Posted on Mon Jan 28, 2019
Dr Keith Bush talks us through what these symptoms may reveal, and how to manage them.
Well, this is not an uncommon complaint in musculoskeletal practice and the first thing is to be thoroughly assessed by someone who understands what the possibilities are. Then, further imaging such as an MRI scan of the lumbar spine and or the pelvis may be required to confirm the clinical suspicion.
Differential diagnosis should include:
Once a firm diagnosis has been established then a treatment strategy can be planned. This may range from manual techniques such as physiotherapy, osteopathy, chiropractic or injectional techniques based on anatomical grounds or under image guidance. A positive response to an injection in the short term absolutely confirms the diagnosis and may be long lasting. For instance, over 80% of sciaticas due to disc herniations will resolve with conservative measures. Steroid injections reduce the inflammation of the nerve root buying pain free time whilst most intervertebral disc herniations regress naturally.
On the other hand osteoarthritis of the hip is generally a progressive condition which ultimately may require total hip replacement. However, repeated injections may delay the need for surgery for many years which is important in younger patients. Furthermore, when patients are suffering from dual potential pathology, a positive response to an injection in the short term can be very helpful in localising the predominant pain source that may ultimately require a surgical solution.
Dr Keith Bush is the Consultant Orthopaedic and Sports Physician for the KB Clinic on Harley Street specialising in diagnosing and imaging musculoskeletal disease including sporting injuries. For further information contact the clinic here firstname.lastname@example.org.
We offer affordable diagnostic imaging in London’s world-renowned Harley Street medical district. If you or a patient need a scan, we’re an efficient, affordable and quick option, with MRI scans from £250, Ultrasound from £265, X-ray from £55 and DEXA from £95.
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