Video presented by Ana Bracilovic, MD
When hip pain is coming from within the joint, the most common cause of that type of pain comes from a labral tear. The labrum is the cartilage lining of that socket joint of the ball-and-socket hip joint, and that can tear in different area. Typically, patients will present with pain in the groin. They can feel locking, catching, giving way, or a sense of decreased strength on that side.
The pain can be sharp, or it can feel like a catching sensation. Labral tears can occur in the younger population, including athletes, gymnasts, and dancers. However, it can also occur in an older population where the type of tear is more degenerative.
How is a Labral Tear in the Hip Diagnosed?
In diagnosing the labral tear, normally, the MRI will show where exactly in the labrum the tear is located. In addition to doing the MRI, an arthrogram is helpful, because when you inject a small amount of lidocaine, if it relieves some of the patient’s symptoms, then this clues us in that the problem is actually coming from within the hip joint itself.
How is a Labral Tear in the Hip Treated?
The labral tear can be treated with an intra-articular injection of steroid and lidocaine. In addition to injections into the hip, oral anti-inflammatories can also be helpful. These can either be prescribed or over-the-counter. Ideally, the injection in addition to physical therapy will be sufficient to help the person get to complete pain relief. In recalcitrant cases, when the physical therapy and injections have not been sufficiently helpful, then a surgical evaluation is recommended. But ideally, physical therapy and injections will be sufficient.
Does the Labrum Heal the Tear Itself?
Cartilage on its own does not heal; it is not innervated. But the physical therapy will help to reduce the stress and pressure on the joint, and reduce the stresses that most likely brought on the labral tear to begin with. Also, the anti-inflammatory medications just help with inflammation in the fluid surrounding the injury; they do not do anything for the tear itself.