[31F] With chronic hip pain and bump radiating to knee

Patient Description

A 31-year-old female has been experiencing sharp, constant pain in the back of her hip bone for over two years. The pain is debilitating, radiates to the knee when pressure is applied, and feels like it needs to pop but won't. There is a round, movable bump in the same area, about the size of a baseball, which is soft to the touch and located more towards the back. The bump has been present for the same duration as the pain, with changes in size and consistency over time. The patient also reports numbness and tingling around the bump and down her leg, as well as weakness in the leg. Her medical history includes arthritis, fibromyalgia, multiple sclerosis (MS), and bulging and deteriorating disks, all diagnosed in 2010. She is currently taking Tramadol 50mg every 8 hours for pain management and has allergies to sulfa drugs, most antibiotics, Ceclor, Bactrim, and lithium.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Lipoma: A lipoma is a benign (non-cancerous) tumor made of fat tissue. They are usually soft, movable, and painless, but in some cases, they can cause discomfort if they press on nerves or other tissues.

    • Treatment: Lipomas generally do not require treatment unless they cause pain or other symptoms. In such cases, surgical removal may be recommended.
  • Bursitis: This is the inflammation of the bursa, a small fluid-filled sac that acts as a cushion between a bone and other moving parts such as muscles, tendons, or skin. Bursitis can cause pain and swelling.

    • Treatment: Rest, ice, and over-the-counter pain relievers can help reduce inflammation. Physical therapy or corticosteroid injections may also be recommended.
  • Sciatica: This condition occurs when the sciatic nerve, which runs from your lower back to your legs, is compressed or irritated. It can cause pain that radiates from your lower back to your knee.

    • Treatment: Physical therapy, pain relievers, and anti-inflammatory medications can help manage symptoms. In severe cases, surgery may be necessary.
  • Herniated Disk: A herniated disk occurs when the soft center of a spinal disk pushes through a crack in the tougher exterior casing. This can irritate nearby nerves and cause pain, numbness, or weakness.

    • Treatment: Physical therapy, pain medications, and sometimes surgery are used to treat herniated disks.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest and Avoid Aggravating Activities: Try to avoid activities that worsen your pain. Resting the affected area can help reduce inflammation and pain.
  2. Apply Ice or Heat: Ice packs can help reduce inflammation and numb the pain, while heat packs can help relax and loosen tissues and stimulate blood flow to the area.
  3. Over-the-Counter Pain Relievers: Medications like ibuprofen or acetaminophen can help manage pain and reduce inflammation.
  4. Gentle Stretching and Physical Therapy: Gentle stretching exercises can help relieve tension in the affected area. A physical therapist can provide specific exercises tailored to your condition.
  5. Maintain a Healthy Weight: Excess weight can put additional strain on your joints and spine, so maintaining a healthy weight can help alleviate some of the pressure.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Worsening Pain: If your pain becomes unbearable or significantly worsens, seek medical help.
  • Loss of Bladder or Bowel Control: This could be a sign of a serious condition called cauda equina syndrome, which requires immediate medical attention.
  • Sudden Weakness or Numbness: If you experience sudden weakness or numbness in your leg, it could indicate nerve damage that needs prompt evaluation.
  • Signs of Infection: If the bump becomes red, warm, or starts to drain pus, it could be infected and require medical treatment.

Remember, while these tips can help manage your symptoms, it's crucial to consult a healthcare professional to receive a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What could cause a movable bump near the hip that changes in size and consistency?

A movable bump near the hip that changes in size and consistency could be a lipoma, which is a benign tumor made of fat tissue. It could also be a sign of bursitis, which is inflammation of the bursa. Both conditions can cause discomfort if they press on nerves or other tissues.


How can sciatica be managed at home?

Sciatica can be managed at home by resting and avoiding activities that worsen the pain, applying ice or heat to the affected area, taking over-the-counter pain relievers like ibuprofen or acetaminophen, and performing gentle stretching exercises. Physical therapy can also be beneficial.


What are the potential risks of untreated herniated disks?

Untreated herniated disks can lead to chronic pain, nerve damage, and in severe cases, conditions like cauda equina syndrome, which can cause loss of bladder or bowel control. It's important to seek medical advice to prevent these complications.


When should I seek medical attention for hip pain and associated symptoms?

You should seek medical attention for hip pain if you experience severe or worsening pain, loss of bladder or bowel control, sudden weakness or numbness in your leg, or signs of infection such as redness, warmth, or pus drainage from the bump.


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