L13 Hip symptom/complaint (ICD-10:M25.5)

Introduction

Hip symptoms or complaints refer to any discomfort, pain, or abnormal sensations experienced in the hip region. The hip joint is a crucial joint that allows for movement and stability of the lower body. Hip symptoms can be caused by various conditions, including injuries, arthritis, bursitis, and tendinitis^[1]. This guide aims to provide a comprehensive overview of the diagnostic steps, possible interventions, and lifestyle modifications for hip symptoms.

Codes

• ICPC-2 Code: L13 Hip symptom/complaint^[2]
• ICD-10 Code: M25.5 Pain in joint^[3]

Symptoms

• Pain in the hip joint
• Stiffness or limited range of motion in the hip
• Swelling or tenderness in the hip area
• Difficulty walking or bearing weight on the affected hip
• Clicking or popping sounds in the hip joint^[4]

Causes

• Osteoarthritis: Degenerative joint disease that causes the breakdown of cartilage in the hip joint.
• Rheumatoid arthritis: An autoimmune disease that causes inflammation and damage to the joints, including the hip.
• Hip fractures: Breaks or cracks in the bones of the hip joint, often caused by falls or trauma.
• Bursitis: Inflammation of the bursae, small fluid-filled sacs that cushion the hip joint.
• Tendinitis: Inflammation of the tendons in the hip, often caused by overuse or repetitive movements.
• Hip labral tear: A tear in the ring of cartilage (labrum) that surrounds the hip joint^[5].

Diagnostic Steps

Medical History

• Gather information about the patient’s symptoms, including the location, duration, and severity of hip pain.
• Ask about any previous injuries or trauma to the hip.
• Inquire about any underlying medical conditions, such as arthritis or autoimmune diseases.
• Assess the patient’s daily activities and occupation for potential hip stressors.
• Identify any risk factors for hip conditions, such as obesity or a family history of hip problems^[6].

Physical Examination

• Perform a thorough physical examination of the hip joint, including range of motion tests and palpation for tenderness or swelling.
• Assess the patient’s gait and observe for any abnormalities or limping.
• Check for muscle strength and stability around the hip joint.
• Perform specific tests, such as the Thomas test or Trendelenburg test, to evaluate hip function and stability^[7].

Laboratory Tests

• Blood tests: May be ordered to assess for markers of inflammation, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
• Joint fluid analysis: If there is suspicion of infection or inflammatory arthritis, a sample of fluid may be taken from the hip joint for analysis.
• Rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies: These tests help diagnose rheumatoid arthritis^[8].

Diagnostic Imaging

• X-rays: Provide detailed images of the bones in the hip joint, useful for detecting fractures, arthritis, or structural abnormalities.
• Magnetic resonance imaging (MRI): Produces detailed images of the soft tissues in the hip joint, helpful for evaluating labral tears, tendinitis, or other soft tissue injuries.
• Ultrasound: Can be used to visualize the hip joint and surrounding structures, particularly useful for assessing bursitis or tendinitis.
• Computed tomography (CT) scan: Provides cross-sectional images of the hip joint, helpful for evaluating complex fractures or identifying bone abnormalities^[9].

Other Tests

• Bone scan: A nuclear medicine test that can detect abnormalities in bone metabolism, useful for identifying stress fractures or bone tumors.
• Electromyography (EMG): Measures the electrical activity of muscles and nerves, helpful for diagnosing nerve-related hip conditions.
• Arthroscopy: A minimally invasive procedure that uses a small camera to visualize and treat hip joint problems, such as labral tears or loose bodies^[10].

Follow-up and Patient Education

• Schedule follow-up appointments to monitor the patient’s progress and adjust treatment plans if necessary.
• Provide education on self-care measures, such as rest, ice or heat therapy, and gentle stretching exercises.
• Encourage the patient to maintain a healthy weight and engage in low-impact exercises to improve hip joint strength and flexibility.
• Discuss the importance of adhering to prescribed medications and treatment recommendations.
• Address any concerns or questions the patient may have regarding their hip symptoms or treatment options.

