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Patient of the Month: a Woman With Non-Arthritic Hip Pain

Older couple smiling outdoors. This month we’re highlighting a 60-year-old female who came to Woodbury Chiropractic Center complaining of pain on the outside of her right hip with occasional popping. The patient has had this condition on and off for about two years. She has experienced increased pain during her daily walks and also has increased pain sleeping on her right side.

Upon examination by our physical therapist Maureen Munson, we found that her hip range of motion and strength were within normal limits. Tenderness was complained of with palpation on the lateral part of the hip. The patient complained of increased pain when she lifted her right leg in the side-lying position.

Past Treatment Yielded Only Temporary Relief

In the past, she had treatment with steroid injection, anti-inflammatory meds and physical therapy, but the pain relief was temporary. The woman was diagnosed with trochanteric bursitis which is an inflammation of the hip bursa where the gluteus medius muscle inserts into the bone.

The questions was, “Why would the pain return?” Upon X-ray, there was no arthritis, but there was a bone spur where the tendon inserts into the bone. The bone spur was probably irritating the tendon and causing persistent inflammation. With this case, an MRI was recommended to see if any tears were in the tendon from the bone spurs.

Physical Therapy Modalities

Ordinarily physical therapy will concentrate on using modalities to decrease the inflammation and exercises that would moderately activate the gluteus medius muscle to strengthen without irritating the tendon. In this patient’s case, she experienced significant improvement with conservative care.

Please note that not all patients can improve by using the same exercises. Every patient is different, of course, and results of care will vary.

Today we have talked about one cause of non-arthritic hip pain. In the following months, we will review other types of non-arthritic hip pain which include FAI or femoroacetabulor impingement, acetabular labral tears and structural instability pathologies. Stay tuned!

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