What to do about hip spurs ?

Submitted by Po-Ji on February 13, 2014 - 8:27am
Body: 

Hi all

I wonder if Christine or anyone can tell me what it should mean to me if an X ray report simply returns as 'moderate arthritis' (no other explanation) Might hip spurs show up on the X ray and can injections help get rid of them. Also how does one get a proper diagnosis for hip spurs or some of the other rare arthritic conditions. And what might I expect from following up a hospital appointment on grounds of the X ray ... Phew ! Here's the story:

I have been seeking an explanation for my chronic and often debilitating hip pain worse in the right hip. So far I have three different diagnosis.  One from a doctor who said my symptoms were due to pelvic organ prolapse and wanted me to have the op ! The other was from an osteopath.  My instincts told me the Osteopath was nearer the mark and on his recommendation I requested to have a special scan to detect hip spurs done at the hospital but I had to go through a GP to arrange this.  The GP had never heard of hip spurs and doesn't like Osteopaths and so agreed to me having a bog standard X ray to start with. I thought this would be an O.K start but that was before reading 'Save You Hips.' To my dismay the X ray showed 'moderate arthritis' according to the hospital report. That's all the information I received and that's what theat second GP assumed was cause of pain and all stopped there. My own research has informed me that there are many forms of arthritis and X rays are not necessarily the best ways of detecting them.  Also that cartilage wear is not necessarily the cause of pain, if that's what moderate arthritis means. 

I have Christine's book, its great, very brave, and I have/am reading it again, but forgive me if I say I can't take it all in as yet. Just trying to diagnose my own condition at present. I have been doing the exercises almost every day and am so grateful to have these to focus on and to keep the joints moving. However hip spur conditions are rare, I am learning (and if that's what it is) don't respond well to exercise. If it were calcific tendinitis (I have learnt from 'Save your Hips') corticosteroid injections could even cure it. So I wonder if anyone knows if there is any such cure for hip spurs.

Perhaps if I pursued a hospital appointment on grounds of the X ray I would get some of these answers, but after reading the book I think probably not, I would have to push for what I want and for that I need to be sure of my information and not be vague. I can be easily intimidated by arrogant responses from health professionals and so far both doctors were. I do live in the UK and things are a little different here. At 58 I would be considered too young for a hip op any way. That's just what someone told me..

I am presently seeking the assistance of a holistic doctor for support and guidance but I don't expect orthopedics is his forte but am sure he will be sympathetic to Christine's work, who's knowledge and expertise I very much respect.

Thank you for listening. There's quite a lot of issues here, but any responses would be most welcome..

Forum:

Surviving60

February 13, 2014 - 9:29am

Hi Po-Ji. I answered my first question just by going back and looking at your older posts. I see that you have been diligent with posture but have been dealing with this hip thing for awhile and not getting much of anywhere with the medical professionals. Glad to know that Christine's hips program is at least helping keep things from getting much worse. I don't know a thing about hip spurs but just wanted to give my encouragement. This hips thing is complicated; maybe a consult with the expert herself might be in order - Surviving

Po-Ji

February 13, 2014 - 10:37am

Yes indeed it would but alas I am in UK. i will wait to see if she sees my message. I was told that hip spurs are quite rare by the osteopath who has practiced 30 years and hadn't seem to have much experience of it himself, but knew of them and as my condition didn't appear to fit the regular arthritic patterns (then) this was the conclusion he came to. Seems to fit by internet research I've done but can't be sure. Sorry to come up with something difficult ! Can't expect Christine to know all about this either at this stage. Osteo 's solution was to have them scraped away which i might have been keen to do had I not read the book. The reason he gave for getting them is sometimes people have particularly deep hip joint cavities and over time friction causes these tiny splinters which press on nerves. it is a little different to Christine's description of hip spurs but I guess there are several types and causes. I am grateful for your reply as it has given me a chance to write some more and be more definitive. I guess the more we share, the more we will know.

