knee Pain

Are your knees aching from a sudden injury, or have your symptoms developed gradually over time? A common physical complaint, knee pain can occur at any age and may interfere with many aspects of life, from participation in sports to simply getting up from a chair and walking. Any part of the knee — bones, cartilage, muscles, ligaments, and tendons — can be damaged by disease (such as arthritis) or injury.

• Quick Links:Causes and Prevention
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• Living With Knee Pain

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Do Age and Hip Pain Always Go Together?

It's not written in stone that your hips will give out on you as you age. Learn how to avoid hip pain as you get older.


Common wisdom holds that as you age, you are destined to face a multitude of ills, including hip pain and possibly hip replacement surgery. In fact, hip replacement surgeries do increase after age 65.
Yet this does not have to be your future, say orthopedic surgeons. There are steps you can take to reduce the likelihood of hip pain and surgery as you age.
Hip Pain: It’s Not Inevitable
“Most people don’t get old and wear out. The hip joint is one of the best mechanically designed things that we’ve got,” says Steven Stuchin, MD, director of orthopedic surgery at the Hospital for Joint Diseases of New York University Medical Center and associate professor at NYU School of Medicine in New York City. “The hip is a round ball in a round socket, and nothing is better equipped to deal with stress and motion. For most, hip pain is not a product of aging — it is a product of injury or disease.”
One possible reason that the numbers of hip replacement surgeries appears to skyrocket as people age is that after age 65, Medicare coverage makes long-awaited joint replacement surgeries possible — an individual may have been coping with hip pain for years without insurance to cover the surgery.

Hip Pain: A Matter of Time
It is true that the longer you live, the greater the incidence of arthritis,” says Thomas Parker Vail, MD, professor and chairman of orthopedic surgery at the University of California, San Francisco. “Your risk of having arthritis is greater, partly related to genetics, partly related to injury, partly related to factors that we don’t completely understand about why joints deteriorate.”
Dr. Vail says that as people age, their cartilage, which acts as the cushion between bones that allows them to move freely in a joint, loses its ability to hold water. “It’s the water that cartilage contains that allows it to act like a shock absorber. Cartilage can begin to wear down just like any other shock absorber. When the cartilage wears down, becomes thinner, and loses its mechanical resiliency, that leads to inflammation and fluid in the joint — all of which is perceived as being uncomfortable,” explains Vail. If this process continues, the perfectly designed ball and socket do not match or move as well as they did in earlier years. Yet Vail and Stuchin both stress that many people in their 80s have no hip pain at all.
Hip Pain: Limiting the Risk Factors
Although hip pain may be related to factors beyond your control, like genetic inheritance or structural problems from birth, there are several steps you can take to reduce your risk of hip pain:

• Maintain a healthy weight throughout your life. A review of charts from 305 adults between 18 and 59 years old found that obesity significantly increased the likelihood of having a total hip or total knee replacement.
• Protect the health of your bones. Developing osteoporosis, a condition in which the bones become weakened through loss of calcium, can lead to hip pain as a result of fractures and falls. Stay active, eat calcium-rich foods, and get recommended levels of vitamin D throughout your life to help maintain strong bones.
• Learn about fall prevention. Falls are more likely as you age for a number of reasons, ranging from loss of balance to the side effects of medications. Seek advice for preventing falls at home and at work.
• Seek medical help early. Whether your hip pain is due to arthritis or a repetitive stress injury from sports, talk to your doctor. She can help you make a plan to manage your hip pain.

Hip Pain: Are Lifestyle Choices to Blame?
A change in lifestyle, not age alone, is probably what led to hip pain for Joan O’Connor, a 62-year-old small business owner in San Francisco with osteoarthritis. For most of her working life, she held a desk job; then several years ago she decided to open a home decor and antiques store.
“When I changed my job and started my own business, I became much more active physically, climbing a ladder, carrying stuff. I would come home after work and my joint was so painful. I had no idea what was going on,” says O’Connor. Walking through the uneven streets of San Francisco didn’t help — two falls in a year led her to try acupuncture, chiropractic interventions, and, eventually, a total hip replacement.
Understanding how age, weight, and other factors may influence your hip pain can help you make decisions about preventing it or, if you experience it, seeking care early.
 

