Tendinopathy, a condition characterized by persistent tendon pain and loss of function related to mechanical loading, is a common issue faced by athletes and active individuals. Two prevalent hip tendinopathies are gluteal tendinopathy and proximal hamstring tendinopathy. These conditions can be incredibly frustrating for both patients and clinicians due to the delay in diagnosis, significant disability caused, and lack of response to traditional treatments.
The first line of treatment for hip tendinopathies typically involves specific education and progressive exercise. These conservative approaches offer a low-risk and practical option, particularly for gluteal tendinopathy, and have resulted in greater treatment success rates than corticosteroid injections, both in the short term (8 weeks) and at one year.
However, when conservative treatments fail to provide adequate relief, trigger point injections and orthobiologics may offer a promising solution. Trigger points, hyperirritable spots within taut bands of muscle or fascia, can contribute to pain and dysfunction in hip tendinopathies. Trigger point injections involve the precise injection of a local anesthetic, saline, or other substances directly into the trigger point to reduce pain and promote relaxation of the affected tissue.
In addition to trigger point injections, orthobiologics are emerging as a powerful tool for treating tendinopathies and promoting tissue healing. Platelet-rich plasma (PRP) is an orthobiologic that has recently gained attention. PRP is obtained by centrifuging a sample of the patient’s blood to concentrate the platelets, which contain a rich array of growth factors and cytokines that can stimulate tissue repair and reduce inflammation. When injected into the affected tendon, PRP can promote collagen synthesis, improve blood flow, and accelerate healing.
Cellular therapies, such as bone marrow aspirate concentrate (BMAC), are another promising orthobiologic option for treating hip tendinopathies. These undifferentiated cells can differentiate into various cell types, including those found in tendons, and secrete a wide range of growth factors and anti-inflammatory molecules. When injected into the affected tendon, bone marrow progenitor cells can promote tissue regeneration, modulate inflammation, and improve tendon function.
While trigger point injections and orthobiologics offer exciting possibilities for treating hip tendinopathies, they should be part of a comprehensive treatment plan that addresses underlying issues. Addressing underlying biomechanical issues, load management, and progressive rehabilitation remain crucial to successful treatment.
As research continues to advance our understanding of hip tendinopathies and their management, the integration of trigger point injections and orthobiologics into clinical practice may provide new hope for patients struggling with persistent pain and loss of function. By offering targeted, regenerative treatments for recalcitrant cases, these therapies can help individuals overcome the frustrating cycle of disability and return to the activities they love.
At Columbia Pain Management, we are at the forefront of the evolving pain science. Our team of experts provides innovative treatments to help you regain control of your life. If you’re struggling with persistent pain, we’re here to guide you toward healing and fulfillment. Call 503-654-5636 or 541-205-0173 to schedule an appointment. We’re dedicated to helping you find relief and enhance your quality of life. Take the first step towards a pain-free life with our assistance.