Surviving60

February 13, 2014 - 11:07am

Would love to see you getting some help with this. You can do a phone consult with Christine, assuming you can figure out the time-zone problem! - Surviving

Christine

February 13, 2014 - 12:58pm

Hi Po-Ji,

Just like there is “garden variety” prolapse, which we talk about all the time, there is a very common condition of the degenerating hip joint (sorry, but I don’t know what planet your osteopath comes from :-) It all starts when muscles, tendons and ligaments can no longer hold the joint surfaces slightly apart so the ball can move freely in the joint. You can visualize this very easily once you understand that the ligaments around the joint are “wound up” in natural posture, and “unwound” in postures where the pelvis is tucked under. All this business about “joint space narrowing” as seen on pelvic x-ray, and the way hip OA is diagnosed, is said to be about loss of cartilage and not at all about weakening of the supportive structures around the joint. Isn’t it amazing that all your life the super-strong ligaments have actually been suspending the ball in its socket!

Bone spurs, called osteophytes, are not rare at all, but a classic sign of OA. They are often interpreted as the joint space narrowing process on x-rays. Some people believe they develop as a degenerating hip joint attempts to better seal itself. I reference scientific articles in the book that describe how a painful and arthritic hip produces a great amount of synovial fluid, instead of the trace amount normally used by the hip for lubrication. This fluid contains many inflammatory molecules and also growth factors, which stimulate the ball and socket to form these bony growths!

Pain initially comes from the soft tissue surrounding the joint, but soon the effusion of fluid inside the joint causes great pain as well. It is very similar to an infected tooth - there is nowhere for the swelling to go within the tooth socket, so nerves are compressed and the pain becomes unbearable.

I believe this is all reversible to a greater or lesser extent. The bone spurs may or may not subside after the fluid has been reduced by consistently weight-loading the joint in a more natural way. Bone spurs are not inherently painful in themselves and are consistently found as a normal part of aging. At what point is the joint “ruined” and can only be removed and replaced with a prosthesis? This is the huge question we will be wrestling with into the future. I believe it is preposterous that every older person (in the US, anyway) with hip pain is offered a THR. People should understand that it will take at least a year of consistent effort to see some lessening of painful symptoms.

I don’t believe any injections into the joint are beneficial, and surgery to remove bone spurs leads to…the development of more bone spurs! Those references about steroid injections into the flexor tendon did not include any information whether the injections themselves caused long-term damage to the soft tissue.

This is very new work, Po-Ji, and long term results are going to be slow in coming. But I feel quite certain I have described a much more sane approach to chronic hip disease, and fairly outlined how seriously far off-course orthopedics really is.

I wish I or one of our WW practitioners could work with everyone who is experiencing hip pain to be sure they are properly aligned and doing the stretches and exercises correctly. Hip disease is especially thorny because once the inflammation takes hold it can progress very quickly, particularly in older women. The book and dvd must suffice for most people. PT has been very slow to adopt WW principles, and I don’t expect that to change anytime soon. Addressing chronic inflammation is another part of the WW hip treatment strategy and something I will have more information about in the near future.

Unfortunately, just like with prolapse and gynecology, I do not believe orthopedic surgeons should be treating common adult-onset hip pain.

Wishing you well,

Christine

Po-Ji

February 13, 2014 - 1:47pm

That might be a good idea later on. I will wait and see how far I get with the diagnosis. I'm hoping the holistic doctor will have some authority in at least referring me for the right kind of scan. I will search this site to see how to have a consultation with Christine for a future time. XX

Po-Ji

February 13, 2014 - 5:09pm

Wow ... thanks for all that ! What can I possibly say about what you may or may not know!! Are there really so many health professionals that cannot be trusted not to lead us up the 'Garden path' ? I only saw the osteopath once for a diagnosis though, never seen one before and never again. I think I shall also knock the holistic doctor on the head too.

Your words, whilst very enlightening, came as a blow to begin with. How could I come to terms with having arthritis with the amount of pain I experienced while out walking today at my age? But now I realize this is better than the phantom 'hip spur' diagnosis. ( Well maybe I got it a bit wrong somewhere, but he definitely mentioned the word rare along with the hip spur diagnosis that needed a scan to detect) Now I see it as a temporary condition which I can work with and improve. This is so much better. I believe the emotions and psychological state have a lot to do with most disorders too, and these seem insurmountable, but not impossible also. I'm working on that too. No need to waste time with hospital X rays or scans, great. I think I shall just go away now and ...Have a good laugh about it all..! And have the belief my body will heal itself.

Thank you, and all blessings to you. for all your time and effort you give.

