Hip Pain


 

HIP PAIN


The hips support the body and are susceptible to daily wear and tear and to injuries that can cause discomfort and pain affecting your daily quality of life. At the Center for Integrated Pain Management, conditions are diagnosed and treatment plans are tailored for the patient’s optimal health and pain relief. Below is a list of hip conditions treated at the Center.


  • Trochanteric Bursitis
  • Hip Sprains, Strains and Tears
  • Hip Osteoarthritis
  • Muscle Spasms
  • Snapping Hip Syndrome
  • Nerve Entrapment/Radiculopathy s
  • Tarsal Tunnel Syndrome


A diagnosis will be made once Dr. Kulick reviews your family history, completes a thorough physical examination and conducts an in-office ultrasound. If necessary,  Dr. Kulick may request that you obtain an MRI, a CT Scan or additional X-rays in order to determine the diagnosis and treatment plan.


To learn more about the treatment and relief of hip conditions please contact our office at  212-867-1777.



Trochanteric Bursitis


What is Trochanteric Bursitis?

The bursae are fluid filled sacs that minimize friction between soft tissue such as skin, muscles, and tendons, and bones. Trochanteric Bursitis is the inflammation of the bursa located on the outer hipbone called the greater trochanter. This irritation may be the result of joint overuse by climbing, running up stairs or even standing for a great length of time, bone spurs, a hip injury, arthritis or uneven leg length.


Seek treatment for these symptoms:

  • Outer hip and thigh pain
  • Pain worse at night when lying down on the affected side
  • Difficulty climbing stairs or getting up from a chair


Next Steps

Consult the Center for a diagnosis and for treatment options. Ultrasound-guided corticosteroid injections, ultrasound-guided prolotherapy injections and anti-inflammatory medication may provide relief.


To learn more about the treatment and relief of Trochanteric Bursitis please call 212-867-1777.



Hip Strains, Strains and Tears


What are Hip Sprains, Strains and Tears?

The hip’s ball and socket joint is one of the largest weight bearing joints in the body. It becomes increasingly susceptible to pain, strains and sprains as you age. The hips stabilize your body and permit your legs to move and turn.  A hip sprain is an injury to a ligament, the connective tissue that attaches bones to bones in the hip joint. A sprain may be caused by a hard blow to the hip or a sudden turn in the middle of an activity like running. It can range from a mild overstretching of the ligament to a partial  or complete tear.


The more common hip strain is the overstretching of a muscle or tendon in the hip. The more acute partial or complete tear of tear of a muscle or tendon may also occur. Tendons attach muscle to bone. Strains can occur because of everyday overuse of the muscle or from a direct blow to the hip from a fall or during sports activities.


Seek Treatment for these Symptoms:

  • Hip pain
  • Swelling
  • Muscle weakness
  • Limited range of motion


Next Steps

Consult the Center for a diagnosis and for treatment options. These include rest, ice, ultrasound-guided corticosteroid injections, ultrasound-guided prolotherapy injections and physical therapy. If there is evidence of tendinosis, additional highly specialized and cutting edge options for hip strains are ultrasound-guided tenotomy injections that destroy damaged tissue, followed by ultrasound-guided injections of platelet rich plasma therapy (PRP) to accelerate the growth of healthy replacement tissue.

To learn more about the treatment and relief of hip sprains and strains please call 212-867-1777.


Hip Osteoarthritis


What is Hip Osteoarthritis?

Arthritis, the inflammation of a joint, is a prevalent source of chronic pain for over 30 million people including older adults and children.  When located in the hip joints it may also affect the back and thighs making it difficult to stand, walk or even sit. It is a progressive and degenerative disease and its symptoms range from mild to severe. It causes the cartilage to erode where the bones meet to create the hip joint. Cartilage is connective tissue that protects the ends of the bones and allows the bones to glide smoothly in the joint. When cartilage deteriorates, bones rub against each other creating inflammation, stiffness and pain.  Bone spurs, an overgrowth of the bone, often develop and intensify the pain. Aging and daily wear and tear increase the degeneration of the joint. Risk factors include age, family history, obesity and injuries to the cartilage that cushions the joint.


Seek Treatment for these Symptoms:

  • Hip, buttock or thigh pain
  • Stiffness
  • Loss of movement
  • Redness or swelling
  • Difficulty walking or doing other daily activities


Next Steps

Consult the Center for a diagnosis and for treatment options. Hip osteoarthritis treatments include anti-inflammatory medication, ultrasound-guided corticosteroid injections, ultrasound-guided injections of a hyaluronic acid such as Synvisc and Supartz to help cushion the joint, stem cell therapy and physical therapy.


To learn more about the treatment and relief of Hip Osteoarthritis please call 212-867-1777.



Muscle Spasms

What Are Muscle Spasms?

