Why Does Your Front / Side Hip Hurt When You Sleep at Night?

A common complaint among many people is experiencing pain at nighttime when sleeping on one side or the other. To figure out what's causing this, there are a couple of things you need to do.

The first step is to differentiate between pain on the side of the hip (lateral hip) versus pain in the front of the hip. Pain in the front of the hip is more commonly associated with the hip joint, the labrum, or the hip flexor tendon. Although sometimes it can cause pain on the side of the hip when sleeping, it usually presents differently.

Several classic issues can cause pain on the side of the hip:

1. SI Joint or Ligament Issues: The sacroiliac (SI) joint connects the pelvis to the hip and is a key stabilizing joint. Pain here can radiate to the lower back, side of the hip, and down the leg. SI joint ligament strains or laxity, often from injuries or activities, can also cause pain.

2. Tendonitis or Bursitis: Tendons like the gluteus medius and minimus insert on the side of the hip. Weak hip muscles can overstrain these tendons, causing tendonitis. Direct contact can aggravate the tendons, leading to pain. The bursa, a small fluid sac on the side of the bone, can get irritated, causing bursitis.

3. Pinched Nerve: Chronic lower back pain or arthritis can pinch a nerve at the L3 or L4 level, causing pain on the side of the hip.

4. Other Soft Tissue Irritations: Muscles like the piriformis or hip ligaments strains can also cause side hip pain.

To determine the cause of hip pain, consider the following:

• Pain Location: Is the pain in the front or side of the hip?

• Examination: A physician can assess hip movement, tenderness, and neurologic findings to identify the cause.

• Imaging: X-rays can evaluate bones, while MRI scans are useful for soft tissues like tendons and ligaments or to check for pinched nerves.

Treatments depend on the cause. Common approaches include:

• Core and Hip Strengthening: Exercises to strengthen the core and hips can alleviate instability-related pain by reducing pressure on affected structures.

• Advanced Treatments: If conservative options fail, treatments like prolotherapy or platelet-rich plasma (PRP) can strengthen areas of instability and reduce pain.

To learn more: https://www.ChicagoArthritis.com

Can Rotator Cuff Injuries Get Better Without Surgery?

A common question that patients have is whether a rotator cuff injury can get better without surgery.

The rotator cuff is a group of muscles and tendons around the shoulder that provide strength and control. These four muscles start at the scapula and wrap around the shoulder, allowing a full range of motion, power, and stability. This incredible structure, however, is prone to injuries.

1. Tendinopathy: Mild injury with fraying and inflammation of the tendon.

2. Partial Thickness Tears: A small portion of the tendon is torn, but most of it remains intact.

3. Full Thickness Tears: The tendon is completely torn through. These can be:

   • Non-retracted Tears: The tendon edges are still close together.

   • Retracted Tears: The tendon ends are pulled apart.

No, not all rotator cuff injuries require surgery:

• Tendinopathy: Often treated with physical therapy or rest. Prolotherapy or PRP treatment may be considered if needed.

• Partial Thickness Tears: Most cases (about 80%) improve with physical therapy. If necessary, regenerative medicine treatments like platelet-rich plasma can be used.

• Full Thickness Tears:

• • Non-retracted Tears: Physical therapy can help 75% of people avoid surgery. Treatments with bone marrow-derived stem cells mixed with fat cells can be effective.

  • Retracted Tears: Surgery is often required. After surgical repair, there's a high risk of re-tearing (25-75%). Augmenting with bone marrow-derived stem cells can help strengthen the tendon and prevent recurrence.

Rotator cuff injuries can be very painful, but there are many conservative treatments available that can often work before considering surgery.

Who Should You Consult for Osteoarthritis? Discover the Specialists You Need to Know

In the vast landscape of osteoarthritis care, finding the right medical specialist can be difficult to navigate. But fear not! Read this blog and watch the video to illuminate the path forward.

Within the realm of medical specialties, rheumatologists stand out as experts in inflammatory arthritis, including osteoarthritis. Their arsenal includes injections to alleviate symptoms. Meanwhile, orthopedic surgeons excel in surgical interventions, making them the go-to for those requiring surgical solutions.

For those averse to surgery, non-surgical musculoskeletal experts offer a ray of hope. Physiatrists, sports medicine doctors, and interventional pain physicians specialize in rehabilitation and non-invasive treatments, such as injections guided by imaging technology.

Osteoarthritis isn't just about joints—it's about instability and weakened supportive tissues. Explore regenerative medicine, which utilizes your body's cells to strengthen damaged joints and surrounding tissues. This approach, encompassing techniques like prolotherapy and platelet-rich plasma injections, offers a promising alternative to traditional treatments.

In your quest for relief from osteoarthritis, seek a musculoskeletal expert who excels in non-surgical methods, demonstrates proficiency in image guidance, possesses a deep understanding of prolotherapy, and is well-versed in regenerative techniques. While any musculoskeletal expert may offer these services, a true regenerative medicine specialist embodies all these skills. By finding the right specialist, you pave the way to enhanced pain relief and improved function.