Christine

February 14, 2014 - 7:58pm

I like your attitude, Po-Ji...particularly the good laugh.

Regarding “Are there really so many health professionals that cannot be trusted?”, this is an important and very sticky question.

Enough orthopedic literature has been preserved to clearly see a radical change of course the profession took over the 19th century. Prior to the move to a surgically-based practice, orthopedics was treating hip pain sanely and with success. They described the natural history of hip OA and identified stages during which the disease must be arrested to avoid catastrophic joint degeneration. They knew chronic hip disease was not something that would respond well to surgery and fought to keep orthopedics a non-surgical specialty.

Yet, a certain faction wanted to treat hip pain surgically. It is a fact that the paradigm of why the hip joint degenerates changed completely between the 19th and 20th centuries. Ironically, radiology came on the scene at that time, which imaged bones, not muscles and ligaments. Anesthesia, antibiotics, and the sterile field made surgery on humans possible.

The theories that were developed over the past several decades were very ‘water-tight’, once imaging technologies were manipulated to reinforce the surgical perspective. After a generation of old-school doctors being politically put out to pasture, few questioned the logic of the new paradigm because the hip joint is very deep and not easily visualized or understood. And x-rays, MRIs and CT scans offered so much “proof” that the problem was in the bones and cartilage.

It’s not so much that individual practitioners cannot be trusted, but that the ground they’re standing on is mere shifting sand. I’m sure most orthopedists have no idea why their results are so dismal.

Christine

Po-Ji

February 15, 2014 - 7:48am

This is so interesting. It seems that if there once was a natural and practical approach to orthopedics that worked once then it may not be too difficult to return to that again. I think your work is especially exiting in this respect.
I braved using my stick into the town yesterday and it has been a great help, really. Relieving just that little bit of pressure made the difference between, unable to walk without hugely limping and pain, to bombing along most of the time, in upright WW posture, with just a few stabs here and there. I was being careful, but found that getting into a reasonable moderate to fast pace gave most relief. because that's how I could use the stick best. I use a hiking pole, bought a pair really cheap in the sale, £5 each, adjustable and with anti shock ends. I think that once I got the hang of it I didn't look like I needed a stick and received a few curious looks! That's fun in a way. I've still got to get over being self conscious with using it though and am considering dressing up my stick somehow into an unusual feature, seeing as me and my stick are likely to become one for a while, might as well come to personalize and love it I think. Because my stick and I are likely to become one for a while. My stick is different because it is a Whole Woman Stick!
I have seen your reference to leg hip braces that were used in the past and wonder what you think of some of the modern hip braces on the market. There's one called the the thermoskin hip and brace support http://www.healthandcare.co.uk/ I suppose most are likely to be too tight round the abdomen for women.
I am also not sure whether I have weak ligaments and muscles around the hip or too tight through tension. I have been thinking mine are too tight through tension. My partner appears to be pretty body conscious and aware has been drawing attention to that about me for a long time ( not saying he is right though). The osteopath also mentioned tightness at the side of the hip and was surprised it wasn't sore when pressed. I do catch myself at times tensing up all round the thigh and hip area when standing still and immersed in concentrating or stressing about something. Do you think some of us could be too tight and some too loose? Po-JI

Christine

February 15, 2014 - 6:11pm

There is no brace on the market that transfers the weight from the hip to the entire pelvis. Federal governing agencies decide what is allowed to be sold, and such a hip brace is nonexistent. Unlike the thermoskin, a real OA brace would have a substantial girdle, and then metal stays down the inside and outside of the leg would form a stirrup under the foot. All pressure would be applied to the stirrup and would be born by the entire pelvis. The affected hip would bear no weight at all. Interesting that no such thing exists today.

Changing your posture and allowing the stick to help your lateral glutes should be adequate to heal the first stages of hip OA. So looking forward to hearing of your progress!

:-) Christine

Po-Ji

February 17, 2014 - 10:15am

Thank you very much indeed for all that information. I appreciate it and feel more confident now for moving ahead more positively and I shall certainly let you know of my future progress. XXX

agnusdei

February 17, 2014 - 2:53pm

I thought this might be of interest. I was looking for mastitis remedies, and this was used for bone spurs in the neck, might be worth a look into along with posture.

http://www.quantumagriculture.com/node/203