I have lost a lot of internal and less but some external rotation of my left hip. Along with that it is getting more and more painful to walk on, and any lateral movement makes the pain excruciating. I have very painful soar pevic rotators and the insertion of the quadriceps group is very very painful on palpation. I am developing weakness in my leg especially when walking up or down stairs. I have chronic history of herniations L4-5, L5-S1 plus stenosis, arthritis, spondylosis...
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Possible Labral Tear left hip age 58 female, no recent trauma, on feet all day, prior sports injuries, skiing, horse back riding. nothing broken.
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It sounds like you already have someone you see for your lower back. Some of your leg weakness is probably related to your back. Loss of motion and groin pain is usually related to the hip joint. You may have a labral tear, impingement, or arthritis. These are the most common conditions. You need to see an orthopedic surgeon for X-rays, a good physical exam and a possible MRI. Treatment varies depending on the pathology and severity. This can be anywhere from avoiding certain activities, NSAID's, therapy, injections all the way to surgery. The most common surgical procedures for what is appears you have is an arthroscopy or a hip replacement.
I think you need evaluation by orthopedic surgeon. Loss of motion in your hip join suggest hip pathology, but you also have history of low back problems that may aggravate your symptoms and make diagnosis less intuitive. Experienced orthopedist will likely be able to delineate the source of your hip and back pain.
I agree the MRI and Orthopedic eval are the Gold standards. You may also want to consider an evaluation by a orthopedic PT as well. Someone skilled in manual therapy can manipulate the hip, identify movement pathologies, and in some States provide trigger-point injections or acupuncture to effectively treat the muscle pain and spasm. Check out the AAOMPT for a provider in your area. Good luck to you.
While it is true that Labral Tears are often incidental findings, you are quite active in Sports. An MRI will delineate the extent of the tear and plain films will be helpful for establishing a diagnosis of Femeroacetabular Impingement. Initially, a Cortisone injection is helpful. If the mechanical symptoms persist, hip arthroscopy to debride or repair the labrum is quite succesful.
Sincerely,
Michael J. Katz MD
Sincerely,
Michael J. Katz MD
A labral tear of the hip is often an incidental finding found on MRI of the hip/pelvis (which is the only way to definitely diagnose a tear). Most tears are degenerative in nature and most do not cause significant pain. The hip pain and limited motion are most likely from arthritis of the hip which is best evaluated with plain, standing, weight-bearing X-rays of the pelvis/hip. Physical Therapy with stretching and strengthening of the pelvic and thigh muscles, aquatic therapy, and anti-inflammatory medications may improve the symptoms and physical functioning.
It is possible that the degenerative condition of the lumbar spine may be contributing to the situation. One possible way to understand the amount of pain that is coming from the hip is to have an intra-articular injection, under fluoroscopic guidance, containing a local anesthetic and cortisone. If there is great relief and all other therapies fail then hip replacement surgery could be the answer.
It is possible that the degenerative condition of the lumbar spine may be contributing to the situation. One possible way to understand the amount of pain that is coming from the hip is to have an intra-articular injection, under fluoroscopic guidance, containing a local anesthetic and cortisone. If there is great relief and all other therapies fail then hip replacement surgery could be the answer.
Sounds like multiple issues and overlapping conditions. First step is a complete osteopathic and metabolic evaluation. When that is optimized, Prolotherapy may be helpful.www.drjuhl.com
Limited motion of the hip at this age is generally arthritis. Although a labral tear could be present as part of the degenerative process, it is unlikely to be the primary cause of pain and limited motion. Labral tears do not generally limit motion, but cause clicking or catching with pain. My suggestion would be to obtain a simple Xray of the hip first. If there is significant arthritis then no other imaging is necessary. MRI is likely to be of little value with your history and age, and is expensive. Conservative measures including anti-inflammatories, gentle stretching of the hip to improve motion, and light exercise such as an exercise bicycle or swimming is best. Keep your weight in a normal range. Each pound you carry extra is 4 or 5 lbs to your hip when you climb stairs or squat. To separate your back from hip symptoms, injection of the hip can be tried (requires a fluoroscope) with marcaine and steroid. The temporary relief of symptoms mimics hip replacement. Total hip replacement is generally very reliable and has a very low complication rate if necessary.
The possible labral tear is the least of your concerns. Sounds like you have osteoarthritis of the hip therefore i would get an x-ray & an intraarticular cortisone injection with novocaine .If you get relief great. If not you may require a resurfacing procedure or a total hip replacement.If you don't get any relief, I would get an mri of your lumbar spine with an emg to see if your hip pain is related to herniated disc. If that is the case, I would suggest seeing a pain management specialist.Hope this is helpful & you get well soon