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Hip Osteoporosis

Hip osteoporosis is transient, uncommon syndrome, which leads to transient bone loss in the upper part of the leg or femur. It is important to differentiate between transient hip osteoporosis and the widespread age-related osteoporosis, which is painless, progressive disease with negative implications on the bones throughout the body. The risk of fractures is greater in patients with common age-related osteoporosis than people with transient hip osteoporosis.

Causes

There is no obvious reason for transient hip osteoporosis; however there are some causes that may play part in appearance of this syndrome. These reasons may include:

  • Occlusion of a few of the small blood vessels which surround the hip
  • Change in the hormonal concentrations
  • Atypical physical stresses on the bones

Symptoms

  • Abrupt pain onset, which appears primarily in the front part of the thigh or the groin
  • Pain that increases with carrying heavy things, and decreases with rest
  • No previous history of damage or injury to the joint in the upper part of the leg.
  • Slight hip movements are usually painless, however extreme hip movements are always painful
  • Pain severity is usually increased over time. After weeks or months, the pain may be so intense and disabling.
  • Patients usually limp in order to relieve the pain.

Treatment

Since transient osteoporosis usually relieves by itself, the primary aims of the treatment are to minimize the symptoms and protect any further harm to the bones.

Physical Therapy Interventions

Physical Therapists are professionals, educated and trained to administer interventions. As defined by The Guide to Physical Therapist Practice, interventions are the skilled and purposeful use of physical therapy methods and techniques to produce changes consistent with the diagnosis, prognosis and the patient or client’s goals. Physical therapy is important to restore the strength and flexibility in the muscles supporting the hip. Water exercises are considered as essential part of the treatment because they facilitate the movements, and alleviate weight bearing

  • Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, stretching and joint mobilization by a physical therapist to improve postural alignment, mobility and range of motion. The use of mobilization techniques also helps to modulate pain.
  • Therapeutic Exercises (TE) including site specific stretching and strengthening exercises to improve posture, regain range of motion and strengthen the affected muscles to support, stabilize and decrease the stresses places.
  • Neuromuscular Reeducation (NMR) to restore stability, retrain the affected extremity and improve movement techniques and mechanics, and balance (for example, walking, kneeling, squatting and stair climbing). Gait and balance training may be indicated to reduce the risk of falls.
  • Modalities including the use of ultrasound, electrical stimulation, ice, cold, laser and others to decrease pain and inflammation of the involved area if there is a fracture involved.

Medical Interventions

In addition to performing a thorough examination, your physician may order the following tests to make a more concise diagnosis:

  • X-rays shows marked loss of the bone density of the femoral head.
  • MRI to determine any soft tissue involvement surrounding the hip
  • Although bone density test (densitometry or DEXA scan) is the ideal test to detect age-related osteoporosis, it is ineffective in diagnosis of transient osteoporosis of the hip

Medications

Your doctor may advise you to take non-steroidal anti-inflammatory medication (NSAIDs) such as piroxicam or celecoxib to alleviate pain and inflammation

Weight bearing restrictions

It is preferred that you do not perform any weight-bearing activities. Walkers, crutches, or walking aids may be also considered as effective methods to ease the stress of weight bearing on the hip, and protect against possible fractures.

Diet and nutrition

Many researches focused on the importance of vitamin D and calcium in rebuilding of the bones, and increasing the healing process.