Chronic hip pain is a common condition typically resulting in many years of pain management. The goal of pain management is to prolong the eventual need for hip replacement until the patient is old enough that he/she will not outlive the prosthetic hip and require another replacement in older age.
Can chronic hip pain be cured without hip replacement? Many doctors say yes but it has to start with the accurate diagnosis.
In December 2016 research, radiologists at the Department of Radiology at Logan University published guidelines for understanding the complexities of making an accurate clinical diagnosis. Here is a summary:
- Musculoskeletal sources of adult hip pain can be divided into posterior (pain in the back), lateral (pain in the front), and anterior (pain in the front) categories.
- For posterior hip pain, doctors should look at the lumbar spine and femoroacetabular joint problems, sacroiliac joint, piriformis syndrome, and proximal hamstring tendinopathy.
- For lateral hip pain gluteus tendinopathy and iliotibial band thickening are the most common causes.
- Anterior hip pain is divided into causes that are intra-articular (inside the joint) such as labral tear, osteoarthritis, osteonecrosis and extra-articular, outside the joint snapping hip and inguinal disruption or groin pain-athletic pubalgia.
Clearly their conclusion expresses an accurate description of the challenges of hip pain:
“The evaluation of adult hip pain is challenging. Clinicians should consider posterior, lateral, and anterior sources of pain while keeping in mind that these may overlap.”1
Comprehensive Prolotherapy, PRP, and Stem Cells
Comprehensive Prolotherapy offers non-surgical hope to hip pain patients, as well as to those seeking an alternative to hip surgery or hip replacement. We have successfully treated patients who were told surgery was their only option.
In 2009, Caring Medical and Rehabilitation Services began publishing research on patients treated for hip pain. Published in the Journal of Prolotherapy, the CMRS team was able to document the following:
- Sixty-one patients, representing 94 hips (33 patients had both hips treated) who had been in pain an average of 63 months.
The patients were treated quarterly with dextrose Prolotherapy.
- This included a subset of 20 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of eight patients who were told by their doctor(s) that surgery was their only option.
Patients were contacted an average of 19 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms and activities of daily living, before and after their last Prolotherapy treatment.
- pain levels decreased from 7.0 to 2.4 after Prolotherapy;
- 89% experienced more than 50% of pain relief with Prolotherapy;
- more than 84% showed improvements in walking and exercise ability, anxiety, depression and overall disability;
- 54% were able to completely stop taking pain medications.
There are times when individuals do require hip surgery because the degeneration has progressed too far and to the point where repair is not achievable with Prolotherapy. This however is not the norm. Many people with hip pain have achieved wonderful results with Prolotherapy, resolving their hip pain and regaining their mobility.
When the hip joint is in motion, the ligaments and structures of the hip are subjected to tremendous forces, even with normal every day activities. Prolotherapy heals these structures that are damaged due to overuse, trauma, or wear and tear.
Comprehensive Prolotherapy to the hip involves multiple injections of dextrose-based solution to the affected ligament and tendon attachments around the hip, as well as solution injected inside the hip joint.
Prolotherapy stimulates a natural, local inflammatory response at the weakened structures, triggering the immune system to initiate repair at those sites. This mild inflammatory reaction dramatically increases blood flow to the injured hip joint, signaling the body to send reparative cells. This results in new collagen being laid down at the treated areas which then strengthens the ligaments and tightens and stabilizes the hip. Ligament treatment is explained here Treating hip instability – The ligaments of the hip.
Also see our article on greater trochanteric pain and bursitis
PRP and Stem Cell Prolotherapy
Despite the scientific rush to validate biomedicines (Stem Cell Therapy, Platelet Rich Plasma Therapy) the rates of total hip replacement (arthroplasty) will likely increase in the future.
In our article on degenerative hip disease treatments, we discusses new research and findings for the use of Platelet Rich Plasma and stem cell therapy for degenerative hip disease.
- New research says PRP injections offer a significant clinical improvement in patients with hip osteoarthritis
- In another new study – stem cells can help repair diseased bone.
There are times when individuals do require hip surgery because the degeneration has progressed too far and to the point where repair is not achievable with Prolotherapy. This however is not the norm. Many people with hip pain have achieved wonderful results with Prolotherapy, PRP, and stem cell injections resolving their hip pain and regaining their mobility.
1 Battaglia PJ, D’Angelo K, Kettner NW. Posterior, Lateral, and Anterior Hip Pain Due to Musculoskeletal Origin: A Narrative Literature Review of History, Physical Examination, and Diagnostic Imaging. J Chiropr Med. 2016 Dec;15(4):281-293. Epub 2016 Oct 21. [Pubmed]