Hip Pain: a joint that often gets overlooked
The hip is a ball and socket joint which is very strong and stable. It is held together by a covering of strong muscles and allows weight bearing when we stand or walk.
The hip can be affected by degenerative changes and inflammation, with the pain often felt in the groin region or down the front of the leg. Despite these common and shared problems with the knee joint, treatment for hips is more limited.
Whilst there are some GP’s that will provide knee injections and day case surgery for knees; injections and surgical intervention for the hip joint are much more difficult to access. This is mainly due to the depth of the joint and the costs involved with guided injections performed in Theatre.
However, with appropriate diagnosis and modern ultrasound scans the hip joint does not need to be a poor relation to the knee.
Hip Pain & injections
There are two key areas that can benefit from injections; the Trochanteric Bursa and the joint capsule. The bursa is a fluid-filled sac near the part of the hip called the greater trochanter. When it becomes irritated or inflamed it can cause hip pain and many patients report difficulty in lying on their affected side. The capsule consists of dense, fibrous tissue and ligaments that connect the hip to the pelvis.
Both the trochanteric bursa and the capsular areas can be seen on ultrasound scans and allow for accurate guided needle placement. The worry of touching a nerve or deep vascular structure (blood vessel) is gone because they are clearly visible.
Secondly, hip injections are relatively painless. In the Journal of Arthroscopic Surgery 49 out of 50 patients preferred ultrasound guided injections over x-ray guided. Most people comment ‘is that it’. The worry of the injection is typically far worse than the injection itself!
Hip joints also have a large number of surrounding muscles and therefore with appropriate exercises, the mechanical stability of the joint can be improved. We often recommend that following an injection that you start a course of physiotherapy with us in order to address the strength and flexibility around the hip joint.
The key to all muscle and joint related problems remains the same: Improve the joint chemistry by decreasing inflammation or adding joint lubrication and then optimise the movement pattern and supporting muscle strength.
If you feel you may benefit from a clinical examination and ultrasound scan of your hip joint and surrounding tissues then please phone 01226 282560 to check on appointment availability. Alternatively for pricing and online booking please click “book now” on the home page of the website
What does shoulder pain look like?
Shoulder pain and ‘pain’ in general cannot be seen. What can be seen are changes to the tissues that make up our shoulder joints?
Common problems include shoulder bursitis, which is the inflammation of a fluid sac within your shoulder joint. This can easily be seen on an ultrasound image. It is a common painful condition that responds very well to ultrasound-guided cortisone injections. To ensure accurate needle placement when the tissues are so small requires ultrasound guidance.
Rotator cuff tendon tear
Another common shoulder problem is a tear within the rotator cuff tendon. The rotator cuff muscles are a group of muscles and their tendons that provide both stability and strength to the shoulder joint. Injury can be through trauma or degenerative changes within the tendons. If a tear is identified on ultrasound scanning it may require surgical consideration and appropriate physiotherapy rehabilitation.
Acromioclavicular joint inflammation
A common and often overlooked problem is inflammation of the acromioclavicular joint (ACJ). The ACJ is a joint at the top of the shoulder between the acromion (part of the shoulder blade that forms the highest part of the shoulder) and the outer part of your collar bone (clavicle). Inflammation of the ACJ can cause swelling and pain in the top portion of the shoulder. It can be caused by trauma, degenerative changes or heavy, overhead use of the shoulder. An inflamed ACJ responds well to injection therapy and the ultrasound guidance ensures the successful placement of the steroid into the small space of the ACJ.
If your shoulder is painful then first establish a diagnosis and then select the right treatment for your problem. Again the majority of these conditions will require physiotherapy and rehabilitation following injection therapy to ensure optimal recovery.
For further information on ultrasound scans and injections please view our section on the website. Call us on 01226 282560 for further information or to book an appointment. Alternatively, use our “book now” button for online bookings and availability.