Doc: Pain in the hips is keeping reader up at night
Dear Dr. Roach: I’m a senior, have exercised regularly for years, walking two or more miles a day. I’m in good health, take no medication but for thyroid, and have no weight problem. I’ve developed pain in my hips, mostly in my left hip. The pain is a burning sensation that occurs mostly when I sit or rise from a sitting position and when I lie down. I am able to go to sleep at night, but am awakened by pain in my hips and throbbing in my legs. I cannot find a position that is comfortable. I get partial relief from acetaminophen or naproxen at night. The pain always makes me eager to get out of bed in the morning. What I don’t understand is that I do not have pain in my daily activities, and walking is not at all painful. There is a sore spot that I can detect on the side of my upper leg at the hip area. Am I worsening my condition?
Dear F.H.: This sounds very much like a case of greater trochanteric pain syndrome (formerly called trochanteric bursitis). This happens often in people who walk a lot, like you do, and in people who are overweight or who have a mechanical problem in the knee, hip or back. It seems to be caused by damage to the tendons of the gluteus muscles.
Many general doctors can treat this condition, but the experts are orthopedic surgeons, sports medicine and rehabilitation medicine doctors. It can be diagnosed by a physical exam.
Initial treatment is pain relief and instructions on proper exercise and sitting position. You’ll be evaluated for conditions that might be exacerbating the condition, such as leg-length discrepancy. If the initial treatment doesn’t work (and it often doesn’t), then an injection of steroid into the bursa speeds recovery. With injection, about 60 percent of people with this condition recover within six months. Without treatment, the condition may last one to two years. Cases that last longer than a year should be evaluated for other conditions, especially a gluteus medius tear, which may require surgical repair.
Email questions to ToYourGoodHealth@ med.cornell.edu.