Hip pain is a common issue that can result from a variety of causes, including injury, age-related wear and tear, or underlying health conditions. For those residing in Delhi, there are numerous options available for effective hip pain treatment. In this post, we will provide essential information about Hip Pain Treatment in Delhi.
Introduction:
Hip pain is a common condition and can be quite disabling because of the impact on walking. Pain may be localised to the front, side or back of the hip joint. Common cause for anterior hip pain is joint problems such as arthritis, that on the outer side of hip is greater trochanteric pain syndrome. Whereas posterior hip pain may arise from multiple sources such as sacroiliac joint, lumbar spine, piriformis muscle etc. It is important to evaluate lumbar spine as spine pathology commonly coexists and can be responsible for producing/ exacerbating hip pain.
When it comes to managing hip arthritis pain, there is a large lacuna in the hip pain treatment in delhi options as medications often offer limited relief or are limited by side effects and surgery is not always the answer as many are unwilling or unfit to have one. Some in their 40s and 50s are considered to be too young to undergo a joint replacement. Besides 5 to 15% of patients have persisting pain even after having a hip replacement. New treatment options including radiofrequency ablation, cooled radiofrequency and cryoablation offer a ray of hope for hip arthritis patients not keen on surgery. Although these options have been used most often for arthritis pain, they work equally well for other hip joint pain conditions such as avascular necrosis (AVN).
Common minimally invasive non-surgical interventions offered in pain clinic for hip pain include
Ultrasound guided Hip joint injection
Hip joint is one of the common joints to be affected by osteoarthritis (OA). As this joint has a significant role in mobilization, pain and reduced range of hip movement can adversely affect daily activities, quality of life. Simple activities such as wearing shoes and socks can become a challenge.
Conservative treatment of hip osteoarthritis includes weight management, painkillers, activity modification and physical therapy. Injections can be used for diagnostic and therapeutic purposes. Diagnostic injections can help in differentiating hip pain from pain originating from other sources.
Steroid injections are the most commonly used injection option. As hip joint is a deep joint it is recommended that these injections are performed using ultrasound or x-ray guidance as a day case or outpatient procedure. Ultrasound guidance is preferred as it can be easily performed in the clinic and does not involve radiation exposure.
Ultrasound helps to improve accuracy and reduce chances of complications. Most often a mixture of local anaesthetic and steroid is used for the injection. Local anaesthetics help to relax the muscle and steroids aid in reducing inflammation thus prolonging the effect of the injection.
Injection for Trochanteric bursitis, gluteal muscle tendinosis
Trochanteric bursitis presents as pain on the outer side of the hip. It has been renamed as Greater Trochanteric Pain Syndrome (GTPS) as it represents a number of conditions with similar presentation, including muscle tears, tendon problems, bursitis and trigger points. On the outer side of hip is present the greater trochanter (bony edge on the top of the thigh bone where the buttock muscles attach) and many bursae to prevent friction.
GTPS is more common in middle aged or elderly women and in athletes involved in prolonged running. Trauma, repetitive stress, leg length discrepancies and weak hip muscles are predisposing factors. It presents as pain on the outer side of hip which can radiate towards the knee. Lying on the affected side is uncomfortable.
Conservative management involves avoidance of aggravating activities, ice, weight management, painkillers and physiotherapy. I consider injections if the conservative management fails to produce desired results. Local anaesthetic and steroid injection can help break the pain cycle and facilitate physical therapy. The injection is performed under ultrasound guidance to ensure delivery of medication at the correct site.
Injection for Iliopsoas tendinitis, bursitis
The iliopsoas is made up of two separate muscles: the iliacus and the psoas. These span from the spine and pelvis to the upper part of the thigh bone and play an important role in maintaining upright posture, lifting the leg. Iliopsoas tendinitis or bursitis presents with hip or groin pain which can radiate towards the thigh. The pain tends to be worse with activities involving flexion of hip such as while walking, climbing stairs and wearing shoes. Injuries, overuse, previous hip replacement can predispose to development of this condition. In some cases, an audible clicking/ snapping sound originating can be heard.
Injections are considered if the conservative therapy fails to achieve the desired goals. The procedure involves injecting a mixture of local anaesthetics and steroid under ultrasound guidance.
Lateral cutaneous nerve of thigh block & radiofrequency treatment
Lateral cutaneous nerve of thigh supplies sensation to the front and side of the thigh. Injury, compression or entrapment of the nerve can lead to numbness, altered sensation and pain in the area innervated by the nerve. Recent weight gain or loss, tight belts and clothes are predisposing factors. Common site of compression of the nerve is as it enters the thigh travelling in close relation to one of the thigh ligaments. The nerve can be identified with the help of ultrasound and a guided injection can help to relieve the pain. Pulsed radiofrequency treatment is sometimes utilised to prolong the effects.
NEWER TREATMETNS FOR HIP JOINT PAIN
New treatment options include radiofrequency ablation, cooled radiofrequency and cryoablation. The primary aim of these treatments is the interruption or reduction of the pain signals travelling from the hip joint to the brain. This is achieved by deactivating or stunning the nerves responsible for transmitting the pain signals from the hip joint. The method used for achieving deactivation is where these treatments differ.
These options can be considered for anyone with hip joint pain who has not responded well to non-surgical or surgical options. Typical indications include someone who
· Is not fit for hip replacement
· Doesn’t want to have surgery or is old and doesn’t want to go through extensive recovery and rehabilitation
· Is young and wants to delay the surgery as worries about wearing out of hip joint and need for repeat surgery are not unfounded
· Has persisting pain after hip replacement surgery
· Has chronic hip pain with inadequate response to other treatment options
All the above-mentioned treatment options share some common advantages such as
· Minimally invasive pain management options for those not keen on surgery
· Safe procedures without the increased risk of complications
· Can provide quick, lasting pain relief
· Less pain can translate into improve functional ability and reduced painkiller requirements, disability
· Day care procedure with no requirement for overnight hospital stay
· No cuts or incisions involved in the procedure
· No requirement for general anaesthesia
· Quick return to routine activities with no downtime and no requirement of prolonged rehabilitation
Diagnostic test injections are often performed prior to the radiofrequency procedure. This involves using small amount of local anaesthetic to numb the nerves in order to gauge the chances of success of the subsequent treatment. 50% or more reduction in pain after the test injection is considered a positive response and an indication to proceed with the treatment.
Dr. Amod Manocha is the best Pain Specialist Doctor in Delhi. Pain specialists, also known as pain management physicians or pain medicine doctors, are medical professionals who specialize in the diagnosis and treatment of acute and chronic pain conditions. These specialists possess comprehensive knowledge of the complex mechanisms of pain and utilize a multidisciplinary approach to address pain from various angles.
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