MY HIP BURSITIS AND THE TREATMENT FOR IT…

What is bursitis?

A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. “Bursae” is the plural form of “bursa.” The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When a bursa becomes inflamed, the condition is known as “bursitis.”

Hip bursitis is –

  • A bursa is a fluid-filled sac that functions as a gliding surface to reduce friction between moving tissues of the body.
  • There are two major bursae of the hip.
  • Bursitis, or inflammation of a bursa, is usually not infectious, but the bursa can become infected.
  • Treatment of noninfectious bursitis includes rest, ice, and medications for inflammation and pain. Infectious bursitis (uncommon) is treated with antibiotics, aspiration, and surgery.
  • Bursitis of the hip is the most common cause of hip pain.
  • Trochanteric bursitis frequently causes tenderness of the outer hip.
  • Ischial bursitis can cause dull pain in the upper buttock area.

I saw a hip consultant last week for pain in my hips, mainly my right side. He sent me for an X-ray which showed medial osteoarthritis in the right hip but I had no symptoms or problems on examination for this problem.

What he did find was that I was very tender over the bursa area on my right and also on my left hip which he diagnosed as Bursitis. I was then given a steroid injection into both Bursas in the hope this would relieve my pain.

He also noticed how much discomfort I was in when he touched my sacroiliac joint and in my midline so he is sending me for an MRI of my sacroiliac joint and lumbosacral spine to make sure there is no impingement and to see if there is any inflammation of the sacroiliac joint.

It may be that I require a CT guided injection of my sacroiliac joint if there is arthritis seen on my scan so I will just have to wait for this result after my scan in a couple of weeks.

My pain after the injection initially went much worse and I had a really bad night but within 24 hours I could actually lie on my left hip without pain. My right took about another 24 hrs for it to kick in but I still get low back and sacroiliac pain when I lie on that side so it could be the pain is more related to that problem.

Steroid injections is something I’ve had in the past for my lumber spine and neck. Some work and last for months, others not so long but I always think this type of treatment for your pain is worth trying.

4 BENEFITS OF OWNING A HOT TUB…

When owning your first home, it may be difficult to identify things that you need or would like to have in your first residence. Whether you closed on one of the Cincinnati houses for sale or just bought a home in a rural area, you’re likely going to have to fill it out with various furniture and amenities. An option that is gaining lots of popularity and traction all around the country is hot tubs. Hot tubs are often thought of as a luxury item, something that you should only install if you have some extra money in the bank. That being said, having a hot tub can provide you with many benefits and can be a great addition to your home. So what do you stand to gain from installing a hot tub, and is it worth the large price tag? Here are the benefits of owning a hot tub.

RELAXATION…

It’s no secret that we spend our lives constantly dealing with stress and anxiety. Whether it be from work, school, or personal relationships, stress and anxiety is extremely prevalent in our lives. Unfortunately this is a very bad thing, as constantly being stressed out and anxious about situations can be a major detriment to both your mental and physical health. Thankfully, using a hot tub can relax you and provide you with some amazing stress relief. There’s something extremely soothing about ending your night relaxing in a hot tub. Not only can you let your mind drift off and relax, but you’ll be massaged by the tub’s jets and soothed by the warm water surrounding you. If you have a hot tub, you’ll almost certainly be using it to escape the everyday stresses of life.

PAIN RELIEF…

Another huge benefit of having a hot tub is the pain relief that it can provide you. Many Americans suffer from some form of pain ranging from neck pain to lower back pain. In addition, many Americans may suffer from ailments like arthritis or even major physical injuries like a sprained ankle. While using a hot tub certainly won’t make all of the pain go away, it certainly can go a long way in helping you cope with it. The relaxation that comes with being in a hot tub can put you in a more positive state of mind, something that can help you manage your pain better. In addition, sitting in the hot water and being massaged by the tub’s jets can be a huge help in relieving pain. If you’re someone who struggles with chronic pain and is looking for relief, then a hot tub could be the perfect solution. 

BETTER SLEEP…

As mentioned before, using a hot tub can be a great way to relax and relieve some stress. One way that this can manifest itself is through better sleep. If you use the hot tub at night before you go to bed, you’ll find yourself much more relaxed and carefree. Being relaxed at night, can make falling and staying asleep much easier for you. Many Americans struggle with anxiety or some other sleep problem, leading people to get less than the desired amount of sleep. Doing so can create a vicious cycle, as sleep deprivation can make you feel more stressed and irritated, further adding to your problems. Thankfully, a hot tub can break that cycle, allowing you to relax and get into a calmed mindset before you go to sleep. As a result, you can sleep peacefully and easily, improving your health and your mood for the future. 