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Hip Pain and Arthritis: Get the Facts

Hip pain is commonly due to arthritis. Find out how arthritis causes wear and tear on the hip joints and can even lead to hip replacement. 


Arthritis is a frequent cause of hip pain and hip replacement. Yet the term arthritis actually covers a number of different conditions, such as osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.
Hip Pain and Osteoarthritis
“The most common type of arthritis is osteoarthritis, so-called ‘wear and tear arthritis,’” says Thomas Parker Vail, MD, professor and chairman of orthopedic surgery at the University of California, San Francisco.
Osteoarthritis is caused by the gradual wearing down of cartilage in a joint, which can lead to inflammation of joint lining. It can also be due to an injury to the joint, sometimes referred to as “traumatic arthritis.”
Risk factors for osteoarthritis include:

• Aging
• Obesity
• Damage or trauma to the joint
• Structural problems with the joint
• Having rheumatoid arthritis

Symptoms of osteoarthritis develop slowly, beginning with stiffness or soreness in your hip or hips and eventually becoming painful enough to prevent you from doing normal activities, such as walking or climbing stairs.
Look out for any of these symptoms:

• Pain in the inner thigh, buttock, or groin area
• Pain in your outer thigh down to your knee
• Tendency to limp

Hip Pain and Rheumatoid Arthritis
“There are other conditions like rheumatoid arthritis in which inflammation rather than the wear and tear instigates pain. It may be an immune system response that causes the deterioration characteristic of this kind of joint pain,” explains Dr. Vail, who notes that this is often seen at its most extreme in children who have juvenile rheumatoid arthritis.
Rheumatoid arthritis (RA) is a chronic disease that affects the entire body, not just your hips. It begins with a swelling of the lining of joints, called the synovial lining, and progresses to the deterioration of bone and cartilage.
One way to tell the difference between RA and osteoarthritis is to note whether you have pain in only one or two joints (such as your hips) or whether you feel it in other joints, including your knuckles, knees, and shoulders. If you feel pain in many joints, that indicates more of a systemic problem as opposed to the wear and tear of osteoarthritis, says Vail.
The cause of RA is not fully understood, although researchers believe that an abnormal response of the body’s immune system contributes to the disease. Research also points to the possibility that RA’s cause lies in your genes or even infections. Women are particularly at risk. They are two to three times more likely than men to develop RA and are most vulnerable in the year after giving birth.
Symptoms of RA include:

• Pain developing in joints on both sides of the body, like the same knuckle on the right hand as on the left
• Swelling of the affected joints
• Tiredness
• Morning stiffness
• Soreness after sitting for a long time
• Weakness
• Muscle pain
• Anemia
• Unusual lumps, especially on elbows, called rheumatoid nodules

Early diagnosis of RA is critical to preserving your quality of life, so see a doctor as soon as you become concerned about joint pain.

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Five Common Causes of Hip Pain in Women

 Hip pain in women can be caused by wear and tear, overuse, and a few other sources. Women may be able to use anti-inflammatories for their hip pain.

When you tell your doctor your hip hurts, the first thing he should do is confirm that your hip is actually the problem. Women might say they have hip pain, but what they may mean is they have pain in the side of the upper thigh or upper buttock, or they may be experiencing lower back pain, says Stephanie E. Siegrist, MD, an orthopedic surgeon in Rochester, N.Y., and spokeswoman for the American Academy of Orthopaedic Surgeons. Hip pain is often felt in the groin or on the outside of the hip directly over where the hip joint (a ball-and-socket joint) is located.
Five Common Causes of Hip Pain in Women
When a female patient comes to Dr. Siegrist complaining of hip pain, she considers the patient's age, build, and activity level. If the patient is a thin 20-year-old runner or a heavy, sedentary 80-year-old grandmother, “the possibilities at the top of my list will be different,” she says.