Possible Interventions

Traditional Interventions

Medications:

Top 5 drugs for Hip symptoms/complaint:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., Ibuprofen, Naproxen):
   • Cost: Generic versions can be $3-$20/month.
   • Contraindications: Active peptic ulcer disease, history of gastrointestinal bleeding, severe renal impairment.
   • Side effects: Upset stomach, heartburn, increased risk of bleeding.
   • Severe side effects: Gastrointestinal bleeding, kidney damage, allergic reactions.
   • Drug interactions: Anticoagulants, corticosteroids, selective serotonin reuptake inhibitors (SSRIs).
   • Warning: Long-term use may increase the risk of cardiovascular events.
2. Acetaminophen:
   • Cost: Generic versions can be $3-$10/month.
   • Contraindications: Severe liver disease, alcoholism.
   • Side effects: Rare at therapeutic doses, but high doses can cause liver damage.
   • Severe side effects: Acute liver failure.
   • Drug interactions: None significant.
   • Warning: Avoid exceeding the recommended daily dose to prevent liver damage.
3. Muscle relaxants (e.g., Cyclobenzaprine, Methocarbamol):
   • Cost: Generic versions can be $4-$20/month.
   • Contraindications: Severe liver disease, history of drug abuse.
   • Side effects: Drowsiness, dizziness, dry mouth.
   • Severe side effects: Serotonin syndrome, allergic reactions.
   • Drug interactions: Sedatives, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants.
   • Warning: Avoid driving or operating heavy machinery due to potential drowsiness.
4. Corticosteroids (e.g., Prednisone, Methylprednisolone):
   • Cost: Generic versions can be $4-$30/month.
   • Contraindications: Active infections, uncontrolled diabetes, systemic fungal infections.
   • Side effects: Increased appetite, weight gain, mood changes.
   • Severe side effects: Osteoporosis, adrenal suppression, increased risk of infections.
   • Drug interactions: Nonsteroidal anti-inflammatory drugs (NSAIDs), anticoagulants, antidiabetic medications.
   • Warning: Long-term use may require gradual tapering to avoid adrenal insufficiency.
5. Opioids (e.g., Oxycodone, Hydrocodone):
   • Cost: Generic versions can be $10-$50/month.
   • Contraindications: Severe respiratory depression, acute asthma, paralytic ileus.
   • Side effects: Constipation, drowsiness, nausea.
   • Severe side effects: Respiratory depression, addiction, overdose.
   • Drug interactions: Benzodiazepines, sedatives, alcohol.
   • Warning: High potential for addiction and abuse, should be used cautiously and for short durations.

Alternative Drugs:

• Capsaicin cream: Topical cream that can provide temporary relief from hip pain. Cost: $10-$20 per tube.
• Glucosamine and chondroitin: Dietary supplements that may help improve joint health. Cost: $20-$40 per month.
• Steroid injections: Intra-articular injections of corticosteroids for targeted pain relief. Cost: $100-$500 per injection.
• Hyaluronic acid injections: Injections that can help lubricate the hip joint and reduce pain. Cost: $300-$800 per injection.
• Duloxetine: An antidepressant that can also help manage chronic pain. Cost: $20-$50 per month.

Surgical Procedures:

• Hip arthroscopy: A minimally invasive procedure that uses a small camera to visualize and treat hip joint problems, such as labral tears or loose bodies. Cost: $10,000 to $30,000.
• Total hip replacement: Surgical removal of the damaged hip joint and replacement with an artificial joint. Cost: $30,000 to $50,000.

