Back and Hip
PAIN SOLUTIONS

Hip pain is a common complaint that can be caused by a wide variety of problems. The precise location of your pain can provide valuable clues about the underlying cause. The hip joint is where the ball of the thigh bone (femur) connects to the pelvis at a socket called the acetabulum. There is cartilage covering both the bone of the femur and the acetabulum of the pelvis in the hip joint. Injuries to the cartilage either wear and tear or traumatic injuries can lead to pain. The labrum is soft cartilage that surrounds the hip joint and provides stability. Injuries to the labrum can be traumatic or degenerative and are common source of hip pain. The ligaments around the hip joint attach the femur bone to the bony pelvis. There are a number of muscles and tendons that glide around the hip joint. Tiny fluid-filled sacs, called bursae, provide gliding surfaces for muscles and tendons around the hip joint. Trauma or wear and tear injuries to the ligaments, tendons and bursae all can lead to pain, weakness, instability of the hip joint and more pain. Problems with the hip joint result in pain in the groin and upper thigh or outer buttock. Fortunately, hip injuries are particularly responsive to regenerative medicine therapies.

Hip pain is a common complaint that can be caused by a wide variety of problems. The precise location of your pain can provide valuable clues about the underlying cause. The hip joint is where the ball of the thigh bone (femur) connects to the pelvis at a socket called the acetabulum. There is cartilage covering both the bone of the femur and the acetabulum of the pelvis in the hip joint. Injuries to the cartilage either wear and tear or traumatic injuries can lead to pain. The labrum is soft cartilage that surrounds the hip joint and provides stability. Injuries to the labrum can be traumatic or degenerative and are common source of hip pain. The ligaments around the hip joint attach the femur bone to the bony pelvis. There are a number of muscles and tendons that glide around the hip joint. Tiny fluid-filled sacs, called bursae, provide gliding surfaces for muscles and tendons around the hip joint. Trauma or wear and tear injuries to the ligaments, tendons and bursae all can lead to pain, weakness, instability of the hip joint and more pain. Problems with the hip joint result in pain in the groin and upper thigh or outer buttock. Fortunately, hip injuries are particularly responsive to regenerative medicine therapies.

Common causes of hip pain include:

Osteoarthritis of the Hip
The hip is one of the largest joints in the body and prone to arthritis from degeneration, trauma or hip dysplasia. Common arthritic joint symptoms include pain, stiffness and decreased range of motion. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. It is important to treat it as early as possible.
Labral Tear
The labrum is a soft cartilage between the round femur bone and socket or acetabulum. It can be injured by trauma, overuse, or normal wear and tear. It is not an uncommon cause of groin pain in someone in their 20s to 40s. It is also associated with hip dysplasia (abnormal shape of hip joint). A labral tear can not only cause pain in the groin but also popping or catching as well as instability. If not treated appropriately a labral injury will eventually lead to osteoarthritis of the hip joint.

A labral tear or injury can sometimes be difficult to diagnose and therefore appropriate treatment is delayed. The gold standard for diagnosis is an MRI arthrogram of the hip joint. The cause of pain (pain generator ) is then verified by a diagnostic injection of the hip joint with anesthetic under Ultrasound Guidance.

Bursitis and Tendonitis

The hip has many tendons that connect the leg bones to the pelvis and these tendons can be injured or inflamed which leads to pain, weakness, and hip instability. The most common tendons affected include the gluteal tendons which attach to the side of the hip bone or trochanter and is frequently diagnosed as “hip bursitis”. This can cause severe pain on the outside of the hip region and cause pain with walking, going from sitting to standing and laying on the affected side.

Tendonitis of the hip is particularly responsive to regenerative medical treatments.

Snapping Hip Syndrome
Snapping Hip is a painful syndrome around the hip region associated with a tendon rubbing over a bony prominence causing a popping or snapping with particular movements. This can occur on the inside of the hip by the hip flexor tendon and on the outside of the hip by the gluteal tendons or iliotibial band.
Another cause is from injury to the labrum of the hip or loose cartilage.