Among the most common causes of hip pain in women are:

1. Arthritis. The most common cause of chronic hip pain in women is arthritis, particularly osteoarthritis, the wear-and-tear kind that affects many people as they age. “The ball-and-socket joint starts to wear out,” Siegrist says. Arthritis pain is often felt in the front of your thigh or in the groin, due to stiffness or swelling in the joint.
2. Hip fractures. Hip fractures are common in older women, especially those with osteoporosis (decreased bone density). A woman over age 65 has a one in five chance of experiencing a hip fracture. Symptoms of a hip fracture include pain when you straighten, lift, or stand on your leg. Also, the toes on your injured side will appear to turn out, a sign that can aid your doctor’s preliminary diagnosis.
3. Tendinitis and bursitis. Many tendons around the hip connect the muscles to the joint. These tendons can easily become inflamed if you overuse them or participate in strenuous activities, leading to hip pain in women. One of the most common causes of tendinitis at the hip joint is iliotibial band syndrome — the iliotibial band is the thick span of tissue that runs from the outer rim of your pelvis to the outside of your knee. Runners are prone to iliotibial band injuries. Another common cause of hip pain in women is bursitis, says Marc Philippon, MD, an orthopedic surgeon in Vail, Colo. Fluid-filled sacs called bursae cushion the bony part of the hip that is close to the surface. Like the tendons, these sacs can become inflamed from irritation or overuse, he says. If the sacs are inflamed and you move the hip joint, you will feel pain. Your hip can hurt when you get up from a chair, climb stairs, walk, and even drive.
4. Hernia. In the groin area, femoral and inguinal hernias — sometimes referred to as sports hernias — can cause anterior (frontal) hip pain in women. Pregnant women can be susceptible to inguinal hernias because of the added pressure on the wall of their abdomen.
5. Gynecological and back issues. “Hip pain in women can have gynecological causes,” Siegrist says. “It’s important not to just assume that the pain is caused by arthritis, bursitis or tendinitis. Depending on your age and other health issues, the pain in your hip could be coming from some other system.” Endometriosis (when the uterus lining grows somewhere else) can cause pelvic tenderness, which some women describe as hip pain. Pain from the back and spine also can be referred and felt around the buttocks and hip, Siegrist says. Sciatica, a pinched nerve, can cause pain in the back of the hip — the pain from sciatica can start in your lower back and travel down to your buttocks and legs.

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Hip Pain: What Do Your Symptoms Mean?

When you visit your doctor to find out what you should do about your hip pain, she will probably ask you to describe the kind of pain you are experiencing. Hearing about your symptoms of hip pain will help her determine the cause of your discomfort.
“The first question is, where does the hip hurt?” says Steven Stuchin, MD, director of orthopedic surgery at the Hospital for Joint Diseases of New York University Medical Center and associate professor at the NYU School of Medicine in New York City.
Many people are confused about where their hip really is. “Pain that involves the hip joint is usually in the groin, right where your leg meets your body," Dr. Stuchin says. "The hip joint is in the groin and you can feel it as low as your knee, in the front of your leg down the thigh.”
Here are some common hip pain complaints and their symptoms.
Arthritis: With arthritis-based hip pain, it hurts to move your legs. That includes walking, climbing stairs, and bending down to pick things up. There are many reasons arthritis could be causing your hip pain:

• Osteoarthritis can occur after an injury or infection causes damage to the hip joint.
• Hip dysplasia, a problem with the formation of your hip, can cause early hip arthritis.
• Rheumatoid arthritis causes an inflammatory immune response that affects all your joints.

Piriformis syndrome: With piriformis syndrome, moving the leg out or back from the body causes pain in the buttocks and lower back. “Your hip has some very powerful muscles. Among them is the piriformis,” explains Stuchin. “The piriformis is in the back of the hip and helps rotate the leg outwards.”