Alternative Interventions

• Physical therapy: Targeted exercises and manual therapy techniques to improve hip joint mobility and strength. Cost: $50-$150 per session.
• Chiropractic care: Manual manipulation of the spine and joints to alleviate hip pain. Cost: $50-$200 per session.
• Acupuncture: May help reduce pain and improve hip joint function. Cost: $60-$120 per session.
• Massage therapy: Manual manipulation of soft tissues to relieve muscle tension and improve circulation. Cost: $50-$100 per session.
• Yoga or Pilates: Low-impact exercises that can improve hip flexibility and strength. Cost: Varies depending on the location and instructor.

Lifestyle Interventions

• Weight management: Losing excess weight can reduce stress on the hip joint. Cost: Varies depending on the chosen weight loss program or diet.
• Low-impact exercises: Engaging in activities such as swimming or cycling can improve hip joint mobility without excessive strain. Cost: Varies depending on the chosen activity or gym membership.
• Heat or cold therapy: Applying heat or cold packs to the hip can help alleviate pain and inflammation. Cost: Varies depending on the chosen therapy (e.g., hot/cold packs, heating pad).
• Assistive devices: Using a cane or walker can provide support and reduce strain on the hip joint. Cost: Varies depending on the chosen device.
• Ergonomic modifications: Making adjustments to workstations or seating arrangements to promote proper hip alignment. Cost: Varies depending on the modifications needed.

It is important to note that the cost ranges provided are approximate and may vary depending on the location and availability of the interventions.

Mirari Cold Plasma Alternative Intervention

Understanding Mirari Cold Plasma

• Safe and Non-Invasive Treatment: Mirari Cold Plasma is a safe and non-invasive treatment option for various skin conditions. It does not require incisions, minimizing the risk of scarring, bleeding, or tissue damage.
• Efficient Extraction of Foreign Bodies: Mirari Cold Plasma facilitates the removal of foreign bodies from the skin by degrading and dissociating organic matter, allowing easier access and extraction.
• Pain Reduction and Comfort: Mirari Cold Plasma has a local analgesic effect, providing pain relief during the treatment, making it more comfortable for the patient.
• Reduced Risk of Infection: Mirari Cold Plasma has antimicrobial properties, effectively killing bacteria and reducing the risk of infection.
• Accelerated Healing and Minimal Scarring: Mirari Cold Plasma stimulates wound healing and tissue regeneration, reducing healing time and minimizing the formation of scars.

Mirari Cold Plasma Prescription

Video instructions for using Mirari Cold Plasma Device – L13 Hip symptom/complaint (ICD-10:M25.5)

Localized (0) Sacrum (1) Prostate & Uterus (2) Kidney, Liver & Spleen (3) Heart, Bile & Pancreas (4) Lungs (5) Throat, Lymphatic & Thyroid (6) Neuro system & ENT (7)

Use the Mirari Cold Plasma device to treat Hip symptom/complaint effectively.

WARNING: MIRARI COLD PLASMA IS DESIGNED FOR THE HUMAN BODY WITHOUT ANY ARTIFICIAL OR THIRD PARTY PRODUCTS. USE OF OTHER PRODUCTS IN COMBINATION WITH MIRARI COLD PLASMA MAY CAUSE UNPREDICTABLE EFFECTS, HARM OR INJURY. PLEASE CONSULT A MEDICAL PROFESSIONAL BEFORE COMBINING ANY OTHER PRODUCTS WITH USE OF MIRARI.

Step 1: Cleanse the Skin

• Start by cleaning the affected area of the skin with a gentle cleanser or mild soap and water. Gently pat the area dry with a clean towel.

Step 2: Prepare the Mirari Cold Plasma device

• Ensure that the Mirari Cold Plasma device is fully charged or has fresh batteries as per the manufacturer’s instructions. Make sure the device is clean and in good working condition.
• Switch on the Mirari device using the power button or by following the specific instructions provided with the device.
• Some Mirari devices may have adjustable settings for intensity or treatment duration. Follow the manufacturer’s instructions to select the appropriate settings based on your needs and the recommended guidelines.