Diagnosis is made by clinical exam and Musculoskeletal Ultrasound examination to help visualize the abnormal motion of the tendon.

Groin Pulls and Adductor Tendon Injury
The Adductor tendon connects the groin (adductor) muscles to the pelvis. Injury to the Adductor Tendon causes pain felt in the groin which can lead to weakness and reduced mobility. This is a common sports injury but can also occur from slips and falls or other trauma or overuse.

This condition is typically due to degeneration of the tendon that attaches the adductor muscles to the pelvis. In some cases, the tendon is torn as well. It is a common injury in soccer and football players. This is a difficult injury to treat as it is hard to immobilize or rest it and integral to all motions of the hip and leg.

Osteitis Pubis
The pelvic bone surrounds the pelvic organs and connects on each side to the thigh bone. It connects in the front of the pelvis by a joint called the pubic symphysis. The bones and or cartilage can be injured and inflamed from trauma or overuse and cause Osteitis Pubis. Pain can be over the pubic bone in the midline as well as referred to the groin or front of the hip or lower abdomen.

THE KRASNICK SOLUTION

How can Dr. Krasnick help you recover and restore naturally to health without drugs or surgery?

Hip Ultrasound

EXAM & DIAGNOSIS

Before a patient can be treated for hip pain, a correct diagnosis must be made.

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First, Dr. Krasnick will obtain a detailed history and perform a thorough physical examination. Frequently a musculoskeletal ultrasound will be done to understand where your hip pain is coming from. If you have any imaging studies such as X-rays, MRI or CT Scans, please bring the actual images to the appointment for Dr. Krasnick to review himself.

Injection Treatment

TREATMENT PROGRAM

Once a diagnosis is made, a comprehensive treatment program will be determined.

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This may include regenerative medical treatments such as: Prolotherapy, Platelet Rich Plasma (PRP), Stem Cell Therapy, Prolozone™, Neural Prolotherapy (Lyftogt Technique®) and Hydrodissection. None of these treatments contain any drugs, steroids, narcotics or NSAIDs, are performed in the office and do not require surgery. Dr. Krasnick performs injections under ultrasound guidance, so he is highly accurate in injecting the treatment to the exact location needed. These treatments allow the body’s own natural healing powers to recover and restore to health.

Balanced Diet

HEALTH & WELLNESS

To optimize treatment, we focus on the whole patient and not just the hip pain.

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This means Dr. Krasnick will investigate, discuss and make recommendations about your health and wellness. Important factors in order to optimize outcomes include cellular health. This entails optimizing your nutrition and diet to ensure you are getting the proper macro and micronutrients. Simple changes in diet and addition of vitamins and supplements can go a long way to improving outcomes. Dr. Krasnick will also focus on functional movement, which includes strength and flexibility. We know the body, especially, the musculoskeletal system acts as a whole and therefore pre- and post-treatment exercise or physical therapy will be recommended. Of course treatment and attention to the injured structure (joint or surrounding ligaments and tendons) will be discussed in detail, with specific post-procedure protocols when needed.

A procedure is not always needed and when possible trying to solve the problem with other noninvasive and holistic approaches will be sought.

None of the regenerative treatments contain any drugs, steroids, narcotics or NSAIDs, are performed in the office and do not require surgery. Dr. Krasnick performs injections under ultrasound guidance, so he is highly accurate in injecting the treatment to the exact location needed. These treatments allow the body’s own natural healing powers to recover and restore to health.

If you are looking for a non-surgical, drug-free, natural, alternative pain treatment for your hip pain, then contact us at (734) 585-5653 to schedule a consultation with Dr. Krasnick.

OVERVIEW OF HIP PAIN CONDITIONS

Osteoarthritis of the Hip

More About This Condition
The hip is one of the largest joints in the body and prone to arthritis from degeneration, trauma or hip dysplasia. Common arthritic joint symptoms include pain, stiffness and decreased range of motion. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. It is important to treat it as early as possible.

