Hip Pain
Richard Buttell
Richard Buttell, a 63 year old male, presented to our clinic with right hip pain. The pain started one year earlier. It got worse with walking and radiated down to his right knee and toes. He experienced occasional numbness and tingling in those same areas. He felt his legs were getting fatigued with walking. He was taking Percocet for pain. Due to the pain and fatigue, he needed assistance and started using crutches to ambulate.
Although the patient came presenting with hip pain, we found on examination that the pain was in his low back. An x-ray of his Right hip showed narrowing of the joint with some degenerative change. He also had pain with lateral abduction and hip flexion. There was tenderness around his right greater trochanter. In regards to his lower back, he had tenderness on the right iliolumbar ligaments, sacroiliac ligaments and the upper gluteal attachments on the pelvis. An MRI of his lumbar spine showed a 7mm bulge at L4-L5 with central canal narrowing, 2mm bulge at L3-L4, and a 5mm disc bulge at L2-L3.
We started him on Prolotherapy injections to his low back in the area of his right pelvis and right greater trochanteric bursa. After the first set of injections, he had immediate relief in his lower back and leg. There was still some pain but it was much improved. The following week after discontinuing the Percocet, we injected him again. He no longer needed to use crutches to get around. He was feeling 75% better and had no pain after his third week of treatment. There was no tenderness to palpation in his greater trochanter, iliolumbar ligaments, SI ligaments or gluteal area.
Michele Mastrodomenico
Michele is a 66 year old male who presented to Darrow Wellness Institute on 7/08/10. Michele had complaints of right knee pain for 25 years and left hip pain for 12 years. Michele could not relate his pain to any particular injury. His pain was aggravated by walking which made activities of daily living difficult and furthermore interfered with his daily weightlifting exercise program.
X-Ray Right Knee 6/11/2010
Minimal degenerative changes in right knee and vascular calcification.
X-Rays Right Hip 3/31/2009
Marked joint space narrowing and hypertrophic bone formation with considerable remodeling of the femoral head. Marked subchondral cyst formation of the femur and acetabulum consistent with severe degenerative change since comparison xray in 1998.
Michele decided to begin prolotherapy on his right knee only on 7/26/10. After his first injection he reported he noticed less swelling and after his second injection he reported less pain. After his third injection he noted that his knee did not feel as stiff and he noted much less grinding in the knee during walking. After Michele’s fourth injection he no longer felt it was necessary to wear his knee brace and began confidently walking without the support of the brace. He went on to have three more injections in the right knee for a total of seven injections over seven weeks before he was pain-free after living with right knee pain for 25 years.
Michele was so happy with the success of prolotherapy in his knee that he decided he wanted his hip to feel like his knee. Michele began prolotherapy on his hip on 9/9/10. After his first injection he noticed less pain in his hip. After his second injection he noticed increased range of motion and was able to get in and out of his car without difficulty. Michele went on to have 3 PRP injections in his hip with continued improvement in range of motion and less pain. He continues to be a patient at Darrow Sports and Wellness Institute.