QUESTION: Please help.
I am a senior, senior citizen, and can't always afford medical care all the time.
Perhaps you can diagnose my problem.
What could cause terrible pains in my hip?
ANSWER: For one of the most difficult of all diagnosis to make, you have provided me with far too little information.
There are many causes of "terrible" pains in the hips and, unfortunately, many of them mimic each other.
That made it difficult for doctors to diagnose exact cause of those pains in the past. Even with modern technology, accurate diagnoses still rely upon careful examination and observation by your physician.
X-rays are helpful but many causes relate to the soft tissues which surround your hip joint.
All possibilities must be considered carefully when searching for the cause of your pain. Before we discuss some of the possible origins of your pain, here's a quick description of the hip itself.
It is the only true ball and socket joint in the human body and, except for the knee, is the largest joint.
It is a major source of symptoms of pains in several parts of the body including the back, legs and buttocks.
When you take a step or rise from a sitting position, a force of 2.5 to 3 times the weight of the body is exerted to the weight-bearing dome of the hip.
So, our hips take a "beating" as we live long lives. Arthritis is immediately suspected when a patient goes to a doctor complaining of pain in the hip area.
But there are many clinical conditions that can affect, or be affected by, the hip that do not stem from arthritis. Nevertheless, osteoarthritis and rheumatoid arthritis cause more than 90 percent of such diagnoses. The most common causes of hip pain after a fall or some other trauma are fractures.
Next in frequency are synovitis, necrosis (death of cells in the lining of joints), and avascular necrosis (death of cells caused by a deficiency of blood supply). Occult (difficult to see) fractures most frequently occur in elderly patients with osteoporosis.
They are more common in women than they are in men and usually follow a rather minor fall.
Avascular necrosis happens in all ages and may result from huge corticosteroid intake, excessive alcohol consumption, drugs that cause the immune system to become weakened, trauma, and sickle cell anemia.
There are, of course, other less frequently occurring reasons for hip pain such as untreated congenital dislocation of the hip, metabolic hormonal conditions in children, and other less well understood conditions. There are three major conditions that mimic hip disease.
These include pain caused by pressure on nerve roots, trochanteric bursitis (affects the upper part of the hip bone), and vascular insufficiency. Hip disease treatments usually are conservative, using medication to reduce the pain symptom for as long as patients can tolerate the discomfort and inconvenience.
Using a cane can help relieve some of the pressure from your hip and reduce the pain. Though I would love to be a "miracle doctor" for you and my many other readers, it simply can't be done by answering a question in this column.
In cases such as yours, only the careful examination by a caring physician can start you on the road to relief.
The material contained here is "FOR INFORMATION ONLY" and should not replace the counsel and advice of your personal physician.
Promptly consulting your doctor is the best path to a quick and successful resolution of any medical problem.
