Treatment for Hip Joint Pain

Acetabulo-femoral (Hip Joint) Capsulitis, Acute

History:

·         Night pain at hip joint, unresponsive to traditional physiotherapy.

·         Pain along buttocks.

·         On and off groin and / or anterior thigh pain.

Findings:

·         Limitation in ranges of motion is in capsular pattern:

o   limitation in medial rotation > flexion and abduction > extension.

·         Passive testing shows hard end-feel.

Intervention Done:

·         Local infiltration with 40mg triamcinolone plus 1% lidocaine, to complete 5 ml total volume, using a 23 guage 3.5 inch spinal needle.

Aftercare Instructions:

·         Limit weight-bearing x 2 weeks.

·         Surgery should be avoided for up to six weeks from date of intervention.

·         Repeat infiltrations may be attempted in three months.

·         Annual X-rays should be done, monitoring for degenerative changes.

Manual Medicine Interventions:

·         No hard “adjustments” or chiropractic intervention at this joint for at least two weeks, please.

·         Osteopathic and PT intervention:

o   Range-of motion pain-free activities may be started immediately, but should be graded, and may be gradually increased in frequency and end-range attempted. 

o   Stretching may be done, gradually encouraging further motion end-ranges. 

Excerpted, with copyright maintained by author, from:

Orthopedic Medicine Interventions Dissected

Sandro Strix S. Toledo, M.D., Dip. OMI