The hip joint is a ball-and-socket synovial joint: the ball is the femoral head, and the socket is the acetabulum. The hip joint is the articulation of the pelvis with the femur, which connects the axial skeleton with the lower extremity.
Knee pain refers to any type of pain or discomfort in your hips which can be also caused by causes outside the hip itself.
Knee pain can also be accompanied by black-and-blue mark, burning, feeling of instability, Joint deformity, Stiffness or swelling & giveaway.
Knee pain is very inconvenient as the knee is responsible for carrying nearly the whole-body weight. Whenever there is pain in the knee, it is very difficult and sometimes impossible for the patient to even walk normally. Knee pain can be felt on the inside of the knee, the outside, or along the patellar tendon.
The pain felt by the patient could be mild, moderate or severe, depending on the cause of pain. Mild pain can be treated at home with some rest and above the counter pain killers or anti-inflammatory medications. On the other hand, moderate to severe ankle pain may take a lot of time to resolve particularly if an injury was the cause of pain.
Hip pain can be caused by one or more disorder; these include:
1.Hip Arthritis:
Arthritis is a general term for a group of more than 100 diseases. When it affects the HIP joint it can produce swelling and pain, and may eventually result loss of joint function, and decreased ability to walk.
Osteoarthritis is considered a “wear and tear” disease because the cartilage in the joint wears down with repeated stress and use over time. As the cartilage deteriorates and gets thinner, the bones lose their protective covering and eventually may rub together, causing pain and inflammation of the joint.
Sometimes osteoarthritis develops as a result of abnormal leg mechanics causes less stability in the ligaments, resulting in excessive strain on the joints, which can cause arthritis.
Similar symptoms may be caused by another form of arthritis, rheumatoid arthritis.
-Rheumatoid Arthritis: Patients having this condition are more susceptible to developing hip arthritis as the rheumatoid causes joint inflammation and cartilage damage. This disease is often associated with pain and a numbing or tingling sensation in the knee joint.
2.Trochanteric bursitis
Inflammation and swelling of the fluid-filled sac over the lateral aspect of the hip joint. This causes pain in the hip when inflamed. This is a common cause of hip pain.
Less commonly, hip pain may be caused by:
- femoroacetabular impingement: caused by the bones of the hip rubbing together because have an abnormal shape
- hip dysplasia – where the hip joint socket has a wrong shape since birth.
- A hip fracture – this will cause sudden hip pain and is more seen in older population.
- an infection in the bone or joint.
- reduced blood flow to the hip joint, causing the bone to break down and eventually arthritis.
1.Medication:
-Using anti inflammatory medications which provides varying results from one patient to the other and typically gives short term relief and is ineffective with others.
2.Physiotherapy:
-Performing some physiotherapy exercises with a specialist. This may provide a relief of pain after many sessions. This could be ineffective and some patients do not prefer this type of long course treatment.
3.Pain Killers and Exercise:
-This approach relies on using painkillers combined with stretching exercises and waiting for the pain to improve. This may show an effect within 1 to 6 months.
4.Surgical Intervention:
-When Is Surgery Needed?
When osteoarthritis has progressed substantially or failed to improve with non-surgical treatment, surgery may be recommended. In advanced cases, surgery may be the only option. The goal of surgery is to decrease pain and improve function.
-Some patients resort to surgery to end the severe pain. This approach has varying results according to the cause and severity of the pain and carries the common risks associated with any surgery or undergoing general anesthesia.
-Some types of fractures
5.Localized pain management injection without image guidance:
-This technique relies on injecting certain medication to the pain area at a doctor’s clinic (not radiologist) to relieve the pain. This approach may result in many complications due to the fact that the doctor can’t see where he injected the medication, so he may inject the wrong spot without any benefit and sometimes-even causes even more pain and discomfort to the patient. Statistic accurate localization of painful spot is about 10-30%.
6.Localized pain management injection with ultrasound guidance (our preferred method of administrating the medication):
-This is a modern, advanced, non-surgical treatment technique that relies on injecting specific medication accurately into the area of inflammation under ultrasound guidance. Using an accurate, effective, safe and non-invasive technique, make us achieve better results in terms of pain relief/management. Statistic accuracy rate is about 95-99%.
This technique uses FDA approved medication, which is injected, directly into the pain area under ultrasound guidance. This technique has the following benefits:
-Helps the radiologist to accurately identify the inflamed tendon or bursa, which is important to confirm the clinical examination.
-Allows the radiologist to accurately localize and effectively administer the medicine to one or more compartments of the painful area “if necessary” resulting in better and faster pain relief.
-The patient benefits the most by having the medication in the right spot without pain or complications.
-The patient is injected a numbing local anesthetic. A mild burning sensation can be felt due to the numbing anesthetic.
-The radiologist then uses an ultrasound probe to guide the needle to the painful area.
-The medication is then injected in the exact location.
-The injection needle is then removed.
-The patient can leave immediately after the injection. Some patients may be asked to wait for re assessment.
-After the procedure the patient may experience complete relief of pain.
-The maximum effect of the medications may take up to 2 weeks to show the maximum effect.
-The patient is instructed to use painkillers during the first few days if needed.
Different patients respond differently to the same. So one may have a total relief and others may have residual pain and would benefit from another injection.
Most patients report the following after the procedure:
-A great reduction or total elimination of the pain for a period of several weeks after which they may need to have another injection to maintain the results.
-A great reduction or elimination of the pain for several months.
-A great reduction or elimination of pain for years after the procedure especially if complimented with physiotherapy.
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