Talking With Your Doctor About Hip Pain

Hip pain is a common complaint. There are many possible causes — some obvious, some not so obvious. You'll need to work with your doctor to figure out what's causing your pain. Then you and your doctor can decide on options for treatment.

Here are seven questions that can help you start the conversation.

What do my symptoms tell you about my hip pain?

Your hip pain symptoms will probably be the first thing your doctor wants to know about. They can help point to the cause. For instance:

• Pain that starts after an injury may be due to a muscle tear or strain near your hip.

• Pain that gets worse when you press on your hip or sleep on your side may be due to hip bursitis. This is an inflammation of your hip bursa. That's a fluid-filled sac that cushions the bony point of your hip.

• Pain that has been getting gradually worse over years may be osteoarthritis. This wear-and-tear type of arthritis is most common after age 60. It usually gets worse with certain types of activity.

• Pain that's worse in the morning and gets better during the day may be due to rheumatoid arthritis. It may cause pain in both hips and other joints. You may also have fever and fatigue.

• Pain that starts suddenly, is very severe and comes with a fever may be due to an infection in your hip joint.

Be as specific as possible when describing your symptoms. This will help your doctor make a diagnosis.

What will you do to diagnose my hip pain?

After asking about your symptoms, your doctor will do a physical exam. He or she will feel and move your hip to check for swelling, pain and stiffness. Other tests can produce important information:

• Your doctor may order blood tests to look for signs of inflammation or infection.

• Your doctor may order imaging studies of your hip. Examples are an X-ray, CT scan, MRI and ultrasound.

• Your doctor may take a sample of the fluid in your hip joint. Checking this fluid in a lab can help rule out or reveal the cause of your pain, such as infection.

Will I need medication for my hip pain?

Some medications help relieve symptoms like pain and swelling. Others treat whatever is causing your pain. For instance:

• If your pain is not too severe, your doctor may suggest an over-the-counter painkiller like acetaminophen (Tylenol).

• If you have both pain and swelling, your doctor may prescribe a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil, Motrin).

• If you have severe swelling, your doctor may prescribe a steroid drug to take by mouth. Sometimes an injection of the drug into your joint is most effective.

• If your pain is from rheumatoid arthritis, there are many drugs available to stop the disease from getting worse. Examples include disease-modifying anti-rheumatic drugs (DMARDs) and biologics. Some of these medicines are administered by IV (intravenously) during an infusion procedure.

• Antibiotics may cure the problem and relieve your pain if it’s from a bacterial infection in your hip joint.

Will I need surgery?

You will probably need some type of surgery for a hip fracture or dislocation. You may need hip replacement surgery if you have severe osteoarthritis and other treatments are not helping. If you have a severe bursitis, you might need surgery to remove the inflamed area. This is rare, however.

Will physical therapy help?

Your doctor may suggest working with a physical therapist. Exercise to improve movement and strengthen the muscles around your hip can sometimes ease your pain. This will depend on what's causing your hip pain. However, physical therapy can help with many types of hip pain, including arthritis, injury and recovery after surgery. Physical therapy may include:

• Specific strength and stretching exercises

• Heat or ice treatments

• Massage therapy

• Use of healing energy from electricity or sound waves

• Use of assistive devices like crutches or a walker

What can I do on my own at home?

For short-term relief, your doctor may suggest icing your hip and resting. You may need to avoid activities that make the pain worse. Your doctor may tell you to stop smoking, too. That's because smoking can delay healing. For long-term relief, it may help to lose weight if you are overweight so that your joints don't need to work as hard. You may need to change the way you do certain work or recreational activities that cause hip pain. A physical or occupational therapist can offer suggestions.

When should I schedule a follow-up visit?

Your doctor may give you specific instructions about future appointments. In general, you should call your doctor if:

• Your pain is getting worse.

• Medications are not relieving your pain.

• You have a fever or fatigue along with your pain.

• Your pain is keeping you from your everyday activities.