PRP and Orthobiologics in Ladue, MO

I-170 NORTH

Groin pain that is worse putting on socks is a hip, not a back — and it is one of the most commonly mislocated problems we see.

Getting here from Ladue

I-170 north to Natural Bridge Road — about twenty-two minutes. Parking at the door and a ground-floor entrance, which matters if stairs are part of the problem.

Where hip pain is actually felt

Hip joint pain is felt in the groin and often the front of the thigh, sometimes referring to the knee. It is not felt over the side of the hip, which is where most people point when asked, and it is not usually felt in the buttock.

That single distinction sorts a large fraction of these presentations. Lateral pain is tendon; buttock pain is more often spine or sacroiliac; groin pain that is worse on rotation is the joint itself.

Hip or back? covers how the two are separated on examination.

The functional tells

Difficulty putting on socks and shoes, trouble getting in and out of a car, and pain on rotating the leg inward are the practical signs of joint restriction rather than soft tissue irritation.

Those are more useful than a pain score because they are specific, testable and they change measurably when treatment works.

The hip that is really the spine

Buttock pain, pain that radiates below the knee, or symptoms that change with back position point away from the hip joint. Those are spine presentations and injecting a hip will not touch them.

Separating the two is a short examination and it prevents a common and expensive detour.

Keeping walking

Walking capacity is the single most useful functional measure in this group, and it declines quietly. We record it because it is the number that predicts independence better than any imaging finding.

Preserving it is the aim of treatment, not a side effect of it.

Bring someone if the history is long

A companion frequently recalls what changed and when better than the patient does, particularly where the decline has been gradual.

It also helps with a plan that involves both medication and activity changes, which is a lot to absorb in one visit.

What an orthobiologic can do in a hip

Hip osteoarthritis sets out the realistic position. The hip is a deep joint with less space than a knee, which makes accurate placement essential and makes image guidance non-negotiable rather than a refinement.

The aim is a period of improved comfort and function rather than reversal. Where the joint has lost its space entirely, replacement is the honest answer and we say so.

Age is not the deciding factor

What decides suitability is the state of the joint and the state of the person, not the year of birth. A seventy-five-year-old with a preserved joint space and good muscle is a better prospect than a fifty-year-old with neither.

We assess both rather than using age as a proxy for either.

Falls, and why this matters more here

Hip pain changes gait, shortens stride and reduces the confidence to turn, and each of those raises fall risk in an older adult. A fall is frequently the event that ends independent living.

So treating hip pain in this age group is partly a fall-prevention intervention, and the strength work that goes alongside it is not optional.

The evidence, stated plainly

Hip data is thinner than knee data, largely because accurate placement is harder to standardise. Why the trials disagree.

The ceiling nobody measures

In older adults the metabolic picture and the muscle picture are the same conversation, and both change what treatment can achieve. The metabolic side.

The other hip diagnosis, and it is not the joint

Pain on the outside of the hip, tender to press, worse lying on that side at night and worse climbing stairs, is usually not the hip joint at all. It is gluteal tendinopathy — degeneration where the gluteus medius and minimus attach to the greater trochanter.

It was called trochanteric bursitis for decades, and that name drove a great deal of unhelpful treatment. Imaging and surgical series have since shown that the bursa is frequently not the main problem; the tendon is. It is most common in women past fifty, and it coexists with hip osteoarthritis often enough that a scan showing arthritis does not settle which one is producing the symptoms.

The separation is straightforward on examination. Joint pain is usually felt in the groin and reproduced by internal rotation; tendon pain is felt on the side, reproduced by direct pressure and by single-leg standing.

It matters because the treatments diverge. Tendon problems respond to progressive loading of the abductors and to avoiding the positions that compress the tendon — crossing the legs, standing hip-dropped, sleeping without a pillow between the knees. Repeated corticosteroid into the area performs poorly over time and can make the tendon worse.

What Ladue patients ask

My pain is on the side of my hip. Is that the joint?

Usually not. Lateral pain is typically tendon; the joint refers to the groin: the tendon problem.

Am I too old for this?

Age is not the criterion. Joint space, stability and muscle condition are: who this suits.

Does the injection need imaging?

In a hip, yes. It is deep and blind placement is unreliable, which is a large part of why some people report no effect.

How far is it from Ladue?

About twenty-two minutes via I-170, with parking directly outside.