Labral Tear

More About This Condition
The labrum is a soft cartilage between the round femur bone and socket or acetabulum. It can be injured by trauma, overuse, or normal wear and tear. It is not an uncommon cause of groin pain in someone in their 20s to 40s. It is also associated with hip dysplasia (abnormal shape of hip joint). A labral tear can not only cause pain in the groin but also popping or catching as well as instability. If not treated appropriately a labral injury will eventually lead to osteoarthritis of the hip joint.

A labral tear or injury can sometimes be difficult to diagnose and therefore appropriate treatment is delayed. The gold standard for diagnosis is an MRI arthrogram of the hip joint. The cause of pain (pain generator ) is then verified by a diagnostic injection of the hip joint with anesthetic under Ultrasound Guidance.

Bursitis and Tendonitis

More About This Condition

The hip has many tendons that connect the leg bones to the pelvis and these tendons can be injured or inflamed which leads to pain, weakness, and hip instability. The most common tendons affected include the gluteal tendons which attach to the side of the hip bone or trochanter and is frequently diagnosed as “hip bursitis”. This can cause severe pain on the outside of the hip region and cause pain with walking, going from sitting to standing and laying on the affected side.

Tendonitis of the hip is particularly responsive to regenerative medical treatments.

Snapping Hip Syndrome

More About This Condition
Snapping Hip is a painful syndrome around the hip region associated with a tendon rubbing over a bony prominence causing a popping or snapping with particular movements. This can occur on the inside of the hip by the hip flexor tendon and on the outside of the hip by the gluteal tendons or iliotibial band.
Another cause is from injury to the labrum of the hip or loose cartilage.

Diagnosis is made by clinical exam and Musculoskeletal Ultrasound examination to help visualize the abnormal motion of the tendon.

Groin Pulls and Adductor Tendon Injury

More About This Condition

The Adductor tendon connects the groin (adductor) muscles to the pelvis. Injury to the Adductor Tendon causes pain felt in the groin which can lead to weakness and reduced mobility. This is a common sports injury but can also occur from slips and falls or other trauma or overuse.

This condition is typically due to degeneration of the tendon that attaches the adductor muscles to the pelvis. In some cases, the tendon is torn as well. It is a common injury in soccer and football players. This is a difficult injury to treat as it is hard to immobilize or rest it and integral to all motions of the hip and leg.

Osteitis Pubis

More About This Condition
The pelvic bone surrounds the pelvic organs and connects on each side to the thigh bone. It connects in the front of the pelvis by a joint called the pubic symphysis. The bones and or cartilage can be injured and inflamed from trauma or overuse and cause Osteitis Pubis. Pain can be over the pubic bone in the midline as well as referred to the groin or front of the hip or lower abdomen.

Traditional treatments. Have you tried them and still have pain?

Steroids & Ibuprofen
Traditional treatment for hip pain includes use of pain medications, physical therapy, steroid injections and surgery. Steroids can weaken the immune system and reduce your ability to fight infections, raise blood sugar, weaken bones or worsen osteoporosis and cause weight gain. Repeated use of steroids can worsen glaucoma or cause cataracts. Cortisone injections, though may provide temporary hip pain relief and can help when there is an inflammatory condition, can be harmful, especially when they are repetitively given. Repeated injections will cause tissue (tendon, ligament, cartilage) breakdown and can lead to further or accelerated degeneration and tearing of these structures.

Non-Steroidal-Anti-Inflammatory-Drugs (NSAIDS) such as Ibuprofen, Advil and Motrin can temporarily relieve hip pain, but also reduce the cells that are needed to repair damaged tendons and ligaments and this can lead to more instability and pain! NSAIDS can also lead to bleeding in the stomach, ulcers and kidney damage. Narcotics are also used but can lead to side effects of constipation and drug dependency. For some patients, surgery is considered, but has greater risks such as infection or more pain.

Let us help you make progress toward physical rejuvenation.