Hip Tendinopathy

There is so much to consider with this limited info. I would seek a "super doc" for the area of concern (hip, shoulder? other?) and see what they say. In the past year, I've become convinced your local OS may be fine for hip replacement, fractures, and so on but for major work, I'd seek out the people bringing the field forward. See who's writing the papers you find on PubMed for your diagnosis and go from there

Consider a rheumatologist for thorough evaluation.
I saw an orthopedic surgeon and even had hernia surgery for unilateral
anterior hip area pain. Turns out it was adductor tendon causing it.
Diagnosis was made when I tore it. Caused by psoriatic arthritis.
Maybe I didn’t need the hernia surgery !

@gbryant
I have bilateral gluteal tendinopathy and it is painful and hard to walk/stand/do stairs/maneuver at times.

Have you had cortisone shots? Have you had physical therapy to strengthen your hip muscles and massage to relax them? Do you take any anti inflammatory medications? I believe there are some therapies out there that help to heal tendons (shockwave).

Do you take Omega 3 supplements?

I’ve been in physical therapy including Dry Needling for almost 2 yrs. According to 3 different orthopedic surgeons and a sports medicine specialist cortisone was a contributing cause. Haven’t been taking anti-inflammation post PRP injection per instructions. I’m in good shape for 72, can ride a bike and swing a golf club rather decently. Just can’t walk.

Wanted to hear from anyone who tried PRP. That seems to be my last option and now I am not sure where to turn. Diagnosed with Gluteal Tendinopathy which I feel throughout my body now around knees, hips, shoulders, shoulder blades, thighs, etc. I have tried acupuncture, massage, myofascial trigger release therapy, dry needling, stretch therapy, red light therapy, grounding, PT, OTC, injections and nothing lasts. I stopped steroid injections even though it helped for a few months. One othopedic said PRP good for 6 out of 10 people and not covered by insurance. I have read that menopause induced tendinopathy because of low or no estrogen happens but no answer on how to fix. HRT?

I have pretty much the same things as you do. I have steroid injection directly into my hip bursa twice, except the shots were in different bursas. The second time was in the largest of the 3 and did help some, but relief from the shots doesn’t last very long because it isn’t a cure, unfortunately.
An orthopedic surgeon offered PRP to me, and I finally decided to try it since life continues to get very small. When I saw him the day of the procedure, he asked if I wanted it in my hip. At the time, the gluteal medius was badly inflamed and I thought/hoped it would be healed and relieve much of the other pain, too. Well, it has helped that area, but the hip area in various places can be killer pain. At night I need to use my wheeled walker to go to the restroom because that leg won’t hold my weight very well. During the day with some pain relievers in my system, it’s more tolerable, but still keeps me from doing most things. I see that rheumatologist again soon and will discuss what he thinks the next steps should be. If more PRP, he’ll have to tell me which tendon has the worst injury because it’s nearly impossible to tell. One last thing. I am on an estrogen patch that I wear for a week at a time, mostly to ward off hot flashes (I’m 79…shouldn’t that all be over by now?!?). I don’t think it makes a difference at all in the tendon injury case. I also have psoriatic arthritis, and wonder if it is somehow related.

I'm not an expert on hips aside from the osteoarthritis I had, and a THR took care of that. But to gbryant's question on hip tendonapathy I'm sorry I can't contribute directly.

I have read through most of these posts and am struck by something my spine surgeon told me - essentially, a strong set of core muscles fixes many ills. Specifically for tendinapathy or tendonitis in the hip/gluteal area, some very simple core exercises may help.

Joe

Sorry for your dilemma. I have osteoarthritis in every joint and have had both knees, right hip, and right shoulder replaced all with good outcomes.

You mention cortisone, and except on one occasion in my shoulder, the shots haven't been effective.

I am in the gym everyday and spin for 40 minutes 5x/week. You mentioned you can ride a bike. I hope that helps you.

Joe

After repetitive bending and lifting when doing a house renovation I have injured my piriformis, hamstrings and heaven knows what else. I have been in PT for a month with minimal improvement and I am beginning to think it is a tendon and not a muscle injury, both hips. How do you get a diagnosis? Should I see an orthopedic doctor rather than my GP? They have run all the inflammatory labs and rheumatology labs, all coming back normal.

See a sports medicine orthopedist or osteopath instead of a surgeon if you have that option, many larger orthopedic practices do. They focus on function and rehabilitation, with surgery as a last resort.
Keep in mind that tendon and muscle injuries can heal VERY slowly. I have been in PT for tendinopathy in my shoulder for 3 months and am finally seeing progress. Also healing from "massive" rotator cuff repair in the other arm - approaching normal after 10 months, with a new setback after tendon repair on the elbow on that side.
I am learning to be kinder to my body. Hard to do after 60+ years of doing whatever I wanted!