided hyaluronic acid (HA) injection?

HA injection is also known as Gel injection or Lubricant injection. This viscosupplementation injection is a natural component of synovial fluid. This tends to increase joint fluid viscosity and restores the joint lubrication. Hence, acts as a shock absorber to control the joint /tendon symptoms. Limits the further damage to the joint and delays or avoids the need for the surgery. Aslo, helps to enjoy your daily activities or your preferred hobbies. To find out more please visit our  GUIDED ULTRASOUND HYALURONIC ACID INJECTIONS page from the 'Types of Guided injection' menu on the top.

These injections are very popular, especially for knee joint pain. Any number of injections can be taken in a given period, due to minimal or no side effects from these injections. Usually a course of 3 Injections are preferred, though some may do well just with an injection per year 9 we have patients managing just with 1/year.

What is an ultrasound guided PRP injection?

Platelet Rich Plasma (PRP) injections are rich in growth factors ( helps in repairing the cell and its growth)  and prepared from the patient's own blood. Separated growth factors from the patients blood is injected back into the affected area of the same patient. Due to PRP's  ability to heal and even regenerate injured or aging tendons, ligaments and joints, providing some patients with an alternative to surgery. PRP therapy may reduce the required healing time for the injuries ( especially for sports injuries and early Arthritis ); otherwise athletes/ sports professionals may require longer periods of rest from their sports related activities.  To read more please visit our Ultrasound Guided PRP page.

 Always, consider having the PRP injections under ultrasound guidance for accuracy. 

can i drive after an injection

You will not be able to drive immediately after the procedure. Bring someone with you Or use other form of transport to return home. This is mainly due to your driving licence policy, rather injection efficacy. Majority of the motor insurance policies will not allow you to drive for 3-5 hours after the injection with Local Anesthesia.

What should i expect after an injection?

After the injection, you may feel pain-free for a couple of hours due to Local anaesthesia. However, pain returns after 2 hours, you may even feel more pain for a couple of days due to bruising pain. Usually, you should start feeling better from the third day onwards. Pain relief from the steroid injection may take 1 to 2 weeks.

 

 

How to manage bruising pain?

Discomfort from the needle insertion can be minimised by using an ice pack ( wrapped in a towel, to minimise the risk of frostbite from a direct skin contact) to the area of treatment. 3-4 times a day and 10-15 minutes at each time

 

Will i always feel 100% pain free?

We can accurately inject the treatment area. However, pain relief depends on several factors, such as severity of the problem, body response to the steroid injection, rest period following an injection,  rehabilitation and exposing to the risk factors.

how many injections can i receive?

corticosteroid Injections: 3 or 4 per treatment area/year.

Hyaluronic Acid: no limit as long as you are benefiting.

Platelet Rich Plasma (PRP) a course of 3, you can repeat as you like. 

 

What conditions can be treated?

Arthritis, Tendinopathies, Ligament, Muscle and Nerve related problems. We also offer trigger point injections for persistent pain ( usually a course of 2-5 are effective).

How long the injection effect lasts?

It is hard to determine without an assessment. It may be possible to estimate after assessing the patient. Usually, lasts up to 3 months. There are many patients who benefited for more than a year to 2 years.

AREAS COVERED FOR HIP PAIN TREATMENT

We cover a wide area throughout Warwickshire and surrounding counties, either by home visit or clinics in the following areas: Aylesbury, Rugby,  Coventry, Warwick, Milton Keynes,  Leamington Spa, Stratford upon Avon,  Leicester and Nuneaton. We have clinics throughout the West Midlands including Birmingham and Solihull. We also have a clinic in Newcastle covering the North East.

If you do not see your area listed please still get in touch as we may be able to refer you to another practitioner in your area.

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