Integrated Care and Hip Pain

CASE STUDY BLOG SERIES

How does integrated health actually work? That is a very common question from new and prospective patients. Join us for a multi-part blog series, written by our experienced providers, exploring integrative care at Jade Integrated Health. Learn about real people, whose lives have been changed by collaborative medicine. This blog features physical therapist Melissa Belcher, MSPT, CAPP-OB and acupuncturist, James Constantine DAIM, L.Ac. and their work with a patient Susan.


Susan, a middle aged female runner, sought care at Jade Integrated Health with joint pain and inflammation in both hips and dominant shoulder, which had increased over the last 2 years.  Her biggest concern was pain while running, but she also reported pain while at rest and during daily activities. She had a history of cross country running, and wanted to return to more movement for stress relief, but she wasn’t sure if running was a realistic goal. The patient also reported having a very demanding job which added to her stress levels. Sleep was poor, with difficulties getting to sleep (“mind won’t shut off”) and staying asleep. Susan also reported concerns about grinding her teeth at night.

Physical therapy treatment started with an examination to identify impairments in flexibility, strength and biomechanics as well as an evaluation of the patients running form. After identification of these impairments, treatment consisted of education and retraining proper running techniques combined with a home exercise program which targeted strengthening and increasing flexibility. Over the course of care, the patient saw a reduction in hip pain to where daily activities including walking were no longer painful or limited.  With use of metronome & clinic based running retraining, her gait improved and she was able to tolerate a gradual return to running without a flare up of pain. During the physical therapy treatment, the physical therapist and patient discussed adding acupuncture to her treatment plan to reduce pain levels, improve sleeping and lower stress level.

The acupuncturist found that Susan’s breathing was shallow, high in the chest, and sporadic in rate. Tongue diagnosis revealed a pale tongue body(Blood Deficient), with horizontal cracks in mid-lateral edges, and a red tip. Pulse was deep and wiry. Signs and symptoms lead the acupuncturist to a diagnosis of Liver Yin Deficiency (not nourishing sinews) with Heat Agitating the Heart (which disrupts sleep), with accompanying Qi Deficiency (overwork) and Stagnation causing pain. Her treatment plan included acupuncture directly after physical therapy appointments, dietary and herbal supplement recommendations, and focused breath work during treatments.

After just two weeks of treatments, Susan reported sleeping had improved and stated she had slept the whole night five out of seven nights between appointments. Work stress continues to be a factor, but the patient reports greater resiliency with acupuncture treatments and new found breathing practice. Joint pain (despite osteoarthritis diagnosis) is much more manageable, and shoulder discomfort has disappeared.