MOBILITY…

It’s no secret that in our old age our bodies begin to deteriorate and become limited in their mobility. If you’re old enough to own your own home, then you’ve likely already experienced some of the negative side effects that come with ageing. Getting around the home may be slightly more difficult, and you might find physical tasks that used to be easy much more difficult. Thankfully using a hot tub can actually be a huge help with your mobility and range of motion. Studies have shown that frequently using a hot tub can help relieve joint inflammation and muscle stiffness, something that can be a huge help in improving your mobility. If ageing has made it more difficult to move around, then frequently using a hot tub can be a great way to combat it. 

WHICH INJECTION IS IDEAL FOR BACK PAIN -EPIDURAL, STEROID, FACET JOINT OR TRIGGER POINTS?…

With so many different types of spinal injections available for back pain its difficult to decide which one to try. In a previous post I decided to do a bit of research on epidurals for back pain and other types of injections for back pain.

One I had (which was through the front of my neck ) was highly dangerous and not many pain consultants ( including mine) would perform this procedure. All the way through the procedure the consultant ( another one I had been referred to who specialised in this type of injection )kept saying I must not move one fraction of an inch but instead to shout stop whenever I started to feel it too uncomfortable.

I can honestly say it wasn’t the most pleasant or procedures but I’m always of the opinion of no pain no gain with these type as of procedures. Fortunately I had no after affects and after about three weeks ( I was told it could take that long) the pain relief kicked in and my neck and arm pain disappeared for the first time in years. Now 18 months later some of the pain and pins and needles are coming back but nothing like it was before. 

Spine Health wrote that while the effects of an epidural steroid injection tend to be temporary (lasting from a week to up to a year) an epidural steroid injection can deliver substantial benefits for many patients experiencing low back pain.

  • Recent research reports that lumbar epidural steroid injections are successful in patients with persistent sciatica from lumbar disc herniation, with more than 80% of the injected group with disc herniation experiencing relief (in contrast to 48% of the group that received a saline placebo injection).
  • Similarly, in a study focused on a group of patients with lumbar spinal stenosis and related sciatica symptoms, 75% of patients receiving injections had more than 50% of pain reduction one year following the injections. The majority also increased their walking duration and tolerance for standing.

So, I could see from this information that it seems to be ok for lumber pain but there is no mention of it for cervical pain.

An article in The Daily Mail said that tens of thousands of patients are being given a ‘useless’ back-pain injection, which costs the NHS nearly £40 million every year, an analysis suggests.

Patients that demand a ‘quick fix’ for their discomfort are being given the treatment, priced at £540 per procedure, despite doctors being told to recommend back-pain sufferers be more active or try psychological therapy.

According to an analysis of NHS data by The Times, 70,608 steroid injections into patients’ facet joints, which make spines flexible, occurred last year, compared to 62,570 five years ago.

Guidelines released in both 2009 and 2016 advise against the procedure. 

Figures also show 8,044 operations that fuse spinal bones together were carried out last year, up from 7,224 between 2012 and 2013. 

Spinal Healthcare point out that Epidural steroid injections are actually very safe, since they are simply an injection that contains both local anaesthetic and steroids. In effect these reduce the inflammation that is causing pain in the nerves and the disc in the spin and the local anaesthetic numbs the area, bringing short term numbness to the region. By the time the local anaesthetic wears off the steroid will be working to reduce inflammation.

However there are some risks with the procedure, but these need to be looked at in context. Almost every human activity carries some risk with it. For example, crossing the road, lifting heavy objects, even opening a tin of beans all carry risks. Yet we do them every day, simply because they are necessary to human function.

Reading through lots more posts on epidurals I have come to the conclusion that like anything in life one size does not fit all of us and for some this treatment gives great relief and for others none whatsoever. There is definitely a problem with the cost of this type of injection as you require x ray staff and others to proceed with it. My facet joint injections which were also done in X-ray were cut a couple of years ago due to funding.

After my move down south last June I managed to see a pain team in January of this year but they also said they do not cover facet joint injections which I have found to be the best for me. However, when I talked it through with my GP he said other hospitals offer it and if I got to the stage that I was desperate for them he could organise a referral.

I can quite understand the cuts as the NHS is under so much pressure but I think it would make sense to have a team of people who simply follow up your pain relief after the injection to monitor if it was worth doing or not. That way the ones who benefit could continue having them and and the ones that don’t could try something else.

As far as the safety of this type of injection, I guess any injection into your spine carries risks but that could apply to any type of procedure. However, having it for cervical pain is something I could not find so it makes me think that maybe the one I had was a one off that worked for a while but now it’s back to square one again.

The difference between the nerve block and the epidural is where they put the needle. The nerve block injection usually also contains a steroid to decrease inflammation and pain. The injection is similar to a transforaminal epidural steroid injection, but in a selective nerve root block, there is no attempt to have the medication enter the epidural space.

