[48F] Experiencing severe hip and leg bone pain

Patient Description

A 48-year-old female has been experiencing severe pain in her legs and hip for about a year, with the pain progressively worsening. The pain is described as an unbearable ache in both shins and knees, and a catching sensation in the hip that feels like it is popping out of place. The hip pain is located in the front crease and outer hip, radiating towards the spine, and is exacerbated by walking, laying, and sitting. The patient also reports swelling in her legs. She has a medical history of epilepsy and Crohn's disease, and is allergic to aspirin and unable to take NSAIDs or Tramadol due to her seizures. Currently, she is not on any medications and reports feeling tired, but has not experienced any recent weight loss, fever, or infections.

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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:

  • Osteoarthritis: This is a common form of arthritis that causes pain and stiffness in your joints. It can affect any joint, but it's most common in the hips, knees, and lower back. The pain is usually worse with activity and relieved by rest. It's more common in older adults, but it can occur at any age.
    • Treatment usually involves a combination of lifestyle changes (like exercise and weight loss), physical therapy, and medications to manage pain and inflammation.
  • Fibromyalgia: This is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It amplifies painful sensations by affecting the way your brain processes pain signals.
    • Treatment often involves a combination of medications, exercise, stress-reduction measures, and cognitive behavioral therapy.
  • Rheumatoid Arthritis: This is an autoimmune disease that causes pain and swelling in the joints. The pain is usually symmetrical (it affects both sides of your body). It's more common in women and often starts between the ages of 30 and 60.
    • Treatment involves medications to reduce inflammation and prevent joint damage, as well as physical therapy and sometimes surgery.
  • Polymyalgia Rheumatica: This is an inflammatory disorder that causes muscle pain and stiffness, especially in the shoulders and hips. It usually occurs in people over 50.
    • Treatment usually involves low doses of corticosteroids, such as prednisone.

Please note that these are just possibilities. It's important to see a healthcare provider for an accurate diagnosis and treatment.

What you can do

While you wait for your appointment, here are some things you can do to manage your symptoms:

  1. Over-the-counter pain relievers: Since you're allergic to aspirin and can't take NSAIDs, you might try acetaminophen (Tylenol) for your pain. However, it's important to not exceed the recommended dose.
  2. Heat and cold therapy: Applying heat can help to relax your muscles and relieve joint pain. Cold may help to numb the area and reduce inflammation.
  3. Gentle exercise: While it might be difficult due to your pain, try to stay as active as possible. Low-impact activities like swimming or cycling can help to keep your joints flexible and strengthen the muscles that support them.
  4. Rest: Make sure you're getting enough sleep and taking breaks throughout the day to rest. This can help to manage your fatigue.

What you should look out for

Here are some signs that you should seek medical attention immediately:

  • Severe pain that isn't relieved by rest or over-the-counter pain relievers
  • Sudden swelling in your joints
  • A fever or unexplained weight loss
  • Difficulty moving or walking due to your pain

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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7 mo ago


People Also Ask


What are the common symptoms of osteoarthritis and how is it treated?

Common symptoms of osteoarthritis include joint pain, stiffness, and swelling, particularly in the hips, knees, and lower back. Treatment typically involves lifestyle changes such as exercise and weight management, physical therapy, and medications to manage pain and inflammation.


How does fibromyalgia differ from other musculoskeletal disorders?

Fibromyalgia is characterized by widespread musculoskeletal pain, fatigue, and issues with sleep, memory, and mood. It differs from other disorders as it affects the way the brain processes pain signals, often requiring a combination of medications, exercise, stress-reduction techniques, and cognitive behavioral therapy for management.


What are the treatment options for someone with rheumatoid arthritis who cannot take NSAIDs?

For someone with rheumatoid arthritis who cannot take NSAIDs, treatment options may include disease-modifying antirheumatic drugs (DMARDs), biologics, corticosteroids, and physical therapy to reduce inflammation and prevent joint damage.


What lifestyle changes can help manage symptoms of polymyalgia rheumatica?

Lifestyle changes that can help manage symptoms of polymyalgia rheumatica include engaging in regular low-impact exercise, maintaining a healthy diet, ensuring adequate rest, and possibly taking low doses of corticosteroids as prescribed by a healthcare provider.


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