The sciatic nerve is just behind it; in some people, the nerve goes between the tendons of the piriformis muscle. When the muscle pulls, it acts like a pincer on the nerve, causing the pain you feel, explains Stuchin.
Snapping hip: A patient might tell her doctor: “When I move my leg, I feel a pop in my hip at the top of my thigh.” The snapping sound is a tendon, explains Stuchin. Some people are born with a tendon that “snaps” over the top of the femur, the bone that makes up your thigh. “As your leg moves, if that sheath of stuff catches on that bony projection, you’ll get a ‘snap.’”
Stress fracture of the femoral neck: A stress fracture of the femoral neck starts as a dull ache in the groin and gets progressively worse. The femoral neck is the region between the ball at the top of your femur (thigh bone) that moves in the socket of your pelvis bone and the rest of the femur. This can also feel like a pulled muscle, but unlike a muscle, it won’t respond to taking a break from exercise. There are two common reasons for a stress fracture to this area:

• A fall
• A repetitive stress injury as a result of vigorous exercise

Trochanteric bursitis: A patient might tell his doctor: “It’s painful to lie on my hip and at other times, I feel pain on the outside of that hip and upper thigh.” Trochanteric bursitis is an inflammation of the bursae, the fluid filled sacs that act as a cushion, located over the greater trochanter (a bony prominence next to the femoral neck).
If these hip pain descriptions do not perfectly explain your hip pain, don’t worry. Through the right diagnostic tests, your doctor probably still will be able to help identify and treat your pain.

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Hip Pain

Hip pain can make everyday tasks, including getting in and out of a car or walking up a flight of stairs, nearly impossible. Hip pain can affect people of all ages and be caused by injuries to the hip joints or muscles, or by conditions such as tendinitis, bursitis, or osteoarthritis.

Hip Pain Causes and Prevention

Arthritis is one of the most common causes of hip pain, but other conditions can also cause sharp pain in the hip area, including sciatica, tendinitis, osteoporosis, or infection. Fracture is another serious cause of hip pain. Staying in shape with the right diet and exercise, especially stretching, can help lessen the risk of hip problems.

• Hip Pain: What Do Your Symptoms Mean?
• Women and Hip Pain
• Get the Facts on Hip Pain and Arthritis
• Do Age and Hip Pain Go Together?

 

• Hip Pain Causes and Prevention

  Arthritis is one of the most common causes of hip pain, but other conditions can also cause sharp pain in the hip area, including sciatica, tendinitis, osteoporosis, or infection. Fracture is another serious cause of hip pain. Staying in shape with the right diet and exercise, especially stretching, can help lessen the risk of hip problems.
  
  • Hip Pain: What Do Your Symptoms Mean?
  • Women and Hip Pain
  • Get the Facts on Hip Pain and Arthritis
  • Do Age and Hip Pain Go Together?

• Hip Pain Diagnosis

  Have you been slowing down lately because of soreness, stiffness, or pain in your hip? Because hip pain can be due to a number of different causes, the first step toward diagnosing hip pain is to discuss your medical and health history with your doctor. You may also undergo different tests, such as blood work, X-rays, or MRIs.
  
  • Getting a Hip Pain Diagnosis
  • Taking Hip Pain Seriously
  • Tracking the Symptoms of Hip Arthritis
  • Snap, Pop, or Grating in a Hip 
  
  

  • Hip Pain Treatment

    It's important to get an accurate diagnosis to get the right treatment for hip pain. In most cases, the first remedies used to treat hip pain usually include rest, exercises, and an over-the-counter or prescription pain medication. Physical therapy and assistive devices can also help. But if conservative management doesn't do the trick, hip replacement surgery may be needed.
    
    • 6 Moves for Hip Pain
    • Non-Surgical Treatment for Hip Pain
    • Physical Therapy After Hip Surgery
    • Treating Hip Pain With Acupuncture
  
  
  

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