Dr. Siddharth Tambar, an expert in regenerative medicine and rheumatology, shares insights on hip joint pain and the sacroiliac (SI) joint. He covers various causes of hip pain, explains how the SI joint can contribute to hip discomfort, and presents a case where platelet-rich plasma (PRP) was used to treat a patient with SI joint-related hip pain.

Causes of Hip Joint Pain

Hip pain can arise from several sources. The most common type is pain in the hip joint (femoral acetabular joint), usually felt in the groin or front of the hip. Tendons around the hip can also be sources of pain. For instance:

• Hip Flexor Tendon Strain: Causes pain in the front of the hip.
• Abductor Tendonitis and Bursitis: Results in pain on the side of the hip.
• Back of Hip Pain: Often linked to tendon irritation in the rear of the hip.

Nerve issues can also lead to hip pain, such as pinched nerves due to herniated or degenerative discs in the lower back (especially L3, L4, L5 levels), or the sciatic nerve being compressed near the piriformis muscle.

The Role of the Sacroiliac Joint

The sacroiliac (SI) joint, located in the pelvis, is a crucial stabilizer connecting the sacrum and ilium. When the SI joint or ligaments are overstretched, it can cause pain in the hip, lower back, buttocks, and even down the thigh. Women, particularly those who have given birth, are more prone to SI joint instability and pain.

Diagnosing Hip Pain

Diagnosis begins with evaluating the location of the pain:

• Front Hip Pain: Likely from the hip joint or flexor tendon.
• Side Hip Pain: Often from tendonitis, bursitis, or possibly the SI joint.
• Back Hip Pain: SI joint or pinched nerves are typical suspects.

Physical exams, imaging (X-rays, MRIs), and diagnostic blocks help pinpoint the exact cause.

Case Study: SI Joint Pain Treated with PRP

Dr. Tambar treated a 77-year-old woman who had suffered from hip pain for over 40 years. Despite conservative treatments like physical therapy, her pain persisted. After diagnosing SI joint involvement through a diagnostic block, Dr. Tambar administered platelet-rich plasma (PRP) to her SI joint and hip joint. The patient saw a 90% improvement in three months, maintaining her results for three years.

PRP, a regenerative treatment that uses the patient’s own blood platelets, can stimulate healing, reduce inflammation, and provide long-term pain relief and stability.

Conclusion

The sacroiliac joint can be a major contributor to hip pain. Proper diagnosis through clinical evaluation, imaging, and diagnostic blocks, followed by innovative treatments like PRP, can effectively treat SI joint-related hip pain.