The differences between epidurals and the nerve blocks and facet joint injections is that facet joint injections are used for both diagnostic and therapeutic reasons in the treatment of degenerative or arthritic conditions. Along with the numbing medication, a facet joint injection also includes injecting time-release steroid (cortisone) into the facet joint to reduce inflammation, which can sometimes provide longer-term pain relief.

A trigger point injection which I have recently been offered is an anesthetic such as lidocaine (Xylocaine) or bupivacaine (Marcaine), a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine and are used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin.

But, all seem to include some kind of steroid medication for the pain, they are all put into different areas and some involve using x-ray guidance but to me, the actual drug they are using is the same, but of course this is just what I have read online and is not something have discussed with my pain consultant.

 
Another treatment at the Regenerative Clinic in Harley Street London is stem cell therapy and PRP can help patients avoid spinal surgery and the side effects of epidural steroid injections. These procedures utilise the patient’s own natural growth factors or stem cells to treat bulging or herniated discs, degenerative conditions in the spine, and other back and neck conditions that cause pain.

According to Back Pain Expert Researchers at Manchester University’s Division of Regenerative Medicine are still currently running clinical trials in people with back pain to test a revolutionary treatment that could repair damaged intervertebral discs. The revolutionary new treatment based on stem cells, pioneered by Dr Stephen Richardson at Manchester University, may turn out to offer a permanent cure for back pain related to damaged intervertebral discs. For over five years, and backed with funding from the Arthritis Research Campaign, he and his colleagues at the Division of Regenerative Medicine have been developing a way of using cells from the body to regenerate the nucleus polposus in the damaged intervertebral discs.

However, I’m not holding my breath that this treatment will be available on the NHS anytime soon. I do feel that if you have only tried one type of injection and it’s not working as well then it is definitely worth trying another as you can see from this article there are a number of different options available. 

 

 

THE DIFFERENCE BETWEEN OSTEOPENIA AND OSTEOPOROSIS…

If, like me you had never heard of osteopenia then I will explain what this condition is. Web MD write that you should think of it as a midpoint between having healthy bones and having osteoporosis.

Osteopenia is when your bones are weaker than normal but not so far gone that they break easily, which is the hallmark of osteoporosis. Your bones are usually at their densest when you’re about 30. Osteopenia, if it happens at all, usually occurs after age 50. The exact age depends how strong your bones are when you’re young. If they’re hardy, you may never get osteopenia. If your bones aren’t naturally dense, you may get it earlier.

Osteopenia — or seeing it turn into osteoporosis for that matter — is not inevitable. Dietexercise, and sometimes medication can help keep your bones dense and strong for decades.

Recently I was asked to go for a bone scan to look for osteoporosis due to ongoing pain in both my hips, or at least that was what I thought the scan was for. The results came back that I have osteopenia and I have now been put on some medication and they are arranging for me to see a Physiotherapist to start some core strength and weight bearing exercises to avoid it turning into osteoporosis.

When I asked the GP if this was causing my hip pain she said there is no pain associated with osteopenia unless you break a bone. My GP then started asking me a few questions about my hip pain and asked me to pop over and see her. She is now 99% sure that I am suffering from bursitis and is referring me to an Orthopedic Consultant. So, from the pain clinic sending me for a bone scan for hip pain which showed osteopenia I now also have another problem with bursitis which I will cover in another post.

Ortho Atlanta explains about osteopenia and osteoporosis that while these diseases do have some similarities, there are also distinct differences between them. Here’s what you need to know about the differences between osteoporosis and osteopenia.

Osteoporosis means “porous bones.” Bones that are porous, or less dense, are more likely to break. A person with osteoporosis may also walk with a stooped back. Osteopenia is considered a midway point to osteoporosis; the bone density is lower than normal but not as severe and treating it may slow the progression bone loss that leads to osteoporosis. Bone mineral density (BMD) measures the level of calcium in the bones. The lower this level is, the more likely a person is to sustain bone fractures. Osteoporosis and osteopenia are both diseases in which the bone density is low. 

Serious injuries can occur as a result of osteoporosis. Because persons diagnosed with osteoporosis have lost a lot of bone mass, their bones, more porous, and brittle, can fracture from something as simple as a sneeze or a minor fall. Fractures caused by osteoporosis most often occur in the spine. Known as vertebral compression fractures, fractures in the spine are almost twice as common as other fractures typically linked to osteoporosis, such as broken hips and wrists. Osteopenia isn’t quite as serious as osteoporosis because the bones aren’t as porous and measures can be taken to help prevent the onset of osteoporosis

Osteoporosis can’t be reversed; however, it can be managed using the same treatments recommended for osteopenia. In addition to diet and exercise, there are medications the doctor may recommend to help prevent further bone loss.