Case Study: 76 Year Old Female With Hip Pain
Here’s a story from back when I first started Physical Therapy. I was working up in WA and was practicing PT for about 6 months when this 76 year old lady walked in with over 5 years of hip pain. Let’s share her story first. She was diagnosed with moderate hip arthritis from her local doctor after an x-ray and told that’s why she has pain. Her symptoms included not being able to lay on her R side, difficulty with stairs, pain with prolonged sitting and prolonged walking, and difficulty getting out of chairs. These are all very common symptoms for everyone, but none of these pain symptoms relate to arthritis. Her physician stated that if PT didn’t work (this time), she was going to need to get a hip replacement within the next year.
Let’s talk about the symptoms of arthritis first. Arthritis takes years if not decades to build up so it’s a slow progressive process. It’s rare for someone with arthritis to say “the symptoms started 3 years ago or 5 months ago” it’s usually longer than that and without a defined beginning. Additionally, arthritis is painful with beginning motions, not sustaining motion. If pain worsens with continued activity, it’s not arthritis. It’s most likely a soft tissue injury like tendinitis, or bursitis. Pain with sustained sitting or laying down doesn’t fit arthritis either. Laying down or sitting causes compression of soft tissues, not bones or joints, so if sustained laying down or sitting causes pain in the hip, it’s mostly likely not arthritis. Just to sum up, all of the symptoms she described were NOT ARTHRITIS! She described all of the symptoms of bursitis, but because the x-ray revealed arthritis, the doc said, “pain must be from arthritis, look, we have an image to show you have arthritis.” Personally I believe this is lazy medical care.
Back to the story. After she described all of her symptoms I concluded that she was most likely dealing with pain from bursitis in her hip. She had gone to PT 3 times before seeing me, but all of the previous PTs were treating her for arthritis, because that’s what the physician said. They gave her all these exercises and meaningless stretches which didn’t work, so she lived with this problem for 5 YEARS! I decided to treat her for bursitis instead of arthritis because I listened to her story and made a decision on my own, that’s what medical school taught me to do. I didn’t follow the physician’s diagnosis because I felt it was not entirely accurate. Keep in mind she was treated for arthritis 3 by physical therapy times before from other PTs. I wasn’t going to be the same.
She was dealing with this pain and limited mobility for 5 YEARS because of an incorrect diagnosis from her physician with poor treatment from everyone else in her insurance network following the original diagnosis. Fast forward 4 weeks with weekly treatments from myself. She no longer had hip pain when lying down or sitting. She got back into a walking routine and was getting in/out of chairs again without issue. Most importantly she never had to get the hip replacement. Listening to the history of our patients can tell us everything we need to know about what our patients are dealing with. We can make people healthy again without pills or surgery, all we need is some simple massage and some targeted exercises to help maintain our independence.
Stay healthy Movers!
