Hip Pain Treatment Option Prolotherapy
Danielle R. Steilen, MMS, PA-C
Chronic hip pain is a common condition typically resulting in hip replacement surgery. The high rates of wear and tear, attributable to normal use of an artificial hip, can result in long term problems for the patient. 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.
Not everyone who is a candidate for a new hip will choose this option, as the operation has inherent risks including poor outcome, osteolysis and need for revision, deep vein thrombosis and limited life span.
Because of the limited response of chronic hip pain to other traditional therapies, many people are turning to alternative therapies, including Prolotherapy, for pain control.
Prolotherapy is becoming a widespread form of pain management in both complementary and allopathic medicine.
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.
A unique characteristic of Caring Medical is that our medical staff looks beyond the obvious to treat the true origin of pain. Unlike the traditional orthopedists or sports medicine doctors, our doctors don’t rely on cortisone shot or solely on physical therapy, and we certainly don’t rush to surgery as hip pain treatments! Our Prolotherapists perform a thorough physical examination of the painful and injured joint and listen to the patient’s history to determine the cause of the patient’s pain.
Prolotherapy: A successful alternative to hip replacement surgery
Prolotherapy offers hope to these 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.
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.
The experienced Prolotherapist will take a good history, perform a thorough examination, and ask particular questions regarding the location of the hip pain and the mobility of the hip joint. This information can provide the Prolotherapist with valuable information about the source and nature of the hip pain.
For instance, is the pain inside the hip, or in the groin? Is the pain outside of the hip, at the upper thigh, or is it located at the buttock? How does the person with hip pain walk? And what is the mobility of the hip joint in question? An experienced Prolotherapist will be able to tell you the type and frequency of treatments that are recommended to resolve your hip pain.
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.
Hip pain kept 31-year-old patient from his active lifestyle
A recent patient, Ethan, is an example of Caring Medical’s approach to chronic pain. An active 31-year-old man, Ethan worked as a manager in the recycling business and stayed active with running, stretching and practicing Judo. Unfortunately his hip pain was preventing him from running like he desired. Even worse, his Judo workouts led to a level of hip pain that caused him to limp for a few hours or days following the workout. He had previously visited an orthopedist for hip pain treatments, but who ordered an X-ray. He was told that the X-ray revealed early osteoarthritis. Not knowing where to turn, Ethan learned to live with the pain in hopes it would improve. Finally someone at his Judo club referred him to Caring Medical for Prolotherapy hip pain treatments.
Prolotherapy Hip Pain Treatments
Upon physical examination at his first visit, we determined that Ethan was a good Prolotherapy candidate. We confirmed Ethan’s early onset of osteoarthritis but explained that Prolotherapy can reverse the osteoarthritic process by rebuilding cartilage and strengthening the joint. Ethan received 68 injections of dextrose Prolotherapy in his hip. He was instructed to discontinue the use of Advil (anti-inflammatory medication) as it inhibits healing. Ethan was instructed to work on strengthening and rebuilding by using a BOSU ball, engaging in one-legged standing, and taking Prolotherapy supplements.
Two months later Ethan returned and reported a 25% improvement following his hip pain treatments. Both his pain and function were improved. He received the same treatment at his next visit, this time with human growth hormone added to the dextrose solution. Two months after this treatment he returned and reported a 40% improvement. He was able to exercise more but reported some stiffness and occasional pain with exercise or heavy impact activities. Although Ethan thought this might be his third and final treatment, we were suspicious of the stiffness.
Upon examination at this third visit, we noted that Ethan’s range of motion had not improved as much as he would have liked. We ordered an X-ray for Ethan to rule out a bone spur. If a bone spur was present, it could be the cause of the limited range of motion. Bone spurs occur when the joint is loose. The best analogy for this is your kitchen cabinets. If the two adjacent cabinet doors are hitting, you would not sand down the doors, you would fix the hinge! Prolotherapy is the way to fix the hinge (joint) to prevent the bones from abnormally rubbing and creating or worsening the bone spurs. When bone spurs are found on X-ray, we look to correct the reason they formed in the first place: joint instability. The way to correct this is with Prolotherapy.
Ethan’s third treatment included the same dextrose Prolotherapy injections with human growth hormone. Ethan is now back to performing all of the sports and activities that he loves to do!
Caring Medical’s success in treating chronic pain
As demonstrated with Ethan’s case, our Prolotherapists don’t rush to the typical pain treatments, and they also think beyond the treatment they perform best and most often – Prolotherapy, when needed. When a patient needs something above and beyond Prolotherapy, our staff is skilled at determining what those hip pain treatments might be including Stem Cell Prolotherapy, or Platelet Rich Plasma Therapy.