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Talking With Your Doctor About Hip Pain

Hip pain is a common complaint. There are many possible
causes—some obvious, some not so obvious. You'll need to work with your doctor
to figure out what's causing your pain. Then you and your doctor can decide on
options for treatment.

Here are seven questions that can help you start the
conversation.

What do my symptoms tell you about my hip pain?

Your hip pain symptoms will probably be the first thing your
doctor wants to know about. They can help point to the cause. For instance:

  • Pain that starts after an injury may be due to a
    muscle tear or strain near your hip.

  • Pain that gets worse when you press on your hip
    or sleep on your side may be due to hip bursitis. This is an inflammation of
    your hip bursa. That's a fluid-filled sac that cushions the bony point of your
    hip.

  • Pain that has been getting gradually worse over
    years may be osteoarthritis. This wear-and-tear type of arthritis is most
    common after age 60. It usually gets worse with certain types of activity.

  • Pain that's worse in the morning and gets better
    during the day may be due to rheumatoid arthritis. It may cause pain in both
    hips and other joints. You may also have fever and fatigue.

  • Pain that starts suddenly, is very severe and
    comes with a fever may be due to an infection in your hip joint.

Be as specific as possible when describing your symptoms.
This will help your doctor make a diagnosis.

What will you do to diagnose my hip pain?

After asking about your symptoms, your doctor will do a
physical exam. He or she will feel and move your hip to check for swelling,
pain and stiffness. Other tests can produce important information:

  • Your doctor may order blood tests to look for
    signs of inflammation or infection.

  • Your doctor may order imaging studies of your
    hip. Examples are an X-ray, CT scan, MRI and ultrasound.

  • Your doctor may take a sample of the fluid in your
    hip joint. Checking this fluid in a lab can help rule out or reveal the cause
    of your pain, such as infection.

Will I need medication for my hip pain?

Some medications help relieve symptoms like pain and
swelling. Others treat whatever is causing your pain. For instance:

  • If your pain is not too severe, your doctor may
    suggest an over-the-counter painkiller like acetaminophen (Tylenol).

  • If you have both pain and swelling, your doctor
    may prescribe a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen
    (Advil, Motrin).

  • If you have severe swelling, your doctor may
    prescribe a steroid drug to take by mouth. Sometimes an injection of the drug
    into your joint is most effective.

  • If your pain is from rheumatoid arthritis, there
    are many drugs available to stop the disease from getting worse. Examples
    include disease-modifying anti-rheumatic drugs (DMARDs) and biologics. Some of
    these medicines are administered by IV (intravenously) during an infusion
    procedure.

  • Antibiotics may cure the problem and relieve your
    pain if it’s from a bacterial infection in your hip joint.

Will I need surgery?

You will probably need some type of surgery for a hip
fracture or dislocation. You may need hip replacement surgery if you have
severe osteoarthritis and other treatments are not helping. If you have a
severe bursitis, you might need surgery to remove the inflamed area. This is
rare, however.

Will physical therapy help?

Your doctor may suggest working with a physical therapist.
Exercise to improve movement and strengthen the muscles around your hip can
sometimes ease your pain. This will depend on what's causing your hip pain.
However, physical therapy can help with many types of hip pain, including
arthritis, injury and recovery after surgery. Physical therapy may include:

  • Specific strength and stretching exercises

  • Heat or ice treatments

  • Massage therapy

  • Use of healing energy from electricity or sound
    waves

  • Use of assistive devices like crutches or a
    walker

What can I do on my own at home?

For short-term relief, your doctor may suggest icing your
hip and resting. You may need to avoid activities that make the pain worse.
Your doctor may tell you to stop smoking, too. That's because smoking can delay
healing. For long-term relief, it may help to lose weight if you are overweight
so that your joints don't need to work as hard. You may need to change the way
you do certain work or recreational activities that cause hip pain. A physical
or occupational therapist can offer suggestions.

When should I schedule a follow-up visit?

Your doctor may give you specific instructions about future
appointments. In general, you should call your doctor if:

  • Your pain is getting worse.

  • Medications are not relieving your pain.

  • You have a fever or fatigue along with your
    pain.

  • Your pain is keeping you from your everyday
    activities.
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