PRP and Orthobiologics in O’Fallon, MO

I-70 EAST TO I-270

Lateral hip pain that hurts when you lie on it is almost never bursitis, and treating it as bursitis is why it has not gone.

Getting here from O’Fallon

I-70 east to I-270 north, then east to Natural Bridge Road — around twenty-four minutes outside the afternoon peak. Parking is at the door.

The diagnosis that is usually wrong

Pain on the outside of the hip, worse lying on that side and worse climbing stairs, gets called trochanteric bursitis almost automatically. Imaging and surgical series have shown for years that the bursa is frequently uninvolved.

What is actually degenerating is the gluteal tendon where it attaches to the greater trochanter — a tendinopathy, not an inflamed sac. That is why repeated cortisone into the bursa produces less each time and why the problem outlives it.

Gluteal tendinopathy covers the anatomy and what distinguishes the two.

Why the commute makes it worse

A long daily drive is a sustained hip position with the leg adducted and the tendon under compression against the bone. Add a desk at the other end and the tissue spends most of the day in the position that irritates it.

That is worth naming because it changes the advice. Crossing the legs, sleeping on the painful side, and sitting low all compress the same structure, and adjusting those does more early on than most treatments.

Cortisone, and its cost

A steroid injection into this area frequently helps for a few weeks. Repeated, it has a measurable adverse effect on tendon tissue — the structure that is already failing.

So the honest framing is that cortisone buys time rather than repairing anything, and each round buys less. PRP versus cortisone sets out what the evidence actually supports for each.

Sleeping on it

The single most effective early change for lateral hip pain is usually not a treatment. It is a pillow between the knees and, where possible, not sleeping on the painful side, because side-lying compresses the tendon against the bone for hours.

People discount it because it sounds trivial. It is frequently the difference between a tendon that is irritated for eight hours a night and one that is not.

Where the back comes into it

Lateral hip pain and referred pain from the lumbar spine overlap, and a proportion of what gets treated as hip is coming from the back. The two are separable on examination.

Hip or back? covers how that is worked out, and it is worth settling before anything is injected into either.

Strength is the treatment that holds

Abductor weakness both causes and results from gluteal tendinopathy, and the loop closes quickly. A program that loads the tendon progressively is what changes the tissue; everything else manages symptoms.

It is slower than an injection and it is the part that decides whether the result lasts past six months.

When to stop and reassess

Night pain that is not positional, pain that is escalating rather than fluctuating, or any fever belongs in a different conversation and should not be managed as tendinopathy.

Those are uncommon and they are worth stating, because a confident wrong diagnosis is more dangerous than an uncertain right one.

If both hips hurt

Bilateral lateral hip pain shifts the question toward load, gait and sometimes the spine rather than two coincidental tendon problems.

It also raises inflammatory and metabolic causes, which is a different workup and one worth doing before injecting either side.

What the plan looks like

Load management first, then a structured strengthening program for the abductors, then injection only where that has genuinely been run and stalled.

The recovery timeline sets out how long each stage should take, so a normal plateau is not mistaken for failure.

What we do instead

Confirm the structure, load it properly, and where a repair response is worth provoking, use an orthobiologic preparation suited to tendon rather than to joint.

The loading part is not optional and it is the part patients most often skip, because it is slower and less dramatic than an injection. Without it the injection is treating tissue that will be asked to do exactly what failed it before.

Hip pain in a younger patient is usually a different diagnosis

The hip discussion on this page assumes degenerative change. In patients under about forty, groin pain with clicking, catching or a sharp limit at the end of hip flexion more often reflects femoroacetabular impingement and the labral injury that comes with it.

The mechanism is a shape mismatch rather than wear: extra bone on the femoral neck, a deeper-than-usual socket, or both, so the two surfaces collide at the end of range instead of clearing each other. Repeated collision damages the labrum and the adjacent cartilage.

The tells are specific — pain reproduced by flexing, adducting and internally rotating the hip, difficulty sitting for long periods, and a history in a sport with repeated deep hip flexion.

It matters here because the treatment sequence is different and because the surgical option is genuinely effective in selected patients, unlike much of what is offered for degenerative hips. Getting the diagnosis right early, before secondary cartilage damage accumulates, changes what is available later.

What O’Fallon patients ask

I was told it is bursitis. Is that wrong?

Usually, yes. The bursa is frequently uninvolved and the tendon is the structure that has degenerated: gluteal tendinopathy.

Why did my cortisone injection stop working?

Because it suppresses inflammation without repairing tendon, and repeat exposure has a cost to the tissue: the comparison.

Can I keep driving to work?

Yes, with adjustments — seat height, avoiding crossed legs, and breaking up the position. Those change the load the tendon is under all day.

How far is it from O’Fallon?

About twenty-four minutes via I-70 and I-270, with free parking outside.