Hip pain

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   Our user asked: "Sudden onset of anterior hip pain 1/25. Leg movemt into the wrong positions (partly flexed & 20-50 degree abductn) caused pain of 9 / 10. Strictly positional for 8+ weeks w no relation to weight bearing. It oc'd standing, sitting, lying down. 1/27 Xray & cortisone injectn- no fracture & min pain decr. Best initial guess was inflamtn of psoas bursa. Didn't quite fit but nothing did. Tried otc nsaid for 6 wks, then got mri which showed large amt fluid in hip, some acetabular overgrowth & some labral damage in diff area, ? if tear or erosion. Had fluid drained 2x w cort injects, more xrays. Surgeon sd xray shows good joint space so unlikely I need hip replcmt. Fluid clean. Pain has increased, w freq tension&pain down front of thigh. No clicking, no RoM impairmt exc 4 pain. No stiffness or muscle weakness. Last sevl wks pain worse w almost any load bearing. Taking robax hydroco & nap.sodium to take edge off...7/10. I'm at 14 wks averaging 3 hr sleep/nt. Seems a mechanical probl, but now 3d dr has said he can't diagnose it, is sending me on for arthr surgery... w/o a diagnosis. Not if I can help it. Could phy therapist help? If so, what pos diag have these guys missed."

Ask a PT Response: "You mentioned MRI was positive for a labral tear. A labral tear can contribute to pain with hip range of motin and doesn't require weight bearing to elicit pain. MRI might not catch tears at all locations. Since you have been experiencing pain for so long and have tried conservative methods, a scope may give you a better idea of what is going on. Physical therapy could help if it truly is mechanical and not structural. Aquatic therapy along with open chain exercises along with stretching, manual therapy and modalities would most likely be included in the plan of care. I hope this helps and wish you the best of luck."

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Ask a PT Members Profile Send Private Message Find Members Posts Add to Buddy List Senior Member Joined: Jul 07 2008 Status: Offline Points: 954	Post Options Post Reply Quote Ask a PT Report Post Thanks(0) Quote Reply Topic: Hip pain Posted: May 02 2012 at 4:21pm
	Our user asked: "Sudden onset of anterior hip pain 1/25. Leg movemt into the wrong positions (partly flexed & 20-50 degree abductn) caused pain of 9 / 10. Strictly positional for 8+ weeks w no relation to weight bearing. It oc'd standing, sitting, lying down. 1/27 Xray & cortisone injectn- no fracture & min pain decr. Best initial guess was inflamtn of psoas bursa. Didn't quite fit but nothing did. Tried otc nsaid for 6 wks, then got mri which showed large amt fluid in hip, some acetabular overgrowth & some labral damage in diff area, ? if tear or erosion. Had fluid drained 2x w cort injects, more xrays. Surgeon sd xray shows good joint space so unlikely I need hip replcmt. Fluid clean. Pain has increased, w freq tension&pain down front of thigh. No clicking, no RoM impairmt exc 4 pain. No stiffness or muscle weakness. Last sevl wks pain worse w almost any load bearing. Taking robax hydroco & nap.sodium to take edge off...7/10. I'm at 14 wks averaging 3 hr sleep/nt. Seems a mechanical probl, but now 3d dr has said he can't diagnose it, is sending me on for arthr surgery... w/o a diagnosis. Not if I can help it. Could phy therapist help? If so, what pos diag have these guys missed." Ask a PT Response: "You mentioned MRI was positive for a labral tear. A labral tear can contribute to pain with hip range of motin and doesn't require weight bearing to elicit pain. MRI might not catch tears at all locations. Since you have been experiencing pain for so long and have tried conservative methods, a scope may give you a better idea of what is going on. Physical therapy could help if it truly is mechanical and not structural. Aquatic therapy along with open chain exercises along with stretching, manual therapy and modalities would most likely be included in the plan of care. I hope this helps and wish you the best of luck."

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