what kind of treatment for hip pain?
July 19, 2011 8:51 PM   Subscribe

Mid 30s and healthy. Who should I see for recently appearing hip pain? Orthopedist, physical therapist, rolfing, other?

My hips hurt. They got looser, to the point where I could often crack them like knuckles, after I had my kids, but they weren't painful and the cracks usually felt good. But more recently, in the past month or so, my right hip hurts when I walk more than a few minutes. It seems as if it's been aggravated by a few seemingly innocuous events recently: sleeping on strange mattresses while traveling; walking in heels; walking in uncushioned flats; an ill-advised afternoon on a bicycle... anyway the upshot is my hip hurts, sort of inside the joint, when I walk more than a few minutes, and I'm worried and uncomfortable. Has anyone had treatment that helped a situation like this? What sort of treatment should I seek? I have decent insurance but very limited time.
posted by fingersandtoes to Health & Fitness (12 answers total) 1 user marked this as a favorite
 
I saw a physical therapist for tailbone pain, and he was very helpful.
posted by The corpse in the library at 9:07 PM on July 19, 2011


Start with your family doctor and work off of referrals. One of the nice things about good insurance is you can often pick and choose who you see, but going to a specialist right off the bat might not be the best start if you're uncertain. Let the family Doc be your advocate, where you could springboard from there to specialists while keeping him/her in the loop.
posted by samsara at 9:24 PM on July 19, 2011 [3 favorites]


I have no idea if my situation was at all similar, but a few sessions with a physical therapist helped my hip pain. By helped I mean it was nearly gone, and I didn't feel the need to crack them nearly as often. She showed me how to do some simple but very specific stretching at home as well.

I'd been able to pop/crack for a while, but didn't get much pain until I started to carry a 20 or 25 pound backpack regularly. I wouldn't say they were looser though, quite the opposite. The PT said it was due to one particular muscle being tight relative to the other muscles. I'd been worried it was due to some sort of joint problem, and I was very happy with how easy it was to treat.

Try to find a PT that works with more active people, or a sports medicine specialist. Does anyone even have a "family doctor" these days? If your time is extremely limited start with an MD who specializes in sports medicine. If you see a doctor or PT who acts like you are getting around well enough, tells you to quit walking so much, or just wants to give you painkillers you need to see a different person.

It's very easy to hurt yourself on a bicycle that does not fit well, I wouldn't call it an innocuous event. Also, get yourself some insoles for the flats and don't wear heels.

If you have gained weight or are carrying a heavy bag or pack that will tend to increase any pain in the joints of your legs. If you do a lot of traveling get something with wheels. If the pain is indeed in your joints you need to do whatever you can to avoid weight gain, or it will get worse more quickly than otherwise.
posted by yohko at 1:06 AM on July 20, 2011


If your GP and/or a physical therapist can't help with the pain, can I suggest seeing an orthopedist who specialises in hips? I've recently been diagnosed with hip dysplasia after several years of pain, popping etc. This is probably not what you have (!) but I thought I'd mention it in case your GP doesn't have much experience diagnosing hip pain.
posted by mgrrl at 2:57 AM on July 20, 2011


Start with your internist. He's probably not going to be able to do much, but he can 1) figure out pretty quickly what's probably going on and 2) give you a referral to the right specialist and/or other professional. This could be muscular, skeletal, arthritic, some combination of the three, or straight up idiopathic, but you're going to need to get your physician involved to figure out which.
posted by valkyryn at 3:53 AM on July 20, 2011


It sounds a bit like a labral tear - is the joint pain mostly localized in the groin?

Anyway, I had this in both hips - the right one went away after minimal physical therapy, but the left one will require surgery in the coming months.
posted by elizardbits at 5:20 AM on July 20, 2011 [1 favorite]


I have had labral tear surgery and was told by my ortho that PT before surgery would have made it worse. LOTS of hip discussion here. Feel free to memail me if you are diagnosed with this and have more questions.
posted by futz at 7:02 AM on July 20, 2011


Best answer: I had similar symptoms, went to two orthopedists, got x-rays, got a bone scan, and ended up with "huh, we don't see anything unusual, sucks to be you." I got sent to PT, and within the first session the therapist brought up bursitis. I looked it up, the symptoms were dead on, and after about 6 sessions I'm fine. I did need a referral from a doctor to get PT, though, so you're probably going to have to do that first.

tl;dr: orthopedist who specializes in hips
posted by desjardins at 9:07 AM on July 20, 2011


I would start with your GP first, so that you (hopefully) get sent to the right specialist, if necessary. I had pain and stiffness in both hips and it turned out to be IT band inflammation (which typically manifests as pain on the side of the knee). My GP sent me to a physical therapist and the therapy was tremendously helpful.
posted by WorkingMyWayHome at 10:05 AM on July 20, 2011


Seconding an orthopedist who specializes in hips! After far too long with symptoms similar to yours, and a lot of x-rays indicating nothing, it took an orthopedist and an MRI to finally find a gouge in the cartilage around the femoral head.
posted by bunji at 2:19 PM on July 20, 2011


Does the pain stop when you stop walking, or does it continue on?

The symptoms for bursitis and labral tear are very similar, and these soft-tissue problems don't show up on Xrays.

If nothing can be found, and your problem continues, you'll need an MRI.
posted by HiroProtagonist at 8:27 PM on July 20, 2011


Best answer: even an MRI may be inconclusive and I agree with the above advice, GP first and then an orthopod that specialises in Hips . Labral Tear, bursitis, Osteitis pubica can all present as you've described.
posted by Wilder at 9:40 AM on July 21, 2011


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