[44F] Experiencing chronic right hip pain with neurological symptoms

Patient Description

A 44-year-old female has been experiencing chronic right hip pain for the past five years. The pain is described as sharp and burning, accompanied by a loss of control of balance and the leg giving out. The symptoms worsen with activities such as climbing stairs, walking, long standing, and touching the side of the hip. The patient reports swelling and warmth to the touch in the affected area. The pain occurs daily with severe episodes in spurts. There is a history of a bilateral labral tear, likely from an old softball injury, confirmed by MRI. The patient experiences clicking and locking sensations in the hip, as well as numbness, tingling, and weakness in the leg. A steroid injection in the groin was administered, but no surgeries have been performed. There is no family history of musculoskeletal or neurological conditions, and the patient does not use tobacco, alcohol, or recreational drugs. No known allergies or chronic illnesses are reported.

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Arora's Assessment

What might be happening

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

  • Hip Labral Tear: Since you mentioned a confirmed bilateral labral tear, this is likely contributing to your hip pain, instability, and the sensation of your leg giving out. Labral tears can cause sharp pain, a catching or locking sensation, and may lead to swelling and warmth in the area. Physical therapy is often recommended to strengthen the surrounding muscles and improve joint stability. In some cases, surgical intervention may be considered if conservative treatments do not provide relief.

  • Hip Osteoarthritis: Given the chronic nature of your symptoms and family history of musculoskeletal issues, hip osteoarthritis could be a contributing factor. This condition involves the degeneration of joint cartilage and can cause pain, stiffness, and swelling. Management typically includes physical therapy, pain relief medications, and lifestyle modifications. In advanced cases, joint replacement surgery may be considered.

  • Nerve Impingement or Sciatica: The numbness, tingling, and weakness in your leg could be related to nerve impingement, such as sciatica. This occurs when the sciatic nerve is compressed, often due to a herniated disc or bone spur. Treatment may involve physical therapy, medications, and in some cases, injections or surgery.

What you can do

  1. Continue Physical Therapy: Since you've already tried physical therapy, continue with the exercises and stretches recommended by your therapist to strengthen your hip and improve flexibility.

  2. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen may help manage pain and reduce inflammation. However, consult with a healthcare provider before starting any new medication.

  3. Lifestyle Modifications: Avoid activities that exacerbate your symptoms, such as climbing stairs or standing for long periods. Consider using assistive devices like a cane for added stability.

  4. Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share insights with your healthcare provider. This can help in identifying patterns and triggers for your pain.

What you should look out for

  • Worsening Symptoms: If your pain becomes more severe or frequent, or if you experience new symptoms like changes in bowel or bladder function, seek medical attention promptly.

  • Increased Instability: If your leg giving out becomes more frequent or leads to falls, consult with a healthcare provider to reassess your treatment plan.

  • Surgical Consideration: If conservative treatments are not providing relief, discuss with your doctor the possibility of surgical options to address the labral tear or any other underlying issues.

Remember, while this information can be helpful, it's important to consult with a healthcare professional for a formal diagnosis and personalized treatment plan.

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14 d ago

People Also Ask

What are the common symptoms of a hip labral tear?

Common symptoms of a hip labral tear include sharp pain in the hip or groin, a catching or locking sensation in the joint, instability, and sometimes swelling and warmth in the affected area.

How can hip osteoarthritis be managed without surgery?

Hip osteoarthritis can be managed with physical therapy to strengthen muscles around the joint, pain relief medications like NSAIDs, lifestyle modifications such as weight management and low-impact exercises, and using assistive devices if needed.

What are the signs of nerve impingement or sciatica?

Signs of nerve impingement or sciatica include numbness, tingling, and weakness in the leg, often accompanied by sharp or burning pain that radiates from the lower back down the leg.

When should I consider surgery for a hip labral tear?

Surgery for a hip labral tear may be considered if conservative treatments like physical therapy and pain management do not provide relief, and if the symptoms significantly impact daily activities and quality of life.

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