Hip Pain
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 treatment 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).
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 mobilisation, 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.