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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have Chronic Tendonitis On Right Hip. Took Cortisone Injections. Have Pain In Hip. Right Medication?

Hi I have had chronic tendonitis of the right hip to 18 months, I have had 3 cortisone injections which have not worked and am now doing exercises sent to me by nhs physiotherapists but I am still experiencing chronic pain in the lower part of my hip/bottom, although I am not as stiff as I was three months ago but still a long way off from normal bending and kneeling and still walk with a limp - I stopped taking ibruprofen several weeks ago as I felt they had no effect but when I can n't take the pain anymore I do take co codamol 8/500 which does takes the edge of the pain away for a short time
Wed, 20 Nov 2013
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General & Family Physician 's  Response
hello there!
thank you for asking. I read your query and i am sorry for the trouble you are facing. chronic tendonitis for 18 months non responsive to corticosteroids injections means its time for step up. like lengthening the tensor fasciae latae/iliotibial band complex by surgical interventions.

We don't recommend use of NSAIDs during or near these procedures.

The goal of all of these therapies is to restart the healing process by increasing inflammation and blood flow into an area, thereby allowing new progenitor cells to come into the area, lay down healthier collagen, and improve the organization of collagen. Any patients who undergo these treatments should not use anti-inflammatory medications because these drugs will prevent the inflammation that is being sought. So no more anti inflammatory agents please near these steroid injection or procedures

We call it Prolotherapy (also called proliferative therapy) involves injecting 3% NaCl or 10% dextrose into and around the affected tendon to restart the inflammatory cascade.

Injections of autologous whole blood and platelet-rich plasma concentrations have also been used for the treatment of tendinopathy under ultrasound guidance .

Likewise, performing percutaneous needling of the tendon by fenestration with an 18- or 21-gauge needle before administration of the injection will improve the flow of blood and inflammation into the tendon.

You can try some other NSAIDs but for short term
Nabumetone (Relafen)
Ketoprofen (Actron, Orudis, Oruvail)
Naproxen (Naprosyn, Anaprox, Aleve, Naprelan)
Ibuprofen (Motrin, Excedrin IB, Ibuprin, Advil)
Celecoxib (Celebrex)

some other analgesics like
Acetaminophen (Aspirin-free Anacin, Tylenol, Feverall, Tempra)
Tramadol (Ultram, Ultram ER)

i personally recommend acetaminophens over NSAIDs as they are not anti inflammatory agents like NSAIDs but help the pain.

you should know that prolonged recovery is usual and nothing to frustrate about. Keep it slow pace and continue physio therapy. you will be fine and i am sure you will be

I hope i was of some help.

Take care

regards
Dr S Khan
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Have Chronic Tendonitis On Right Hip. Took Cortisone Injections. Have Pain In Hip. Right Medication?

hello there! thank you for asking. I read your query and i am sorry for the trouble you are facing. chronic tendonitis for 18 months non responsive to corticosteroids injections means its time for step up. like lengthening the tensor fasciae latae/iliotibial band complex by surgical interventions. We don t recommend use of NSAIDs during or near these procedures. The goal of all of these therapies is to restart the healing process by increasing inflammation and blood flow into an area, thereby allowing new progenitor cells to come into the area, lay down healthier collagen, and improve the organization of collagen. Any patients who undergo these treatments should not use anti-inflammatory medications because these drugs will prevent the inflammation that is being sought. So no more anti inflammatory agents please near these steroid injection or procedures We call it Prolotherapy (also called proliferative therapy) involves injecting 3% NaCl or 10% dextrose into and around the affected tendon to restart the inflammatory cascade. Injections of autologous whole blood and platelet-rich plasma concentrations have also been used for the treatment of tendinopathy under ultrasound guidance . Likewise, performing percutaneous needling of the tendon by fenestration with an 18- or 21-gauge needle before administration of the injection will improve the flow of blood and inflammation into the tendon. You can try some other NSAIDs but for short term Nabumetone (Relafen) Ketoprofen (Actron, Orudis, Oruvail) Naproxen (Naprosyn, Anaprox, Aleve, Naprelan) Ibuprofen (Motrin, Excedrin IB, Ibuprin, Advil) Celecoxib (Celebrex) some other analgesics like Acetaminophen (Aspirin-free Anacin, Tylenol, Feverall, Tempra) Tramadol (Ultram, Ultram ER) i personally recommend acetaminophens over NSAIDs as they are not anti inflammatory agents like NSAIDs but help the pain. you should know that prolonged recovery is usual and nothing to frustrate about. Keep it slow pace and continue physio therapy. you will be fine and i am sure you will be I hope i was of some help. Take care regards Dr S Khan