Tendonitis/Bursitis
Tendonitis refers to inflammation of a tendon. Tendons are connective tissues that attach muscle to bone. Hip tendons work hard with every step. They work hard during ordinary daily tasks like sitting, turning, and getting into a car. These tendons suffer microscopic tearing during regular activities. When we are young these minor injuries rapidly heal with natural healing that doesn’t require assistance. As we age the ability for these injuries to completely heal on their own is impaired by age related changes in circulation in the tiny blood vessels that nourish the tendon.
When these tendons become inflamed the pain is often associated with discomfort that is felt as an ache deep in the hip. Often one can press firmly about the hip and reproduce the pain.
Bursitis, inflammation of a bursa, can cause pain that is very similar to tendonitis of the hip. A bursa is a slippery, slimy, fluid-filled sac that serves an important purpose of lubricating movements of hip muscles and tendons.
Hip bursitis and tendonitis can be tough to accurately diagnose since sacroiliac disorders, disc problems in the lower back, and arthritis of the hip can cause similar pain.
The correct diagnosis of tendonitis or bursitis is made by a doctor. Dr Jernigan will carefully listen to the patient’s description of their symptoms and conduct a physical exam of the lower extremities and spine. X-rays are usually helpful. Sometimes advanced imaging like MRI is appropriate.
Patients with this diagnosis are typically bothered enough that they want relief.
Most have already tried:
- Rest and passage of time
- Activity modification
- Over the counter anti-inflammatory medicines such as Aleve or Ibuprofen
I find that hip tendonitis pain can be helped by injection.
Injection of the bursa that is superficial to the trochanteric prominence of the hip with cortisone is sometimes a good treatment.
Resistant cases that have been diagnosed as “bursitis” are sometimes suffering from gluteus medius tendonitis. This condition will not respond favorably to a bursa injection. This form of tendonitis often responds to injection of the tendon. I use ultrasound guidance and a specially equipped procedure room to do this.
Platelet rich plasma treatment has the potential to accelerate a stalled natural healing response and can result in natural healing of a partial tear that has failed to heal for months or years. It is my strong opinion that platelet rich plasma treatment, if properly targeted by a proficient physician using ultrasound guidance to properly target the correct area, can result in resolution of partial gluteus medius tendon tears that cause symptoms.