Muscle spasms are very common and can happen without warning. Perhaps you pick up a heavy box, reach for an item or even sleep in an awkward position. This suddenly triggers a muscle spasm in your hip and you cannot straighten or move without pain. Muscle spasms are the involuntary contraction or tensing of one or more muscles. They may occur in the wrist, forearm, hand, neck, upper or lower back, hips and legs.  Muscle spasms may be caused by heavy lifting, muscle overuse, weak muscles, nerve compression, spinal conditions such as degenerative disc disease or a herniated disc, and many sports injuries. Some sports including golf, football, weightlifting and basketball that require the constant twisting of the spine may lead to back spasms. Spasms may seem to appear out of nowhere, however, typically small tears in the muscle may have developed over time. These tears may lead to swelling that compresses the nerves surrounding the muscle. This in turn triggers a muscle spasm that can cause pain, cramping or twitching.

Seek Treatment for these Symptoms:

  • Muscle pain that does not dissipate on its own
  • Constant muscle cramps
  • Difficulty moving
  • Muscle appears hard or distorted

Next Steps

If the muscle spasm does not resolve by itself after a few days of rest, icing the area for short periods of 10 to 20 minutes every two hours or using a heated pad, and taking non-steroidal anti-inflammatory medication, then seek treatment. Consult the Center for a diagnosis and for options.  The spasm may be the result of an underlying condition that can be treated. Once identified, treatment options may include ultrasound-guided corticosteroid injections, trigger point therapy, ultrasound guided prolotherapy injections or anti-inflammatory or muscle relaxant medication. Ultrasound guided injections of platelet rich plasma (PRP), or stem cell therapy may be advised. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve or ultrasound-guided nerve block injections will be recommended.

To learn more about the treatment and relief of Muscle Spasms please call our office at 212-867-1777.



Snapping Hip Syndrome


What is Snapping Hip Syndrome?

Snapping Hip Syndrome is a condition in which a snapping or clicking noise is heard when you move your hips while walking, dancing or even sitting down or getting up from a chair.  Typically it is caused when the a very tight band of connective tissue called the iliotibial band, comprised of tendons that attach muscle to bone, slips over the thigh’s bony protrusion called the greater trochanter. As it slides past, the band makes a snapping sound. It may merely cause an irritating noise, but it can also lead to bursitis of the hip.  Other tendons may pass over the back of the thigh bone or the front of the thigh bone when you use your hips to move and similarly make snapping sounds. Tightness in the muscles and tendons is often the culprit. Dancers and young athletes are particularly prone to this syndrome.


Seek Treatment for these Symptoms:

  • Snapping or clicking sound when you move
  • Pain in hip area accompanied by snapping sound


Next Steps:

Consult the Center for a diagnosis and treatment options. Physical therapy along with ultrasound-guided corticosteroid injections may be recommended. If bursitis is indicated, prolotherapy injections and anti-inflammatory medication may be additional options.


To learn more about the treatment and relief of Snapping Hip Syndrome  please call our office at 212-867-1777.



Nerve Entrapment/Radiculopathy


What Is Radiculopathy?

Radiculopathy is a group of conditions affecting one or more nerves in the spine. These nerves may become pinched or compressed, causing pain, numbness or tingling in the arms or legs. The sciatic nerve, the large nerve that runs down the lower back, hip, buttocks, and back of leg to the foot may be compressed in the lower back as a result of a herniated disc or other spinal damage.

Radiculopathy commonly occurs in the cervical spine (neck), the thoracic spine (mid back)or the lumbar spine (lower back).

Cervical, thoracic, and lumbar radiculopathy are often caused by herniated discs in the vertebrae (bones of the spine) and spinal stenosis, a narrowing of the hole in the vertebrae through which spinal nerves exit.  This places pressure on the nerves as they branch out from the spine. The compression may also be caused by an injury, overuse of muscles and tendons, poor posture, bone spurs, and arthritis.

Seek Treatment for these Symptoms:

  • Pain that radiates outward from the injured nerve
  • Numbness, tingling, burning sensation
  • Muscle weakness
  • Cervical radiculopathy affects the neck, upper back, shoulder, chest, arm,or hand.
  • Thoracic radiculopathy affects the chest, ribs, shoulders, mid back or stomach area
  • Lumbar radiculopathy causes sciatica which is an irritation of the large sciatic nerve located in the lower back.  This causes pain to radiate down the back of the leg to the calf or foot called sciatica
  • Pain may be aggravated by activities such as walking, climbing stairs or sitting

Next Steps

Consult the Center for a diagnosis and for treatment choices.  Depending on the diagnosis, treatment options may include ultrasound-guided corticosteroid injections, ultrasound -guided injections of platelet rich plasma (PRP), ultrasound-guided prolotherapy injections, physical therapy and anti-inflammatory medication. If nerve entrapment is indicated then a steroid-free hydrodissection to release the nerve and ultrasound-guided nerve block injections will be recommended.


To learn more about cervical radiculopathy and its treatment please call our office at 212-867-1777.






Location
Alexander Kulick, MD
112 East 61st Street
Upper East Side

New York, NY 10065
Phone: 917-810-4139
Fax: (646) 585-0042
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917-810-4139