Step 3: Apply the Device

• Place the Mirari device in direct contact with the affected area of the skin. Gently glide or hold the device over the skin surface, ensuring even coverage of the area experiencing.
• Slowly move the Mirari device in a circular motion or follow a specific pattern as indicated in the user manual. This helps ensure thorough treatment coverage.

Step 4: Monitor and Assess:

• Keep track of your progress and evaluate the effectiveness of the Mirari device in managing your Hip symptom/complaint. If you have any concerns or notice any adverse reactions, consult with your health care professional.

Note

This guide is for informational purposes only and should not replace the advice of a medical professional. Always consult with your healthcare provider or a qualified medical professional for personal advice, diagnosis, or treatment. Do not solely rely on the information presented here for decisions about your health. Use of this information is at your own risk. The authors of this guide, nor any associated entities or platforms, are not responsible for any potential adverse effects or outcomes based on the content.

Mirari Cold Plasma System Disclaimer

• Purpose: The Mirari Cold Plasma System is a Class 2 medical device designed for use by trained healthcare professionals. It is registered for use in Thailand and Vietnam. It is not intended for use outside of these locations.
• Informational Use: The content and information provided with the device are for educational and informational purposes only. They are not a substitute for professional medical advice or care.
• Variable Outcomes: While the device is approved for specific uses, individual outcomes can differ. We do not assert or guarantee specific medical outcomes.
• Consultation: Prior to utilizing the device or making decisions based on its content, it is essential to consult with a Certified Mirari Tele-Therapist and your medical healthcare provider regarding specific protocols.
• Liability: By using this device, users are acknowledging and accepting all potential risks. Neither the manufacturer nor the distributor will be held accountable for any adverse reactions, injuries, or damages stemming from its use.
• Geographical Availability: This device has received approval for designated purposes by the Thai and Vietnam FDA. As of now, outside of Thailand and Vietnam, the Mirari Cold Plasma System is not available for purchase or use.

References

1. Gomberawalla, M. M., Kelly, B. T., & Bedi, A. (2013). Interventions for Hip Pain in the Maturing Athlete. Sports Health, 5(1), 70-77. https://doi.org/10.1177/1941738112464761
2. ICPC-2 – English. (n.d.). World Health Organization. Retrieved June 21, 2024, from https://www.who.int/standards/classifications/other-classifications/international-classification-of-primary-care
3. ICD-10 Version:2019. (n.d.). World Health Organization. Retrieved June 21, 2024, from https://icd.who.int/browse10/2019/en#/M25.5
4. Hip pain. (n.d.). Versus Arthritis. Retrieved June 21, 2024, from https://www.versusarthritis.org/about-arthritis/conditions/hip-pain/
5. Dutton, A. (2021, May 10). 10 Tips for Healthy Hips! Dr Andrew Dutton Orthopaedic & Sports Clinic. https://www.drandrewdutton.com/blog/10-tips-for-healthy-hips/
6. Hip Pain: Causes and Treatment. (n.d.). American Hip Institute. Retrieved June 21, 2024, from https://www.americanhipinstitute.com/blog/hip-pain-what-are-the-causes-and-treatment-40422.html
7. Hip Examination. (2022, April 11). Physiopedia. https://www.physio-pedia.com/Hip_Examination
8. Runhaar, J., Özbulut, Ö., Kloppenburg, M., Boers, M., Bijlsma, J. W. J., & Bierma-Zeinstra, S. M. A. (2021). Diagnostic criteria for early hip osteoarthritis: first steps, based on the CHECK study. RMD Open, 7(3), e001654. https://doi.org/10.1136/rmdopen-2021-001654
9. Hip Pain Diagnosis & Treatment. (n.d.). Dignity Health. Retrieved June 21, 2024, from https://www.dignityhealth.org/conditions-and-treatments/orthopedics/common-hip-injuries-and-conditions/hippain/diagnosis-and-treatment
10. Hip Pain Treatment Options. (n.d.). Hospital for Special Surgery. Retrieved June 21, 2024, from https://www.hss.edu/hip-pain-center-treatments.asp