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Diagnosed Bursitis. Took Several Steroid Shots. Suffer Pain. On Pain Medications. Need Surgery?
Question: my father is 90 yrs old and has been told that he has bursitis in his right hip. the specialist we just seen, after many others said his hip has many more miles left. we have tried everything from nsaids, ice heat, pt, and several steroid shots all around and in the area to no avail. seen specialist approx 2weeks ago another sreroid shot was given, but now he is in the worst pain hehas had. doesent get out of bed much, cant sleep through the night, not eating or drinking much, andi forgot to say he is on pain meds too.i heard that the bursa can be removed, can u tell me how big a operation this would be, or is there anything else that has been proven to work on the elderly. signed desperate.
Hi, thanks for writing to XXXXXXX
This is just to let you know that there are a few bursae around the hip joint which when inflamed can give rise to pain.
* TROCHANTERIC BURSITIS - Pain is typically felt over the upper outer aspect of the hip and thigh region. There will be local tenderness and at times crepitus (a grating sensation) can be felt while flexing and extending the hip. Xrays may not give much information but may show shadows suggesting swelling of the soft tissues.
In trochanteric bursitis,it is important to exclude underlying causes like GOUT, RHEUMATOID DISEASE or INFECTIONS LIKE TUBERCULOSIS.
The usual treatment is conservative (which you have already tried with no response). Symptomatic cases not responding to conservative management may be treated by EXCISION OF THE BURSA.
This excision surgery is not a major operation because this bursa is present just beneath the muscular plane (Hip joint exposure is not necessary).
* ILIOPSOAS BURSITIS - pain is typically felt in the groin and the upper inner aspect of thigh. The most important clinical feature is increased pain in sitting position with the legs one over the other (cross legging). Treatment guidelines are the same as trochanteric bursitis.
But I personally feel that the bursitis around the hip will not produce so much of pain and distress so as to render them sleepless and not making them to eat or drink. I suspect some other problem in and around the hip that may be causing pain.
Unrelenting pain in an elderly patient not responding to conservative measures always needs a detailed evaluation.
Hope I have addressed all your issues. Happy to help for any more clarifications.
Good day
This is just to let you know that there are a few bursae around the hip joint which when inflamed can give rise to pain.
* TROCHANTERIC BURSITIS - Pain is typically felt over the upper outer aspect of the hip and thigh region. There will be local tenderness and at times crepitus (a grating sensation) can be felt while flexing and extending the hip. Xrays may not give much information but may show shadows suggesting swelling of the soft tissues.
In trochanteric bursitis,it is important to exclude underlying causes like GOUT, RHEUMATOID DISEASE or INFECTIONS LIKE TUBERCULOSIS.
The usual treatment is conservative (which you have already tried with no response). Symptomatic cases not responding to conservative management may be treated by EXCISION OF THE BURSA.
This excision surgery is not a major operation because this bursa is present just beneath the muscular plane (Hip joint exposure is not necessary).
* ILIOPSOAS BURSITIS - pain is typically felt in the groin and the upper inner aspect of thigh. The most important clinical feature is increased pain in sitting position with the legs one over the other (cross legging). Treatment guidelines are the same as trochanteric bursitis.
But I personally feel that the bursitis around the hip will not produce so much of pain and distress so as to render them sleepless and not making them to eat or drink. I suspect some other problem in and around the hip that may be causing pain.
Unrelenting pain in an elderly patient not responding to conservative measures always needs a detailed evaluation.
Hope I have addressed all your issues. Happy to help for any more clarifications.
Good day
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
we have been to 5-6 doctors and specialists, so it has been detailed extentsivly your answer gave me no help, please refund my money of 15.00 dollars back on my debit card! and cancel my subscription. YYYY@YYYY
can somebody please answer my above answer to your reply. i was severely dissapointed with your services, so when will i be reimbursted on my credit card,im sorry i feel this way but this is my fathers last chance to find help.i will keep looking but your website just didnt help. please answer asap. steve monaghan. YYYY@YYYY .
can somebody please answer my above answer to your reply. i was severely dissapointed with your services, so when will i be reimbursted on my credit card,im sorry i feel this way but this is my fathers last chance to find help.i will keep looking but your website just didnt help. please answer asap. steve monaghan. YYYY@YYYY .
Hi, this is to inform you that your query has been answered to the best of my knowledge based on the description provided.
I have already addressed in my last answer that excising the trochanteric bursa is not a big deal and can be done comfortably under spinal anesthesia.
Please let me know your expectation. Thanks
I have already addressed in my last answer that excising the trochanteric bursa is not a big deal and can be done comfortably under spinal anesthesia.
Please let me know your expectation. Thanks
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
allright, i made my father one more ortho-docter appt in 2 weeks. i will ask him about removing the bursa on the outside of his hip. as for gout, rhourmatoid arthrites, is there blood tests that can determen if it is either one of these conditions,or what tests do i ask him to preform.he also has scoliosis of his spine, which i just learned, could that have any affect on the bursa.he told me today the pain was starting to hurt down in his knee, any thoughts. steve
Hi XXXXXXX thanks for your prompt response.
MY RATIONALE : As your father is not responding to general conservative line of management for a trochanteric bursitis (which should normally be), its logical to think into other possible underlying causes (though rare).
*To rule out Gout - Serum uric acid estimation has to be done
*Blood and serum rheumatoid profile
*Mantoux test, TB serology & C reactive protein to rule out tuberculosis
Scoliosis has got nothing to do with the trochanteric bursa.
At times, a problem in the hip joint will present as pain in the knee because of the common innervation (nerve supply) of both joints by the genicular branch of the femoral nerve.
Hope this information is helpful.
Regards
MY RATIONALE : As your father is not responding to general conservative line of management for a trochanteric bursitis (which should normally be), its logical to think into other possible underlying causes (though rare).
*To rule out Gout - Serum uric acid estimation has to be done
*Blood and serum rheumatoid profile
*Mantoux test, TB serology & C reactive protein to rule out tuberculosis
Scoliosis has got nothing to do with the trochanteric bursa.
At times, a problem in the hip joint will present as pain in the knee because of the common innervation (nerve supply) of both joints by the genicular branch of the femoral nerve.
Hope this information is helpful.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thank you and i will follow up with you after we see this doctor on the 26th. steve
Welcome XXXXXXX
Wishing your Father a quick recovery. Good luck
Wishing your Father a quick recovery. Good luck
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Dr. K. Naga Ravi Prasad
Orthopaedic Surgeon, Joint Replacement
Practicing since :1996
Answered : 2148 Questions
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